中华消化外科杂志
中華消化外科雜誌
중화소화외과잡지
CHINESE JOURNAL OF DIGESTIVE SURGERY
2013年
12期
901-904
,共4页
肥胖症,病态%腹腔镜检查%胃袖状切除术%疗效
肥胖癥,病態%腹腔鏡檢查%胃袖狀切除術%療效
비반증,병태%복강경검사%위수상절제술%료효
Obesity,morbid%Laparoscopy%Sleeve gastrectomy%Efficacy
目的 评价腹腔镜胃袖状切除术(LSG)治疗病态性肥胖症的5年疗效.方法 回顾性分析2006年1月至2007年12月中国医科大学附属盛京医院收治的31例病态性肥胖症患者的临床资料.31例患者行LSG,观察患者围手术期及远期并发症情况、手术前后降糖药物或胰岛素应用情况,检测患者术后6个月、1、2、3、4、5年BMI和多余体质量减少率(EWL),分析患者术后合并症缓解率、并发症发生率及患者满意度评分.率的比较采用x2检验或Fisher确切概率法.对于各组重复测量数据应用重复测量方差分析,对于满足球形检验数据无需校正,如需校正采用Greenhouse-Geisser校正.结果 患者术后连续随访5年,其中25例患者完成随访.随访患者中,胃食管反流病发生率为16.0％ (4/25),经药物治疗后缓解;吻合口狭窄发生率为4.0％(1/25);8.0％ (2/25)的患者EWL＜ 60％;16.0％ (4/25)的患者偶尔有腹痛发生.糖尿病患者比例由术前的9.7％ (3/31)下降至术后5年的4.0％(1/25),术前与术后5年比较,差异有统计学意义(P＜0.05).脂肪肝患者比例由术前的93.5％(29/31)下降至术后5年的32.0％(8/25),术前与术后5年比较,差异有统计学意义(x2=19.10,P＜0.05).高脂血症患者比例由术前的77.4％(24/31)下降至术后5年的12.0％(3/25),术前与术后5年比较,差异有统计学意义(x2=35.51,P＜0.05).BMI由术前的(38.8 ±4.2) kg/m2下降至术后5年的(28.5 ± 3.1) kg/m2,术前与术后各时间段比较,差异有统计学意义(F=113.36,P＜0.05).EWL由术后6个月的42％± 11％增加至术后5年的69％±16％,术后各时间段比较,差异有统计学意义(F =41.71,P＜0.05).患者术后5年各时间段疗效满意度评分比较,差异无统计学意义(F =0.92,P＞0.05).结论 LSG减重效果显著,远期并发症少.
目的 評價腹腔鏡胃袖狀切除術(LSG)治療病態性肥胖癥的5年療效.方法 迴顧性分析2006年1月至2007年12月中國醫科大學附屬盛京醫院收治的31例病態性肥胖癥患者的臨床資料.31例患者行LSG,觀察患者圍手術期及遠期併髮癥情況、手術前後降糖藥物或胰島素應用情況,檢測患者術後6箇月、1、2、3、4、5年BMI和多餘體質量減少率(EWL),分析患者術後閤併癥緩解率、併髮癥髮生率及患者滿意度評分.率的比較採用x2檢驗或Fisher確切概率法.對于各組重複測量數據應用重複測量方差分析,對于滿足毬形檢驗數據無需校正,如需校正採用Greenhouse-Geisser校正.結果 患者術後連續隨訪5年,其中25例患者完成隨訪.隨訪患者中,胃食管反流病髮生率為16.0％ (4/25),經藥物治療後緩解;吻閤口狹窄髮生率為4.0％(1/25);8.0％ (2/25)的患者EWL＜ 60％;16.0％ (4/25)的患者偶爾有腹痛髮生.糖尿病患者比例由術前的9.7％ (3/31)下降至術後5年的4.0％(1/25),術前與術後5年比較,差異有統計學意義(P＜0.05).脂肪肝患者比例由術前的93.5％(29/31)下降至術後5年的32.0％(8/25),術前與術後5年比較,差異有統計學意義(x2=19.10,P＜0.05).高脂血癥患者比例由術前的77.4％(24/31)下降至術後5年的12.0％(3/25),術前與術後5年比較,差異有統計學意義(x2=35.51,P＜0.05).BMI由術前的(38.8 ±4.2) kg/m2下降至術後5年的(28.5 ± 3.1) kg/m2,術前與術後各時間段比較,差異有統計學意義(F=113.36,P＜0.05).EWL由術後6箇月的42％± 11％增加至術後5年的69％±16％,術後各時間段比較,差異有統計學意義(F =41.71,P＜0.05).患者術後5年各時間段療效滿意度評分比較,差異無統計學意義(F =0.92,P＞0.05).結論 LSG減重效果顯著,遠期併髮癥少.
