CAJ | 학술논문

目的：研究腹腔镜Roux-en-Y胃旁路术对2型糖尿病患者排气、排便习惯的影响。方法选取2011年2月至2013年3月间行腹腔镜Roux-en-Y胃旁路术70例，以问卷调查的方式对术后6个月以上的患者的排便习惯、排气频率、气味及对日常生活的影响等方面进行统计。结果手术前67.1％的患者认为自己排便习惯正常，68.6％的患者认为排气正常，视觉模拟评分揭示排气、排便情况很少有困扰并不会影响日常生活。手术后47.1％的患者认为自己排便习惯正常，45.7％的患者有稀便和腹泻，稀便患者数增多40％（28／70），术前为7.1％（5／70），差异有统计学意义（P＜0.001），其中42.9％认为与进食高脂肪食物有关（P＜0.001），而便秘的患者明显减少7.1％（5／70），术前为22.9％（16／70），差异有统计学意义（P＝0.016），视觉模拟评分显示57.1％的患者的日常生活及社会活动未受到影响（P＝0.05）。50％的患者认为排气量明显增加，且55.7％有恶臭，与术前比较具有明显差异（P＜0.001），视觉模拟评分显示60％的患者认为这种改变不影响其日常生活及社会交往活动（ P＝0.212）。结论腹腔镜下Roux-en-Y胃旁路术后部分患者出现稀便和腹泻、排气量明显增加及恶臭等不适，但经过适当治疗后，这些改变不会影响其日常生活及社会交往活动。
목적：연구복강경Roux-en-Y위방로술대2형당뇨병환자배기、배편습관적영향。방법선취2011년2월지2013년3월간행복강경Roux-en-Y위방로술70례，이문권조사적방식대술후6개월이상적환자적배편습관、배기빈솔、기미급대일상생활적영향등방면진행통계。결과수술전67.1％적환자인위자기배편습관정상，68.6％적환자인위배기정상，시각모의평분게시배기、배편정황흔소유곤우병불회영향일상생활。수술후47.1％적환자인위자기배편습관정상，45.7％적환자유희편화복사，희편환자수증다40％（28／70），술전위7.1％（5／70），차이유통계학의의（P＜0.001），기중42.9％인위여진식고지방식물유관（P＜0.001），이편비적환자명현감소7.1％（5／70），술전위22.9％（16／70），차이유통계학의의（P＝0.016），시각모의평분현시57.1％적환자적일상생활급사회활동미수도영향（P＝0.05）。50％적환자인위배기량명현증가，차55.7％유악취，여술전비교구유명현차이（P＜0.001），시각모의평분현시60％적환자인위저충개변불영향기일상생활급사회교왕활동（ P＝0.212）。결론복강경하Roux-en-Y위방로술후부분환자출현희편화복사、배기량명현증가급악취등불괄，단경과괄당치료후，저사개변불회영향기일상생활급사회교왕활동。
Objective To observe the impact of laparoscopic Roux-en-Y gastric bypass on bowel habits in patients with type 2 diabetes mellitus(T2DM).Methods 70 cases of T2DM undergoing laparoscopic Roux-en-Y gastric bypass were studied.Changes in bowel habits, frequency and odor of flatulence, and social life were estimated at least 6 months after surgery using a self-administered questionnaire.Results 67.1%of the patients had normal bowel habit, 68.6%of patients maintained normal flatus before undergoing surgery, and visual ana-logue scale reveals bowel and flatus habit would cause little trouble on daily life.47.1% of patients maintained their normal bowel habit, and 45.7%of patients had loose stools and diarrhea after surgery.The number of pa-tients with loose stools significantly increased(28/70, 40% after surgery vs 5/70, 7.1% before surgery), with statistical difference( P<0.001) .42.9%patients believed that eating high-fat diet was related with loose stools (P<0.001).Patients with constipation decreased significantly after surgery(5/70, 7.1% vs the preoperative 16/70, 22.9%), with statistical difference(P=0.016).Visual analogue scale showed that 57.1% of patients thought their daily life and social activities were not affected(P=0.05).50%of patients considered an increase flatus, and 55.7%had malodorous flatus, which had statistical significance compared with those before surgery ( P<0.001) .A visual analogue scale showed that 60%of patients thought that this change would not affect their daily life and social activities( P=0.212) .Conclusions After laparoscopic Roux-en-Y gastric bypass surgery, some patients had loose stod, diarrhea, increased flatus and and offensive odor, but after proper treatment these changes do not affect their daily life and social activities.