腹腔镜下袖状胃切除术治疗高体重指数2型糖尿病的效果分析

目的探讨腹腔镜袖状胃切除术(LSG)治疗高体重指数2型糖尿病(T2DM)患者的可行性及疗效的稳定性。 方法回顾性分析2010年至2016年间两个医院24例实施LSG的T2DM患者的临床资料，所有数据建立完整的excel表格，采用SPSS 17.0分析。术前术后体重和糖化血红蛋白(HBALc)水平以( ±s)表示，采用t检验；分类数据以频率和百分比表示，采用卡方检验。P<0.05认为差异有统计学意义。 结果24例患者平均基线体重为(117.2±30.2) kg，在术后3个月、6个月、12个月和24个月时显著下降至(100.3±22.1) kg、(91.6±22.4) kg、(81.3±16.5) kg和(80.3±14.3) kg, P<0.001。术前平均基线HbA1c为(8.5±2.2)%，分别在3个月、6个月、12个月和24个月显著降低至(6.4±1.6)%，(5.8±1.1)%, (5.7±0.7)%和(5.3±0.6)% P<0.001。19例接受袖状胃切除术的T2DM患者停止使用胰岛素和口服降糖药，根据血糖控制标准，24例患者24个月缓解率达79.2%。除1例继续使用2种降压药外，其余高血压患者(17例)停止降压药治疗。 结论LSG治疗高体重T2DM患者，方法简单，手术安全，治疗效果确切，值得在临床中普遍推广应用。

Clinical Analysis of laparoscopic sleeve gastrectomy in treating patients with type 2 diabetes and high BMI

Objective To investigate the feasibility and efficacy of laparoscopic sleeve gastrectomy(LSG) in the treatment of patients with type 2 diabetes(T2 DM) and high body mass index(BMI). Methods The clinical data of 24 patients with T2DM and high BMI who underwent LSG were analyzed retrospectively from 2010 to 2016. Statistical analysis were performed by using SPSS 17.0 software package. Measurement data such as preoperative/postoperative body weight and HbAlc levels were expressed as (x±s) and examined by using independent t-test. Count data were expressed as frequency and percentage, and were compared by using χ^2 test. A P value of <0.05 was considered as statistically significant difference. Results The average baseline weight of 24 patients was(117.2±30.2) kg, which decreased significantly to(100.3±22.1) kg,(91.6±22.4) kg,(81.3 ± 16.5) kg and(80.3 ± 14.3) kg at 3 months, 6 months, 12 months and 24 months after surgery respectively(P<0.001). The preoperative average baseline HbA1 c was(8.5±2.2)%, which was significantly decreased to(6.4±1.6)%,(5.8±1.1)%,(5.7± 0.7)% and(5.3±0.6)% at 3 months, 6 months, 12 months, and 24 months, respectively(P<0.001). 19 patients with type 2 diabetes who underwent sleeve gastrectomy discontinued insulin and oral hypoglycemic agents. According to the level of blood glucose control, remission rate of 24 patients was 79.2% 24 months after surgery. Except one case, other 17 patients with hypertensive stopped antihypertensive treatment after surgery. Conclusion LSG is a safe,feasible and effective for the treatment of patients with T2 DM and high BMI. It is worthy of widespread clinical application.