腹腔镜下胃旁路术治疗2型糖尿病

目的：探讨腹腔镜下胃旁路手术治疗2型糖尿病的有效性及可行性。方法参照2011年中国《手术治疗糖尿病专家共识》，选择2型糖尿病患者实施胃旁路手术，并回顾性分析其中随访满12个月的52例患者的糖代谢指标、胰岛细胞功能指标。结果本组2型糖尿病患者术后治疗有效45例（86.5%），完全缓解38例（73.1%），部分缓解7例（13.5%），无效7例（13.5%）。术后空腹血糖、餐后2 h 血糖、糖化血红蛋白较术前明显下降（P〈0.05）；胰岛素与术前比较有统计学差异，但是 C 肽无统计学意义。虽然术后有一定的手术相关并发症，但总体可控。结论腹腔镜下胃旁路手术是2型糖尿病患者一种有效可行的治疗方法，但需严格把握手术指征；术后胰岛素敏感性的提高发挥重要的治疗作用。

The treatment of type 2 diabetes mellitus by laparoscopic gastric bypass surgery

Objective To evaluate the efficacy and feasibility of laparoscopic gastric bypass surgery in Chinese patients with type 2 diabetes mellitus （T2DM）. Methods T2DM patients were studied before and after the laparoscopic gastric bypass surgery according to ＆quot;expert consensus of surgical treatment for diabetes＆quot; 2011, China. Glucose metabolism indicators and islet cell function of 52 patients who were over 12 months of follow-up were studied by retrospective analysis. Results There were 45 （86.5%） patients having an improvement in glucose metabolism indicators after surgery. Complete remission, partial remission and non-effect were 38 （73.1%）, 7 （13.5%） and 7 （13.5%）, respectively. Fasting plasma glucose, postprandial 2-hour blood glucose, glycated hemoglobin decreased significantly compared with the preoperative （P〈0.05）; Insulin level was significantly lower than before the operation, with significant difference, but there was no obvious change in the level of C-peptide. Although some procedure-related complications occurred postoperatively, it can be controlled overall. Conclusions Laparoscopic gastric bypass surgery in patients with T2DM is an effective and feasible treatment method, but it needs a strictly thorough evaluation; improvement of postoperative insulin sensitivity plays an important role on outcomes.