目的 探讨改良腹腔镜胃旁路术治疗2型糖尿病的临床疗效.方法 前瞻性分析2012年1月至10月第四军医大学西京医院收治的30例2型糖尿病患者的临床资料.依据患者住院号将30例患者分为常规手术组(15例),施行常规腹腔镜胃旁路术;改良手术组(15例),施行改良腹腔镜胃旁路术.比较两组患者手术时间、术中出血量、肛门排气时间、术后住院时间、术后严重并发症、术后3个月BMI、空腹血糖(FPG)、空腹血清胰岛素(Fins)、空腹血清C肽(FC-P)和糖化血红蛋白(HbA1c)的差异,计量资料组间比较采用t检验,计数资料比较采用Fisher确切概率法检验.结果 常规手术组和改良手术组患者手术时间分别为(141 ±22)min和(113±26) min,两组比较,差异有统计学意义(t=3.184,P＜0.05).常规手术组和改良手术组患者术中出血量、肛门排气时间、术后住院时间及术后3个月BMI、FPG、Fins、FC-P和HbA1c分别为(65±29) ml、(2.5±1.2)d、(7.5±2.1)d、(27±4) kg/m2、(6.7±1.5)mmol/L、(18±8)mU/L、(2.0±0.6)μg/L、5.8％±1.5％和(57±25) ml、(2.1±1.0)d、(7.1±1.9)d、(28±4)kg/m2、(6.4±2.0) mmol/L、(17±6)mU/L、(1.9±0.6) μg/L、6.1％±1.4％,两组比较,差异无统计学意义(t=0.809,0.992,0.545,0.485,0.463,0.523,0.130,0.572,P＞0.05).常规手术组患者术前BMI、FPG、Fins、FC-P和HbA1 c分别为(31 ±4) kg/m2、(11.3 ±2.3)mmol/L、(13 ±4) mU/L、(1.4 ±0.5) μg/L和8.6％±1.0％,与术后3个月相应指标比较,差异有统计学意义(t=2.304,6.615,3.109,2.920,5.997,P＜0.05).改良手术组患者术前BMI、FPG、Fins、FC-P和HbA1c分别为(31 ±4) kg/m2、(11.9±2.4)mmol/L、(12±5)mU/L、(1.4±0.6)μg/L和8.9％±0.9％,与术后3个月相应指标比较,差异有统计学意义(t =2.165,6.711,2.616,2.478,6.571,P＜0.05).结论 改良腹腔镜胃旁路术的安全性、治疗2型糖尿病的近期疗效与常规腹腔镜胃旁路术相当,但能明显缩短手术时间.
目的 探討改良腹腔鏡胃徬路術治療2型糖尿病的臨床療效.方法 前瞻性分析2012年1月至10月第四軍醫大學西京醫院收治的30例2型糖尿病患者的臨床資料.依據患者住院號將30例患者分為常規手術組(15例),施行常規腹腔鏡胃徬路術;改良手術組(15例),施行改良腹腔鏡胃徬路術.比較兩組患者手術時間、術中齣血量、肛門排氣時間、術後住院時間、術後嚴重併髮癥、術後3箇月BMI、空腹血糖(FPG)、空腹血清胰島素(Fins)、空腹血清C肽(FC-P)和糖化血紅蛋白(HbA1c)的差異,計量資料組間比較採用t檢驗,計數資料比較採用Fisher確切概率法檢驗.結果 常規手術組和改良手術組患者手術時間分彆為(141 ±22)min和(113±26) min,兩組比較,差異有統計學意義(t=3.184,P＜0.05).常規手術組和改良手術組患者術中齣血量、肛門排氣時間、術後住院時間及術後3箇月BMI、FPG、Fins、FC-P和HbA1c分彆為(65±29) ml、(2.5±1.2)d、(7.5±2.1)d、(27±4) kg/m2、(6.7±1.5)mmol/L、(18±8)mU/L、(2.0±0.6)μg/L、5.8％±1.5％和(57±25) ml、(2.1±1.0)d、(7.1±1.9)d、(28±4)kg/m2、(6.4±2.0) mmol/L、(17±6)mU/L、(1.9±0.6) μg/L、6.1％±1.4％,兩組比較,差異無統計學意義(t=0.809,0.992,0.545,0.485,0.463,0.523,0.130,0.572,P＞0.05).常規手術組患者術前BMI、FPG、Fins、FC-P和HbA1 c分彆為(31 ±4) kg/m2、(11.3 ±2.3)mmol/L、(13 ±4) mU/L、(1.4 ±0.5) μg/L和8.6％±1.0％,與術後3箇月相應指標比較,差異有統計學意義(t=2.304,6.615,3.109,2.920,5.997,P＜0.05).改良手術組患者術前BMI、FPG、Fins、FC-P和HbA1c分彆為(31 ±4) kg/m2、(11.9±2.4)mmol/L、(12±5)mU/L、(1.4±0.6)μg/L和8.9％±0.9％,與術後3箇月相應指標比較,差異有統計學意義(t =2.165,6.711,2.616,2.478,6.571,P＜0.05).結論 改良腹腔鏡胃徬路術的安全性、治療2型糖尿病的近期療效與常規腹腔鏡胃徬路術相噹,但能明顯縮短手術時間.
