BillrothⅡ式胃切除术后顽固性腹泻1例报告

1　病历简介男性病人 ,3 5岁。因十二指肠球部溃疡行BillrothⅡ式胃切除术后 15d出现水样腹泻 ,于 2 0 0 2年 5月 12日收入院。每日腹泻多达 10余次 ,腹泻物中无进食物 ,含较多胆汁样成分。术后进食正常 ,无体重减轻及发热 ,经止泻药物治疗无效。大便镜检 :见较多脂肪滴 ,无脓血便。大便细菌培养 :无痢疾杆菌生长。结肠镜检查 :结直肠未见新生物 ,粘膜光滑 ,无明显充血、水肿。胰腺CT检查 :胰腺未见病变。钡餐胃肠系检查 :BillrothⅡ式胃切除术后胃与空肠起始段吻合。输入、输出口通畅 ,小肠未见梗阻 ,未见瘘。入院诊断 :BillrothⅡ式胃切…     

不同消化道重建方式对胃癌合并2型糖尿病患者血糖的影响

目的探讨胃癌合并2型糖尿病患者行不同消化道重建手术方式对血糖的影响。方法回顾性分析我院2010年1月~2012年12月收治的53例远端胃癌合并2型糖尿病患者的临床资料,根据消化道重建方式分为两组:Ⅰ组25例,采用BillrothⅠ式手术行消化道重建;Ⅱ组28例,采用BillrothⅡ式手术行消化道重建。比较两组术后血糖的变化及疗效。结果Ⅰ组术后空腹血糖(FBG)、OGTT 2h血糖(2h PBG)、糖化血红蛋白(Hb A1c)及空腹C肽与术前比较均无明显变化(均P0.05),Ⅱ组术后FBG、2h PBG及Hb A1c较术前明显降低(均P0.05),空腹C肽较术前明显升高(P0.05)。两组患者术后FBG、2h PBG、Hb A1c及空腹C肽等指标比较均具有统计学差异(均P0.05)。Ⅰ组临床有效率为20%,Ⅱ组为92.9%,组间比较差异具有统计学意义(χ2=28.876,P0.01)。结论 BillrothⅡ式消化道重建方式对于胃癌合并2型糖尿病患者具有一定的血糖控制作用。     

2型糖尿病合并骨质疏松患者IGF-Ⅱ水平的变化

目的研究2型糖尿病合并骨质疏松患者血IGF-Ⅱ水平的变化,及其与骨质疏松发生的关系。方法受试者101例,均测量身高、体重、腰围、血糖、糖化血红蛋白、尿蛋白、IGF-Ⅱ和骨密度。按糖尿病病程将糖尿病患者分为病程<10年组、病程≥10年组;根据糖尿病肾病病程将糖尿病患者分为正常组、肾病病程<10年组、肾病病程≥10年组;根据骨密度结果将所有受试者分为骨密度正常组、骨量减低组、骨质疏松组。结果与非糖尿病组相比,糖尿病病程<10年组及糖尿病病程≥10年组患者骨质疏松的发生率差异无统计学意义。随着糖尿病病程延长,IGF-Ⅱ水平下降;随着骨密度的降低,IGF-Ⅱ水平下降;糖尿病患者中随着骨密度的降低,IGF-Ⅱ水平无明显变化。结论骨质疏松的发生与2型糖尿病无关系,与血糖控制好坏无关。IGF-Ⅱ可能参与了2型糖尿病的发病过程。IGF-Ⅱ的下降参与了骨质疏松的发生。     

腹腔镜袖状胃切除术治疗肥胖症合并2型糖尿病的临床效果

目的:探讨肥胖症合并2型糖尿病行腹腔镜袖状胃切除术(LSG)的近期疗效.方法:选取2018年6月至2020年6月采用LSG治疗的60例2型糖尿病合并肥胖症患者,根据治疗方法分为LSG组(n=29)与腹腔镜Roux-en-Y胃转流术(LRYGB)组(n=31);分析两组术后3个月、6个月糖代谢及围术期指标的变化,并比较术...     

袖状胃切除术治疗Ⅱ型糖尿病的进展

袖状胃切除术作为一种新型独立的减重术式,在世界范围得到了越来越多外科医师的青睐。但随着时代的推移,越来越多的对比研究发现袖状胃切除术在体重及血糖控制方面可能并不完美,本文现就目前国内外出现的袖状胃切除术结合旁路手术的新型术式作一简要综述。     

腹腔镜袖带胃切除术治疗病态性肥胖合并2型糖尿病的疗效评价

目的评估腹腔镜袖带胃切除术（LSG）治疗病态性肥胖2型糖尿病的疗效。方法2007年1月至7月,对来自全美的30例体质量指数（BMD大于或等于35、且合并2型糖尿病的病态性肥胖志愿患者行LSG,术后所有病例随访6个月。分析患者手术前后血糖控制情况、BMI变化和超重体重下降百分比（EWL％）及血糖指标变化情况和Ghrelin激素。结果本组30例患者在接受LSG后6个月,糖尿病治愈率达63％（19／30）,缓解率达37％（11／30）,术后6个月总有效率为100％。结论LSG对病态性肥胖2型糖尿病有着良好的短期治疗效果。     

腹腔镜袖状胃切除术对肥胖合并2型糖尿病患者牙周状况影响的临床研究

目的:探讨腹腔镜袖状胃切除术对肥胖合并2型糖尿病患者牙周状况的影响.方法:分析2019年6月至2020年4月接受腹腔镜袖状胃切除术的肥胖合并2型糖尿病患者的临床资料,选取其中的34例牙周炎患者,男11例,女23例.分别于术前及术后3、6、12个月记录患者身高、体重,检测血糖水平、探诊深度、出血指数、菌斑指数、临床附着丧...     

