CAJ | 학술논문

目的探讨腹腔镜Roux-en-Y胃旁路术(LRYGB)治疗肥胖型2型糖尿病的临床疗效.方法回顾性分析2009年3月至2011年2月间在北京世纪坛医院接受LRYGB治疗的18例肥胖型2型糖尿病患者的临床资料,分别于术前及术后3个月检测血糖、血脂及营养指标,记录减重情况.结果 18例患者中男8例,女10例,年龄27～62(42.4±10.7)岁,BMI 28.7～57.4(34.9±6.9)kg/m2.全组患者均在腹腔镜下完成手术,无中转开腹,无围手术期死亡及并发症发生.术后3个月,患者体质量明显下降,空腹及餐后血糖水平、糖化血红蛋白、胰岛素抵抗指数、胰岛功能指数均较术前显著好转(均P＜0.05);临床完全缓解率为77.8％(14/18),总有效率为100％(18/18).术后3个月时患者血脂水平亦明显下降(P＜0.05),营养指标手术前后的比较,差异无统计学意义(均P＞0.05).结论 LRYGB可以有效地治疗肥胖型2型糖尿病.
목적 탐토복강경Roux-en-Y위방로술(LRYGB)치료비반형2형당뇨병적림상료효.방법 회고성분석2009년3월지2011년2월간재북경세기단의원접수LRYGB치료적18례비반형2형당뇨병환자적림상자료,분별우술전급술후3개월검측혈당、혈지급영양지표,기록감중정황.결과 18례환자중남8례,녀10례,년령27～62(42.4±10.7)세,BMI 28.7～57.4(34.9±6.9)kg/m2.전조환자균재복강경하완성수술,무중전개복,무위수술기사망급병발증발생.술후3개월,환자체질량명현하강,공복급찬후혈당수평、당화혈홍단백、이도소저항지수、이도공능지수균교술전현저호전(균P＜0.05);림상완전완해솔위77.8％(14/18),총유효솔위100％(18/18).술후3개월시환자혈지수평역명현하강(P＜0.05),영양지표수술전후적비교,차이무통계학의의(균P＞0.05).결론 LRYGB가이유효지치료비반형2형당뇨병.
Objective To explore the treatment outcomes of obese type 2 diabetes mellitus(T2DM)after laparoscopic gastric bypass.Methods The clinical data of 18 patients with obese T2DM who underwent laparoscopic Roux-en-Y gastric bypass in Beijing Shijitan Hospital between March 2009 and February 2011 were retrospectively analyzed.The clinical parameters included preoperative and postoperative blood glucose,blood lipid,nutrition status and weight lose.Results Eighteen patients included 8 men and 10 women.The range of age was 27-62 years(mean,42.4±10.7 years).The range of BMI was 28.7-57.4 kg/m2(mean,34.9±6.9 kg/m2).All the patients underwent laparoscopic Rouxen-Y gastric bypass,and no mortality,complication or conversion to open operation occurred.At 3 months after operation,there were significant changes in OGTT,BMI,HbA1c,Homa-IR and Homa-β(all P＜0.05).Fourteen patients(77.8％)showed clinical complete remission,and the overall effective rate was 100％(18/18).The level of blood lipid decreased significantly(P＜0.05),and the change of nutritional status was not statistically significant(P＞0.05).Conclusion Gastric bypass is an effective treatment for obese type 2 diabetes mellitus.