목적 탐토개량복강경위방로술치료2형당뇨병적림상료효.방법 전첨성분석2012년1월지10월제사군의대학서경의원수치적30례2형당뇨병환자적림상자료.의거환자주원호장30례환자분위상규수술조(15례),시행상규복강경위방로술;개량수술조(15례),시행개량복강경위방로술.비교량조환자수술시간、술중출혈량、항문배기시간、술후주원시간、술후엄중병발증、술후3개월BMI、공복혈당(FPG)、공복혈청이도소(Fins)、공복혈청C태(FC-P)화당화혈홍단백(HbA1c)적차이,계량자료조간비교채용t검험,계수자료비교채용Fisher학절개솔법검험.결과 상규수술조화개량수술조환자수술시간분별위(141 ±22)min화(113±26) min,량조비교,차이유통계학의의(t=3.184,P＜0.05).상규수술조화개량수술조환자술중출혈량、항문배기시간、술후주원시간급술후3개월BMI、FPG、Fins、FC-P화HbA1c분별위(65±29) ml、(2.5±1.2)d、(7.5±2.1)d、(27±4) kg/m2、(6.7±1.5)mmol/L、(18±8)mU/L、(2.0±0.6)μg/L、5.8％±1.5％화(57±25) ml、(2.1±1.0)d、(7.1±1.9)d、(28±4)kg/m2、(6.4±2.0) mmol/L、(17±6)mU/L、(1.9±0.6) μg/L、6.1％±1.4％,량조비교,차이무통계학의의(t=0.809,0.992,0.545,0.485,0.463,0.523,0.130,0.572,P＞0.05).상규수술조환자술전BMI、FPG、Fins、FC-P화HbA1 c분별위(31 ±4) kg/m2、(11.3 ±2.3)mmol/L、(13 ±4) mU/L、(1.4 ±0.5) μg/L화8.6％±1.0％,여술후3개월상응지표비교,차이유통계학의의(t=2.304,6.615,3.109,2.920,5.997,P＜0.05).개량수술조환자술전BMI、FPG、Fins、FC-P화HbA1c분별위(31 ±4) kg/m2、(11.9±2.4)mmol/L、(12±5)mU/L、(1.4±0.6)μg/L화8.9％±0.9％,여술후3개월상응지표비교,차이유통계학의의(t =2.165,6.711,2.616,2.478,6.571,P＜0.05).결론 개량복강경위방로술적안전성、치료2형당뇨병적근기료효여상규복강경위방로술상당,단능명현축단수술시간.
Objective To investigate the efficacies of conventional and modified laparoscopic gastric bypass in the treatment of type 2 diabetes mellitus.Methods The clinical data of 30 patients with type 2 diabetes mellitus who were admitted to the Xijing Hospital of the Fourth Military Medical University from January 2012 to October 2012 were prospectively analyzed.All the 30 patients were randomly divided into the conventional group (15 patients) and the modified group (15 patients) according to the random number table.Patients in the 2 groups received conventional and modified laparoscopic gastric bypass,respectively.The operation time,blood loss,anal exhaust time,duration of postoperative hospital stay,incidence of severe complications,postoperative 3-month body mass index (BMI),fasting plasma glucose (FPG),fasting serum insulin (Fins),fasting serum C-peptide (FC-P) and glycosylated hemoglobin (HbAlc) of the 2 groups were compared.The measurement data were analyzed using the t test,and the count data were analyzed using the Fisher exact probability.Results The operation time of the conventional group and the modified group were (141 ± 22)minutes and (113 ± 26)minutes,with significant difference between the 2 groups (t =3.184,P ＜ 0.05).The volume of intraoperative blood loss,anal exhaust time,duration of postoperative hospital stay,postoperative 3-month BMI,FPG,Fins,FC-P and HbAlc were (65 ±29)ml,(2.5 ±1.2)days,(7.5 ±2.1)days,(27 ±4)kg/m2,(6.7 ±1.5)mmol/L,(18 ± 8) mU/L,(2.0 ± 0.6) μg/L and 5.8％ ± 1.5 ％ in the conventional group,and (57 ± 25) ml,(2.1 ± 1.0) days,(7.1 ± 1.9) days,(28 ± 4) kg/m2,(6.4 ± 2.0) mmol/L,(17 ± 6) mU/L,(1.9 ± 0.6) μg/L and 6.1％ ± 1.4％ in the modified group,with no significant difference between the 2 groups (t =0.809,0.992,0.545,0.485,0.463,0.523,0.130,0.572,P ＞ 0.05).The levels of preoperative BMI,FPG,Fins,FC-P and HbAle of the conventional group were (31 ± 4) kg/m2,(11.3 ± 2.3) mmol/L,(13 ± 4) mU/L,(1.4 ± 0.5) μg/L and 8.6％ ± 1.0％,which were significantly different from those at 3 months after operation (t =2.304,6.615,3.109,2.920,5.997,P ＜ 0.05).The levels of preoperative BMI,FPG,Fins,FC-P and HbAlc of the modified group were (31 ±4)kg/m2,(11.9±2.4)mmol/L,(12±5)mU/L,(1.4 ±0.6) μg/L and 8.9％±0.9％,which were significant different from those at 3 months after operation (t =2.165,6.711,2.616,2.478,6.571,P ＜0.05).Conclusion The safety and short-term efficacy of modified laparoscopic gastric bypass are comparable to those of the conventional laparoscopic gastric bypass,but the operation time of the modified method is significantly shorter.
