本文關(guān)鍵詞： 腹腔鏡 袖狀胃切除術(shù) 肥胖癥 2型糖尿病 療效分析　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:探討腹腔鏡袖狀切除術(shù)(laparoscopic sleeve gastrectomy,LSG)治療肥胖癥合并2型糖尿病(type 2 diabetes mellitus,T2DM)的手術(shù)安全性及治療效果。方法:選取2013年4月~2015年5月在山西醫(yī)科大學(xué)附屬大醫(yī)院行LSG的12例肥胖癥合并T2DM的患者為研究對(duì)象。術(shù)后隨訪為12個(gè)月,比較患者手術(shù)前后體重、體重指數(shù)(BMI)、多余體重減少率(the percentage of excess weight loss,EWL%)、空腹血糖(fasting plasma glucose,FPG)、空腹胰島素(fasting insulin,FINS)、空腹C肽(fasting C-peptide,FCP)、糖化血紅蛋白(hemoglobin A1C,HbA1C)、胰島素抵抗指數(shù)(homeostatic model assessment of insulin resistance,HOMA-IR)、甘油三脂(triglyceride,TG)、總膽固醇(total cholesterol,TC),低密度脂蛋白(low-density lipoprotein,LDL)、高密度脂蛋白(high-density lipoprotein,HDL)、尿酸、收縮壓及舒張壓等相關(guān)代謝指標(biāo)的變化情況。結(jié)果:12例患者手術(shù)均順利完成,無(wú)中轉(zhuǎn)開(kāi)腹,術(shù)中無(wú)大量出血,術(shù)后未出現(xiàn)胃漏、胃出血、胃食管反流等嚴(yán)重并發(fā)癥。術(shù)后隨訪時(shí)間分別為1、3、6、12個(gè)月,術(shù)后各時(shí)間點(diǎn)患者的體重、BMI、FPG等均低于術(shù)前(P0.05),EWL%呈上升趨勢(shì)(P0.05);其他相關(guān)代謝性指標(biāo),如FINS、FCP、HbA1C、HOMA-IR、TG、TC、LDL、HDL、尿酸、收縮壓及舒張壓等較術(shù)前明顯改善;部分患者隨訪至術(shù)后12個(gè)月發(fā)現(xiàn)空腹血糖及體重下降趨勢(shì)明顯減緩,逐漸進(jìn)入平臺(tái)期。結(jié)論:LSG減肥降糖效果確切,安全性可控,短期療效滿意,因病例數(shù)較少及隨訪時(shí)間較短,中遠(yuǎn)期療效仍待進(jìn)一步研究。
[Abstract]:Objective: to evaluate the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity with type 2 diabetes mellitus type 2 diabetes mellitusus T2DM.Methods: from April 2013 to May 2015, we conducted the operation at the affiliated Hospital of Shanxi Medical University. Twelve patients with obesity associated with T2DM in LSG were studied. The weight of patients before and after operation was compared, Body mass index (BMI), excess weight loss rate (percentage of excess weight loss), fasting plasma glucose (FPG), fasting insulin fasting (FINSN), fasting C-peptide (FCP), glycosylated hemoglobin A1CHbA1CU, insulin resistance index (IRI), homeostatic model assessment of insulin resistance (HOMA-IRN), triglyceride triglyceride (TGN), total cholesterol cholesterol (TC), total cholesterol cholesterol (TC), hemoglobin A1CbA1C, insulin resistance index (IREI), homeostatic model assessment of insulin resistance (HOMA-IRM), triglyceride triglyceride (TGN), total cholesterol cholesterol (TC), total cholesterol cholesterol (TC). Low density lipoprotein, low density lipoprotein, high density lipoprotein, high density lipoprotein, uric acid, Results all the 12 cases of operation were successfully completed, no conversion to laparotomy, no massive bleeding during operation, no gastric leakage, no gastric bleeding, no postoperative gastric leakage, no gastric bleeding, no postoperative gastric leakage, no gastric bleeding, no postoperative gastric leakage, no gastric bleeding, no postoperative gastric leakage, no gastric bleeding, and no postoperative gastric bleeding. Severe complications, such as gastroesophageal reflux, were followed up for 6 and 12 months, respectively. The body weight of patients with BMI-FPG was significantly lower than that of preoperation (P0.05 / EWL%, P 0.05%). Other related metabolic indexes, such as FINSUN FCPHbA1CHOMA-IRTGG TGGN LDLL, uric acid, uric acid, et al, were found to be higher than those before operation (P < 0.05), and other related metabolic indexes, such as FINSF-FCPHbA1CHOMA-IRT, TGGN, LDLL, uric acid, uric acid, etc. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly improved than those before operation, and some patients were followed up to 12 months after operation to find that the trend of fasting blood glucose and body weight decreased significantly, and gradually entered the plateau stage. The short-term curative effect is satisfactory, because the number of cases is small and the follow-up time is short, the medium-long-term effect still needs further study.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.1;R589.2;R656.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前7條

1 楊巍;宋培立;;腹腔鏡袖狀胃切除術(shù)治療病態(tài)性肥胖合并2型糖尿病近期療效觀察[J];實(shí)用醫(yī)技雜志;2014年12期

2 湯朝暉;Mustafa Hussain;Vivek N.Prachand;John C.Alverdy;Donald Liu;劉穎斌;全志偉;;腹腔鏡袖狀胃切除治療病態(tài)性肥胖及2型糖尿病的意義及國(guó)際專家共識(shí)[J];中國(guó)實(shí)用外科雜志;2013年01期

3 Jong Won Kim;Jae-Ho Cheong;Woo Jin Hyung;Seung-Ho Choi;Sung Hoon Noh;;Outcome after gastrectomy in gastric cancer patients with type 2 diabetes[J];World Journal of Gastroenterology;2012年01期

4 魏煒明;胡旭光;陳丹磊;印慨;柯重偉;鄭成竹;;胃旁路術(shù)對(duì)非肥胖型2型糖尿病療效的前瞻性對(duì)照研究[J];中華消化外科雜志;2011年03期

5 鄒大進(jìn);鄭成竹;吳鴻;丁丹;;手術(shù)治療糖尿病專家共識(shí)[J];中國(guó)實(shí)用外科雜志;2011年05期

6 丁丹;鄭成竹;;手術(shù)治療肥胖癥及糖尿病——在共識(shí)與爭(zhēng)議中發(fā)展[J];中國(guó)實(shí)用外科雜志;2011年01期

7 田曉豐;曹宏;陳丹磊;柯重偉;印慨;鄭成竹;;胃旁路術(shù)對(duì)糖尿病大鼠胰島β細(xì)胞凋亡的影響及其機(jī)制研究[J];中華外科雜志;2010年23期

，

本文編號(hào)：1529955