中华普通外科学文献（电子版）
中華普通外科學文獻（電子版）
중화보통외과학문헌（전자판）
CHINESE JOURNAL OF GENERAL SURGERY(ELECTRONIC VERSION)
2014年
4期
321-331
,共11页
汤聪%梁文丰%岑宏%陈强
湯聰%樑文豐%岑宏%陳彊
탕총%량문봉%잠굉%진강
袖状胃切除术%胃转流手术%2型糖尿病%远期疗效%缓解率
袖狀胃切除術%胃轉流手術%2型糖尿病%遠期療效%緩解率
수상위절제술%위전류수술%2형당뇨병%원기료효%완해솔
Sleeve gastrectomy(SG)%Gastric bypass surgery(GBP)%Type 2 diabetes mellitus%Long-term efficacy%Remission
目的探讨袖状胃切除术（SG）及胃转流术（GBP）对2型糖尿病（T2DM）的近、长期疗效的循证支持。方法检索Cochrane图书馆、Medline及EMbase数据库关于SG及GBP手术治疗合并肥胖的T2DM患者疗效的文献，设立纳入与排除标准筛选文献，进行质量评价、提取数据和数据统计分析。结果纳入Meta分析标准的文章有34篇，其中8篇为RCT，26项研究涉及GBP，27项研究涉及SG。术前GBP及SG手术患者的基础BMI（kg/m2）分别为44.8±5.2、46.68±7.3；术前指标糖化血红蛋白（%）分别为7.86±0.73、7.91±0.98；空腹血糖水平（mg/dl，1mg/dl=0.0555 mmol/L）分别为158.0±18.1、167.7±41.6。随访1年GBP和SG术后T2DM缓解率分别为77%、74%，3年缓解率则为74%、85%，5年及以上缓解率分别为77%、74%。8篇RCT文献中行GBP与SG手术治疗T2DM效果的Meta分析，RR=1.26，95%CI=1.10~1.44，GBP术后T2DM缓解率较SG高。结论 GBP及SG手术均是治疗肥胖合并T2DM的有效措施，其近、远期疗效随随访时间无明显下降。GBP治疗T2DM的疗效优于SG手术。
目的探討袖狀胃切除術（SG）及胃轉流術（GBP）對2型糖尿病（T2DM）的近、長期療效的循證支持。方法檢索Cochrane圖書館、Medline及EMbase數據庫關于SG及GBP手術治療閤併肥胖的T2DM患者療效的文獻，設立納入與排除標準篩選文獻，進行質量評價、提取數據和數據統計分析。結果納入Meta分析標準的文章有34篇，其中8篇為RCT，26項研究涉及GBP，27項研究涉及SG。術前GBP及SG手術患者的基礎BMI（kg/m2）分彆為44.8±5.2、46.68±7.3；術前指標糖化血紅蛋白（%）分彆為7.86±0.73、7.91±0.98；空腹血糖水平（mg/dl，1mg/dl=0.0555 mmol/L）分彆為158.0±18.1、167.7±41.6。隨訪1年GBP和SG術後T2DM緩解率分彆為77%、74%，3年緩解率則為74%、85%，5年及以上緩解率分彆為77%、74%。8篇RCT文獻中行GBP與SG手術治療T2DM效果的Meta分析，RR=1.26，95%CI=1.10~1.44，GBP術後T2DM緩解率較SG高。結論 GBP及SG手術均是治療肥胖閤併T2DM的有效措施，其近、遠期療效隨隨訪時間無明顯下降。GBP治療T2DM的療效優于SG手術。
목적탐토수상위절제술（SG）급위전류술（GBP）대2형당뇨병（T2DM）적근、장기료효적순증지지。방법검색Cochrane도서관、Medline급EMbase수거고관우SG급GBP수술치료합병비반적T2DM환자료효적문헌，설립납입여배제표준사선문헌，진행질량평개、제취수거화수거통계분석。결과납입Meta분석표준적문장유34편，기중8편위RCT，26항연구섭급GBP，27항연구섭급SG。술전GBP급SG수술환자적기출BMI（kg/m2）분별위44.8±5.2、46.68±7.3；술전지표당화혈홍단백（%）분별위7.86±0.73、7.91±0.98；공복혈당수평（mg/dl，1mg/dl=0.0555 mmol/L）분별위158.0±18.1、167.7±41.6。수방1년GBP화SG술후T2DM완해솔분별위77%、74%，3년완해솔칙위74%、85%，5년급이상완해솔분별위77%、74%。8편RCT문헌중행GBP여SG수술치료T2DM효과적Meta분석，RR=1.26，95%CI=1.10~1.44，GBP술후T2DM완해솔교SG고。결론 GBP급SG수술균시치료비반합병T2DM적유효조시，기근、원기료효수수방시간무명현하강。GBP치료T2DM적료효우우SG수술。
Objective To analyze the evidence-based study of short-term and long-term remission of type 2 diabetes mellitus(T2DM) after sleeve gastrectomy(SG) or gastric bypass surgery(GBP). Methods Related articles were systematically retrieved by searching Medline, Embase database, and Cochrane library. Inclusion and exclusion criteria to select literatures were set up. The data were qualitatively evaluated and analyzed by STATA or SPSS software.Results Thirty-four articles were involved including 8 randomized controlled trials (RCTs). Among them, 26 studies were on GBP surgeries and 27 on SG. The preoperative BMI of GBP and SG group were (44.8±5.2) kg/m2 and (46.68±7.3) kg/m2, preoperative glycosylated hemoglobin index were (7.86±0.73)% and (7.91±0.98)%, preoperative fasting plasma glucose were (158.0±18.1) mg/dl and (167.7±41.6)mg/dl, retrospectively. After 1 year of follow-up, the remission rate of T2DM was 77% and 74% in GBP and SG groups, while the remission rate was 74% and 85% in follow-up of 3 years. In follow-up of 5 or more years, the remission rate of SG surgery was 77%, while that of GBP group was 74% according to the Meta analysis. Comparing the remission rate of T2DM in GBP and SG group from the 8 RCTs, theRR was 1.26, 95%CI=1.10-1.44. The difference between the two groups was statistically significant (P<0.01).Conclusion Both SG and GBP surgeries are effective treatments for obese T2DM. The remission rate of GBP surgery is higher than SG.
