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...     

腹腔镜袖状胃切除术治疗肥胖合并2型糖尿病的早期临床疗效分析

目的探究腹腔镜袖状胃切除术(LSG)治疗肥胖合并2型糖尿病(T2MD)的早期临床疗效。方法回顾性分析2016年6月至2018年12月收治的58例肥胖症且合并T2MD患者临床资料。27例患者纳入LSG组,31例行腹腔镜胃旁路术患者纳入LRYGB组。使用SPSS24.0软件进行统计学分析,两组患者围手术期指标、糖脂代谢指标等计量资料采用(x±s)表示,组间比较采用独立样本t检验;并发症发生率、T2MD治疗效果两组间比较采用χ^2检验。以P<0.05为差异有统计学意义。结果58例患者均成功在腹腔镜下完成手术。LSG组手术用时明显短于LRYGB组(P<0.05);两组在手术出血量、术后排气时间、术后住院天数及术后并发症发生率等,差异无统计学意义(P>0.05)。术后3个月及6个月,两组患者BMI、血糖代谢指标、脂代谢指标均较术前明显下降(P<0.05),而营养指标白蛋白无明显变化(P>0.05);两组间差异无统计学意义(P>0.05)。LSG组对T2MD的临床完全缓解率为77.8%,LRYGB组为74.2%,两组治疗效果相当(P>0.05)。结论LSG术作为独立减重术式安全有效,早期对于肥胖合并T2MD患者疗效佳,值得临床推广。     

腹腔镜袖状胃切除术治疗肥胖症合并2型糖尿病的近期疗效

肥胖症是指体质指数(body mass index,BMI)>33 kg/m2或BMI≥30 kg/m2同时合并危及生命的心肺疾病和(或)严重糖尿病等.近年来,减重手术已成为治疗肥胖症的有效方法之一.     

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...     

腹腔镜袖状胃切除治疗肥胖合并2型糖尿病的研究

探讨腹腔镜袖状胃切除术治疗肥胖合并2型糖尿病的效果。选取江津区中心医院拟实施手术治疗的90例肥胖合并2型糖尿病患者,采用随机数字表法分为A组和B组各45例,A组采用腹腔镜袖状胃切除术治疗、B组采用腹腔镜下胃旁路术治疗。对比两组手术时间、手术出血量、术后肛门排气时间、进食流质饮食时间;对比两组术前、术后1个月、术后3个月、术后6个月的空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)、空腹C肽,手术前及手术后6个月患者的体重指数(BMI)、腰围、额外体重占比(EWL)、血清甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。A组手术时间短于B组(P0.05);两组手术出血量、术后肛门排气时间、进流质饮食时间差异无统计学意义(P0.05);经重复测量的方差分析,A组和B组在术前、术后1个月、术后3个月、术后6个月的FPG、2hPG、HbA1c、空腹C肽测定值组间比较,差异无统计学意义(P0.05);但是两组患者的FPG、2hPG、HbA1c、空腹C肽在术后1个月、术后3个月、术后6个月均较本组术前呈显著降低趋势(P0.05);手术前、手术后6个月,A组和B组BMI、腰围、EWL值组间比较,差异无统计学意义(P0.05);术后6个月,两组BMI、腰围较本组术前均显著降低(P0.05);手术前、手术后6个月,A组与B组血清TG、TC、HDL-C、LDL-C值组间比较,差异无统计学意义(P0.05);术后6个月,两组血清TG、TC、LDL-C值较本组术前均显著降低(P0.05),HDL-C测定值较本组术前显著升高(P0.05)。腹腔镜袖状胃切除术治疗肥胖合并2型糖尿病的效果与腹腔镜下胃旁路术差异不大,均能够达到较好减重、控制血糖的目的,但是前者手术操作更简单。     

国内腹腔镜袖状胃切除术对肥胖合并2型糖尿病的近期疗效的Meta分析

目的探讨国内腹腔镜袖状胃切除术(LSG)对肥胖合并2型糖尿病(T2MD)的近期疗效。方法检索万方、知网中文数据库、Pub Med和Web of Science英文数据库,按照纳入和排除标准筛选文献,提取纳入文献中的相关数据,并对其进行方法学质量评价,对LSG治疗肥胖合并T2DM的近期疗效(术后空腹血糖和糖化血红蛋白水平)进行Meta分析。结果本研究共纳入7篇文献共计107例符合纳入条件的患者。Meta分析结果显示:1空腹血糖水平:术后6个月与术前比较以及术后12个月与术后6个月比较均明显下降(术后6个月与术前比较:MD=2.99,95%CI为2.39~3.60,P0.000 01;术后12个月与术后6个月比较:MD=0.56,95%CI为0.16~0.95,P=0.006)。2糖化血红蛋白水平:术后6个月与术前比较以及术后12个月与术后6个月比较均明显下降(术后6个月与术前比较:MD=2.24,95%CI为1.43~3.04,P0.000 01;术后12个月与术后6个月比较:MD=0.52,95%CI为0.22~0.81,P=0.000 6)。LSG术后患者空腹血糖和糖化血红蛋白呈下降趋势。结论 LSG治疗肥胖合并T2MD的近期疗效明显,其长期疗效还需要大样本临床随机对照研究数据支持。     

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

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.     

腹腔镜袖状胃切除术

患者女性，30岁，BMI36.6，诊断代谢综合征。患者平卧"大"字位，头高左侧高30°，主刀右侧站位。距幽门2 cm开始紧贴胃壁游离胃大弯，充分游离胃底，显露左侧膈肌脚及食道左侧，经口置入36 F减重胃管，沿胃管距幽门4 cm开始进行袖状胃裁剪，根据胃壁厚度应用不同钉脚高度的切割闭合钉，连续全层缝合加固胃切缘，并将胃切缘复位固定于大网膜及胰腺背膜，经主操作孔取出切除的胃组织，清理腹腔，放置引流管，缝合戳卡孔。