腹腔镜袖带胃切除术治疗病态性肥胖合并2型糖尿病的疗效评价

Objective To evaluate the efficacy of laparoscopic sleeve gastrectomy (LSG) on improving glycemic control of morbidly obese patients with type 2 diabetes mellitus. Methods Prospective study of 30 type 2 diabetes mellitus(T2DM) patients with BMI≥35 undergone LSG was carried out. Pre- and post-operative clinical parameters associated with diabetes mellitus 6 months after operation were evaluated. Data collected included demographics, weight loss (BMI, EWL%), diabetes control (FPG, HbA1C) and ghrelin. Results Fasting plasma glucose and glyeosylated hemoglobin concentration tests and clinical outcomes suggested LSG resulted in significant improvement or resolution of T2DM in all the 30 patients with CR 63%(19/30) and PR 37%(11/30). Conclusions LSG can lead to significant changes in controlling glycemia on morbidly obese patients with T2DM in 6 months. Long-term efficacy needs further follow-up.     

腹腔镜袖带胃切除术治疗病态性肥胖合并2型糖尿病的疗效评价

Objective To evaluate the efficacy of laparoscopic sleeve gastrectomy (LSG) on improving glycemic control of morbidly obese patients with type 2 diabetes mellitus. Methods Prospective study of 30 type 2 diabetes mellitus(T2DM) patients with BMI≥35 undergone LSG was carried out. Pre- and post-operative clinical parameters associated with diabetes mellitus 6 months after operation were evaluated. Data collected included demographics, weight loss (BMI, EWL%), diabetes control (FPG, HbA1C) and ghrelin. Results Fasting plasma glucose and glyeosylated hemoglobin concentration tests and clinical outcomes suggested LSG resulted in significant improvement or resolution of T2DM in all the 30 patients with CR 63%(19/30) and PR 37%(11/30). Conclusions LSG can lead to significant changes in controlling glycemia on morbidly obese patients with T2DM in 6 months. Long-term efficacy needs further follow-up.     

腹腔镜袖带胃切除术治疗病态性肥胖合并2型糖尿病的疗效评价

Objective To evaluate the efficacy of laparoscopic sleeve gastrectomy (LSG) on improving glycemic control of morbidly obese patients with type 2 diabetes mellitus. Methods Prospective study of 30 type 2 diabetes mellitus(T2DM) patients with BMI≥35 undergone LSG was carried out. Pre- and post-operative clinical parameters associated with diabetes mellitus 6 months after operation were evaluated. Data collected included demographics, weight loss (BMI, EWL%), diabetes control (FPG, HbA1C) and ghrelin. Results Fasting plasma glucose and glyeosylated hemoglobin concentration tests and clinical outcomes suggested LSG resulted in significant improvement or resolution of T2DM in all the 30 patients with CR 63%(19/30) and PR 37%(11/30). Conclusions LSG can lead to significant changes in controlling glycemia on morbidly obese patients with T2DM in 6 months. Long-term efficacy needs further follow-up.     

腹腔镜袖带胃切除术治疗病态性肥胖合并2型糖尿病的疗效评价

Objective To evaluate the efficacy of laparoscopic sleeve gastrectomy (LSG) on improving glycemic control of morbidly obese patients with type 2 diabetes mellitus. Methods Prospective study of 30 type 2 diabetes mellitus(T2DM) patients with BMI≥35 undergone LSG was carried out. Pre- and post-operative clinical parameters associated with diabetes mellitus 6 months after operation were evaluated. Data collected included demographics, weight loss (BMI, EWL%), diabetes control (FPG, HbA1C) and ghrelin. Results Fasting plasma glucose and glyeosylated hemoglobin concentration tests and clinical outcomes suggested LSG resulted in significant improvement or resolution of T2DM in all the 30 patients with CR 63%(19/30) and PR 37%(11/30). Conclusions LSG can lead to significant changes in controlling glycemia on morbidly obese patients with T2DM in 6 months. Long-term efficacy needs further follow-up.     

