CAJ | 학술논문

目的探讨精准腹腔镜胃袖状切除术(LSG)治疗肥胖症的疗效.方法回顾性分析2011年8月至2013年7月暨南大学附属第一医院收治的50例施行精准LSG治疗肥胖症患者的临床资料.记录术前、术后患者BMI、并发症情况以及相关代谢性疾病缓解情况.结果 50例患者均顺利完成LSG,手术时间为(59±10)min,出血量为(10 ±4) ml,术后住院时间为(5.2±1.1)d.术后患者未发生严重并发症.术后随访时间＞1年的23例患者多余体质量减少率(EWL)为80％±18％,BMI下降(10.1 ±3.4) kg/m2;术后随访6～12个月的13例患者EWL为71％±15％,BMI下降(8.6±2.3)kg/m2;随访1～6个月(不含6个月)的14例患者EWL为28％±12％,BMI下降(4.2±1.6)kg/m2.6例合并胰岛素抵抗患者恢复正常;6例合并脂肪肝患者,5例血脂水平下降,1例变化不明显;4例合并2型糖尿病患者中,3例无需药物控制血糖,1例口服降糖药物控制良好;3例合并高血压患者停用降压药物血压控制良好.结论施行精准LSG治疗肥胖症,术中采取精细、准确的操作,减少术中、术后并发症,可取得满意疗效,使患者获益.
목적 탐토정준복강경위수상절제술(LSG)치료비반증적료효.방법 회고성분석2011년8월지2013년7월기남대학부속제일의원수치적50례시행정준LSG치료비반증환자적림상자료.기록술전、술후환자BMI、병발증정황이급상관대사성질병완해정황.결과 50례환자균순리완성LSG,수술시간위(59±10)min,출혈량위(10 ±4) ml,술후주원시간위(5.2±1.1)d.술후환자미발생엄중병발증.술후수방시간＞1년적23례환자다여체질량감소솔(EWL)위80％±18％,BMI하강(10.1 ±3.4) kg/m2;술후수방6～12개월적13례환자EWL위71％±15％,BMI하강(8.6±2.3)kg/m2;수방1～6개월(불함6개월)적14례환자EWL위28％±12％,BMI하강(4.2±1.6)kg/m2.6례합병이도소저항환자회복정상;6례합병지방간환자,5례혈지수평하강,1례변화불명현;4례합병2형당뇨병환자중,3례무수약물공제혈당,1례구복강당약물공제량호;3례합병고혈압환자정용강압약물혈압공제량호.결론 시행정준LSG치료비반증,술중채취정세、준학적조작,감소술중、술후병발증,가취득만의료효,사환자획익.
Objective To investigate the efficacy of precision laparoscopic sleeve gastrectomy (LSG) for the treatment of obesity.Methods The clinical data of 50 obese patients who received LSG under the guidance of "precise weight loss surgery" at the First Affiliated Hospital of Jinan University from August 2011 to July 2013 were retrospectively analyzed.The body mass index (BMI),complication and metabolic disease remission before and after operation were recorded.Results All the 50 patients successfully underwent LSG.The operation time,blood loss,postoperative duration of hospital stay were (59 ± 10) minutes,(10 ± 4) ml and (5.2 ± 1.1) days.No severe complications were observed.The percentage of excess weight loss (EWL) and decrease of BMI of 23 patients who were followed up for more than 1 year were 80％ ± 18％ and (10.1 ± 3.4)kg/m2,respectively; the percentage of EWL and decrease of BMI of 13 patients who were followed up for 6-12 months were 71％ ± 15％ and (8.6 ± 2.3) kg/m2,respectively ; the percentage of EWL and decrease of BMI of 14 patients who were followed up for 1-6 months were 28％± 12％ and (4.2 ± 1.6)kg/m2,respectively.The condition of 6 patients with insulin resistance was back to normal.Six patients had hepatic adipose infiltration,5 of them had lipid levels decreased,and the change of lipid level was not obvious in the other 1 patient.Four patients had type 2 diabetes mellitus,3 patients did not need therapy,1 patient only needed drug therapy.Three patients had hypertension,and their blood pressure was controlled at the normal level after stop of drug administration.Conclusion The incidence of postoperative complication could be reduced by fine and accurate manipulation and applying the "precision weight loss surgery" in operation.