腹腔镜下改良Roux-en-Y胃空肠转流术治疗2型糖尿病：附11例报告

目的 探讨腹腔镜下改良Roux-en-Y单纯胃空肠转流术治疗2型糖尿病的临床疗效.方法 回顾性分析11例接受腹腔镜下改良Roux-en-Y单纯胃空肠转流术治疗2型糖尿病患者的临床资料,分析手术前后口服糖耐量及C肽、胰岛素刺激释放试验的变化.结果 术后1个月患者BMI(体重指数)无明显变化,口服糖耐量及C肽、胰岛素刺激释放试验均较术前显著好转(P＜0.05),糖化血红蛋白有明显下降趋势,糖尿病症状获得明显缓解.其中2例随访时间超过9个月,3例随访时间超过3个月,术后BMI无明显变化,糖化血红蛋白、空腹血糖及餐后2 h血糖均较术前有显著缓解.结论 腹腔镜下改良Roux-en-Y单纯胃空肠转流术是非肥胖型和轻度肥胖型2犁糖尿病一种有效的治疗方法.

Modified laparoscopic Roux-en-Y gastric bypass for type 2 diabetes mellitus: a report of 11 cases

Objective:To explore the treatment of type 2 diabetes mellitus (T2DM) patients by modified laparoscopic Roux-en-Y gastric bypass.
Methods:The clinical records of 11 patients with T2DM who underwent modified laparoscopic Roux-en-Y gastric bypass were retrospectively analyzed. The clinical parameters such as oral glucose tolerance test (OGTT), C-peptide releasing test (CPRT) and insulin releasing test  (IRT) were evaluated pre-and postoperatively.
Results:At one mnth after operation, there were no significant changes in BMI (P>0.05), but glycosylated hemoglobin，OGTT, CPRT and IRT were significantly ameliorated (P<0.05), and the diabetic symptoms were markedly relieved. Among them, 2 patients were followed up for more than 9 months, and 3 patients for more than 3 months.In these patients, there were no significant changes in BMI, but glycosylated hemoglobin，OGTT, CPRT and IRT were significantly ameliorated compared to before operation.
Conclusions:The modified laparoscopic Roux-en-Y gastric bypass is an effective treatment modality for non-and mild-obesity T2DM.