腹腔镜袖状胃手术治疗重度肥胖症短期疗效研究

目的 探讨腹腔镜袖状胃手术（LSG）治疗重度肥胖症的短期疗效。方法 选择2018年1月至2019年1月在安徽医科大学第二附属医院接受LSG治疗的42例重度肥胖症患者，回顾性分析患者的临床及随访资料，记录术后并发症情况，比较患者术前和术后第1、3、6、12个月的体质量、体质指数（BMI）、额外体质量下降百分比、甘油三酯（TG）、血清总胆固醇、血清低密度脂蛋白、血清高密度脂蛋白、血清尿酸及肝脏CT值的情况，并通过Epworth嗜睡量表、焦虑自评量表（SAS）、抑郁自评量表（SDS）对患者术前与术后第12个月的嗜睡、焦虑、抑郁状态进行评价。结果 42例患者均顺利完成腹腔镜袖状胃手术，术后2例切口脂肪液化，4例术后呕吐，3例残胃水肿行短期全肠外营养，未发生Clavien-Dindo III类及以上并发症。患者术前与术后第1、3、6、12个月的体质量、BMI差异有统计学意义（P<0.05），患者术后各时间点EWL（%）的差异有统计学意义（P<0.05）。术后第1、3、6、12个月的体质量和BMI均低于术前，术后第3、6、12个月的EWL%均低于术后第1个月，术后第3、6、12个月的TG低于术前，术后第6、12个月患者肝脏CT值高于术前，差异有统计学意义（P<0.05）。术后第12个月的Epworth、SAS和SDS评分均低于术前，差异有统计学意义（P<0.05）。结论 LSG手术可以有效治疗重度肥胖症及其诱发的多种合并症，并发症低，疗效确切，值得推广普及。

Study on short-term effect of laparoscopic sleeve gastrectomy on severe obesity

Objective To explore the short-term effect of laparoscopic sleeve stomach surgery in the treatment of severe obesity. Methods Forty-two patients with severe obesity who received LSG treatment in the Second Affiliated Hospital of Anhui Medical University from January 2018 to January 2019 were selected. The clinical and follow-up data of the patients were retrospectively analyzed, and the postoperative complications were recorded. The body mass, body mass index (BMI), percentage of extra body weight decrease, triglyceride (TG) and serum total bile were compared before and 1, 3, 6 and 12 months after operation Sterols, serum low density lipoprotein, serum high density lipoprotein, serum uric acid and liver CT value were measured. Patients'' sleepiness, anxiety and depression were evaluated by Epworth Sleepiness Scale, Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). Results Laparoscopic sleeve gastrectomy was successfully performed in 42 patients. Postoperative fat liquefaction occurred in 2 patients, vomiting in 4 patients, and short-term total parenteral nutrition in 3 patients with residual gastric edema. No Clavien-Dindo class III or above complications occurred. There were significant differences in body mass and BMI between preoperative and postoperative 1,3,6,12 months (P<0.05), and EWL (%) at each time point after operation was statistically significant (P<0.05). The body mass and BMI at 1,3,6,12 months after operation were lower than those before operation, EWL% at 3,6 and 12 months after operation were lower than those at 1 month after operation, TG at 3,6,12 months after operation was lower than that before operation, and CT value of liver at 6,12 months after operation was higher than that before operation(P<0.05). The scores of Epworth, SAS and SDS at 12 months after operation were lower than those before operation (P<0.05). Conclusion LSG can effectively treat severe obesity and its complications with low complications and definite curative effect, which is worth clinical popularization.