목적 평개복강경위수상절제술(LSG)치료병태성비반증적5년료효.방법 회고성분석2006년1월지2007년12월중국의과대학부속성경의원수치적31례병태성비반증환자적림상자료.31례환자행LSG,관찰환자위수술기급원기병발증정황、수술전후강당약물혹이도소응용정황,검측환자술후6개월、1、2、3、4、5년BMI화다여체질량감소솔(EWL),분석환자술후합병증완해솔、병발증발생솔급환자만의도평분.솔적비교채용x2검험혹Fisher학절개솔법.대우각조중복측량수거응용중복측량방차분석,대우만족구형검험수거무수교정,여수교정채용Greenhouse-Geisser교정.결과 환자술후련속수방5년,기중25례환자완성수방.수방환자중,위식관반류병발생솔위16.0％ (4/25),경약물치료후완해;문합구협착발생솔위4.0％(1/25);8.0％ (2/25)적환자EWL＜ 60％;16.0％ (4/25)적환자우이유복통발생.당뇨병환자비례유술전적9.7％ (3/31)하강지술후5년적4.0％(1/25),술전여술후5년비교,차이유통계학의의(P＜0.05).지방간환자비례유술전적93.5％(29/31)하강지술후5년적32.0％(8/25),술전여술후5년비교,차이유통계학의의(x2=19.10,P＜0.05).고지혈증환자비례유술전적77.4％(24/31)하강지술후5년적12.0％(3/25),술전여술후5년비교,차이유통계학의의(x2=35.51,P＜0.05).BMI유술전적(38.8 ±4.2) kg/m2하강지술후5년적(28.5 ± 3.1) kg/m2,술전여술후각시간단비교,차이유통계학의의(F=113.36,P＜0.05).EWL유술후6개월적42％± 11％증가지술후5년적69％±16％,술후각시간단비교,차이유통계학의의(F =41.71,P＜0.05).환자술후5년각시간단료효만의도평분비교,차이무통계학의의(F =0.92,P＞0.05).결론 LSG감중효과현저,원기병발증소.
Objective To investigate the 5-year efficacy of laparoscopic sleeve gastrectomy for the treatment of morbid obesity.Methods The clinical data of 31 patients with severe morbid obesity and related complications who were admitted to the Shengjing Hospital of Chinese Medical University from January 2006 to December 2007 were retrospectively analyzed.The 31 patients received laparoscopic sleeve gastrectomy and were followed up for 5 years to observe the perioperative condition,incidence of long-term complications,application of hypoglycemic drug and insulin before and after operation,the body mass index (BMI) was detected 6 months,1,2,3,4,5 years after operation,and the decrease of excess weight loss (EWL) was analyzed.The remission rate of complications,incidence of complications and the patient satisfaction score were recorded.The count data were analyzed using the chi-square test or Fisher exact probability.Repeated measurement data were analyzed using the repeated measure ANOVA,a Greenhouse-Geisser adjustment was used to correct serial dependency.Results Twenty-five patients were followed up for 5 years postoperatively.Of the 25 patients,4 (16.0％) had gastroesophageal reflux disease,and were cured by medical treatment; 1 patient (4％) had anastomotic stenosis; the percentage of EWL of 2 patients (8.0％) was under 60％ ; 4 patients (16.0％) had occasional obdominal pain.The percentage of patients with diabetes mellitus was decreased from preoperative 9.7％ (3/31) to postoperative 4.0％ (1/25),with a significant difference (P ＜ 0.05).The percentage of patients with fatty liver was decreased from preoperative 93.5％ (29/31) to postoperative 32.0％(8/25),with significant difference (x2=19.10,P ＜ 0.05).The percentage of patients with hyperlipidemia was decreased from preoperative 77.4％ (24/31) to postoperative 12.0％ (3/25),with significant difference (x2 =35.51,P ＜ 0.05).The level of BMI was decreased from preoperative (38.8 ±4.2) kg/m2 to postoperative (28.5 ± 3.1) kg/m2,with significant difference (F =113.36,P ＜ 0.05).The percentage of EWL was increased from preoperative 42％ ± 11％ to postoperative 69％ ± 16％,with significant difference (F =41.71,P ＜0.05).There was no significant difference in the patient satisfaction score between each year within the 5 years (F =0.92,P ＞ 0.05).Conclusions Laparoscopic sleeve gastrectomy is effective in losing weight with few long-term complications.
