腹腔镜下Roux-en-Y胃旁路术治疗肥胖2型糖尿病患者的近期疗效分析

被引:11
作者
陈满 [1 ]
汪志红 [1 ]
张力 [1 ]
张军 [2 ]
李启富 [1 ]
刘智平 [1 ]
唐瑶 [1 ]
陈书梅 [1 ]
刘秀容 [1 ]
杨淑敏 [1 ]
机构
[1] 重庆医科大学附属第一医院内分泌科
[2] 重庆医科大学附属第一医院普通外科
关键词
Roux-en-Y胃旁路术; 肥胖; 2型糖尿病;
D O I
10.16016/j.1000-5404.2014.07.016
中图分类号
R656.61 [];
学科分类号
摘要
目的观察腹腔镜下Roux-en-Y胃旁路术(laparoscopic Roux-en-Y gastric bypass,LRYGB)在肥胖2型糖尿病患者治疗中的近期临床疗效和安全性。方法纳入我院近3年来行LRYGB手术的肥胖2型糖尿病患者12例,其中男性4例,女性8例;年龄(43.8±10.6)岁;糖尿病病程(8.3±3.9)年;体质量指数(31.3±5.6)kg/m2;空腹血糖(9.4±1.9)mmol/L;HbA1c(8.4±1.6)%。患者均完成术后12个月的随访。以术后停用所有降糖治疗,空腹血糖<7.0 mmol/L和HbA1c<6.5%者,判定为2型糖尿病临床完全缓解。观察手术后患者体质量、血糖、血脂、血压、用药用量等变化以及术后相关并发症情况。结果 LRYGB术后12个月患者显著降低体质量(20.4±9.7)kg,显著缩小腰围(23.4±14.1)cm,同时降低HbA1c(2.1±1.7)%。2型糖尿病临床完全缓解7例(58.3%),临床部分缓解5例(41.7%)。合并有高血压病、血脂异常的患者术后均停用所有降压、降脂药物。与临床部分缓解组相比,临床完全缓解组的糖尿病病程更短[(4.6±3.3)年vs(10.6±3.7)年,P<0.05]。12例患者无1例死亡。患者术后近期并发症发生1例(8.3%),远期并发症发生1例(8.3%)。结论 LRYGB治疗肥胖2型糖尿病患者的近期临床疗效满意,能有效控制患者的血糖、血脂及血压。
引用
收藏
页码:691 / 695
页数:5
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