腹腔镜袖带胃切除术治疗病态性肥胖合并2型糖尿病的疗效评价

Objective To evaluate the efficacy of laparoscopic sleeve gastrectomy (LSG) on improving glycemic control of morbidly obese patients with type 2 diabetes mellitus. Methods Prospective study of 30 type 2 diabetes mellitus(T2DM) patients with BMI≥35 undergone LSG was carried out. Pre- and post-operative clinical parameters associated with diabetes mellitus 6 months after operation were evaluated. Data collected included demographics, weight loss (BMI, EWL%), diabetes control (FPG, HbA1C) and ghrelin. Results Fasting plasma glucose and glyeosylated hemoglobin concentration tests and clinical outcomes suggested LSG resulted in significant improvement or resolution of T2DM in all the 30 patients with CR 63%(19/30) and PR 37%(11/30). Conclusions LSG can lead to significant changes in controlling glycemia on morbidly obese patients with T2DM in 6 months. Long-term efficacy needs further follow-up.     

腹腔镜袖带胃切除术治疗病态性肥胖合并2型糖尿病的疗效评价

Objective To evaluate the efficacy of laparoscopic sleeve gastrectomy (LSG) on improving glycemic control of morbidly obese patients with type 2 diabetes mellitus. Methods Prospective study of 30 type 2 diabetes mellitus(T2DM) patients with BMI≥35 undergone LSG was carried out. Pre- and post-operative clinical parameters associated with diabetes mellitus 6 months after operation were evaluated. Data collected included demographics, weight loss (BMI, EWL%), diabetes control (FPG, HbA1C) and ghrelin. Results Fasting plasma glucose and glyeosylated hemoglobin concentration tests and clinical outcomes suggested LSG resulted in significant improvement or resolution of T2DM in all the 30 patients with CR 63%(19/30) and PR 37%(11/30). Conclusions LSG can lead to significant changes in controlling glycemia on morbidly obese patients with T2DM in 6 months. Long-term efficacy needs further follow-up.     

腹腔镜袖带胃切除术治疗病态性肥胖合并2型糖尿病的疗效评价

Objective To evaluate the efficacy of laparoscopic sleeve gastrectomy (LSG) on improving glycemic control of morbidly obese patients with type 2 diabetes mellitus. Methods Prospective study of 30 type 2 diabetes mellitus(T2DM) patients with BMI≥35 undergone LSG was carried out. Pre- and post-operative clinical parameters associated with diabetes mellitus 6 months after operation were evaluated. Data collected included demographics, weight loss (BMI, EWL%), diabetes control (FPG, HbA1C) and ghrelin. Results Fasting plasma glucose and glyeosylated hemoglobin concentration tests and clinical outcomes suggested LSG resulted in significant improvement or resolution of T2DM in all the 30 patients with CR 63%(19/30) and PR 37%(11/30). Conclusions LSG can lead to significant changes in controlling glycemia on morbidly obese patients with T2DM in 6 months. Long-term efficacy needs further follow-up.     

腹腔镜袖带胃切除术治疗病态性肥胖合并2型糖尿病的疗效评价

Objective To evaluate the efficacy of laparoscopic sleeve gastrectomy (LSG) on improving glycemic control of morbidly obese patients with type 2 diabetes mellitus. Methods Prospective study of 30 type 2 diabetes mellitus(T2DM) patients with BMI≥35 undergone LSG was carried out. Pre- and post-operative clinical parameters associated with diabetes mellitus 6 months after operation were evaluated. Data collected included demographics, weight loss (BMI, EWL%), diabetes control (FPG, HbA1C) and ghrelin. Results Fasting plasma glucose and glyeosylated hemoglobin concentration tests and clinical outcomes suggested LSG resulted in significant improvement or resolution of T2DM in all the 30 patients with CR 63%(19/30) and PR 37%(11/30). Conclusions LSG can lead to significant changes in controlling glycemia on morbidly obese patients with T2DM in 6 months. Long-term efficacy needs further follow-up.     

胃大部切除BillrothⅡ式吻合术后ERCP检查

对３５例胃大部切除ＢｉｌｌｒｏｔｈⅡ式吻合术后的患者施行ＥＲＣＰ检查，２９例造影成功（８３％），失败６例，无严重并发症。其中１９例阳性发现（６６％），认为该项检查有重要临床价值。详细阐述了胃肠正常解剖途径改变所致内镜操作困难的技术问题及注意事项。     

腹腔镜袖带胃切除术治疗病态性肥胖合并2型糖尿病的疗效评价

Objective To evaluate the efficacy of laparoscopic sleeve gastrectomy (LSG) on improving glycemic control of morbidly obese patients with type 2 diabetes mellitus. Methods Prospective study of 30 type 2 diabetes mellitus(T2DM) patients with BMI≥35 undergone LSG was carried out. Pre- and post-operative clinical parameters associated with diabetes mellitus 6 months after operation were evaluated. Data collected included demographics, weight loss (BMI, EWL%), diabetes control (FPG, HbA1C) and ghrelin. Results Fasting plasma glucose and glyeosylated hemoglobin concentration tests and clinical outcomes suggested LSG resulted in significant improvement or resolution of T2DM in all the 30 patients with CR 63%(19/30) and PR 37%(11/30). Conclusions LSG can lead to significant changes in controlling glycemia on morbidly obese patients with T2DM in 6 months. Long-term efficacy needs further follow-up.