经口腔置入OrvilTM在腹腔镜全胃切除（LTG）食管-空肠.docVIP

技术工作总结报告 腹腔镜胃空肠转流术在肥胖型2型糖尿病治疗中的临床应用研究 陈宏 雒洪志 周小雕 余元龙 梁义 王存川 中山市人民医院普外三科 中山 528400 暨南大学附属第一医院胃肠外科 广州 510000 【摘要】 目的 探讨腹腔镜下Roux-en-Y胃空肠转流术（LRYGB）对肥胖型2型糖尿病的临床疗效。方法 以42例肥胖型2型糖尿病患者作为研究对象，实施LRYGB，观察患者术前及术后体重指数（BMI）、空腹血糖、餐后2小时血糖、C肽及糖化血红蛋白，并比较胰岛素抵抗指数（HOMA-IR＝FPG×Fins／22.5）的变化情况，分析手术预后的相关因素。结果42例患者手术顺利，均无术中并发症的发生及中转开腹。术后随访3个月。术后3月BMI、空腹血糖、餐后2小时血糖、糖化血红蛋白均较术前明显降低（P0.05）（P=0.08））（）（P0.05）100% ( 42/42)，治愈率90.4%(38/42)， 无效率0（0/）The clinic study of laparoscopic gastric bypass in obese type 2 diabetes mellitus therapy Chen Hong ,Luo Hong-zhi, Zhou Xiaodiao，Yu Yuanlong,Liang Yi ,Wang Cunchuan Department of General Surgery of the People’s Hospital of Zhongshan City, Zhongshan 528400 Department of Gastrointestinal Surgery of the first Affiliated Hospital of Jinan University, Guangzhou510000 【Abstract】 Objective To investigate the clinic effects of laparoscopic Roux-en-Y gastric bypass in obese type 2 diabetes mellitus therapy. Methods Fourt inpatients suffered obese type 2 diabetes mellitus were underwent LRYGB. The index changes of BMI(body mass index), fasting blood glucose (FBG), 2-hour postprandial blood glucose (2 h PBG), C peptide (C-P) and glycosylated hemoglobin(HbA1C) were observed preoperatively and postoperatively, the insulin resistance index( HOMA－IR) was also calculated and compared.and the prognostic factors were analyzed. Results All the inpatients were successfully underwent LRYGB without intraoperative complications or conversion to open surgery, and were followed up for three months. The levels of BMI、FBG、2h PGB and glycosylated hemoglobin after months were decreased compared with those before operations(P0.05). The level of C-P begin decrease after one month, and decrease obviously after three months, but there were no differernt compared with before operations (P=0.08) ,and HOMA-IR decreased from （7.16±0.65） to（）（P＜0.05）. Conclusion LRYGB is a reliable treatment for obese type 2 diabetes mellitus short-term therapy, can significantly reduce BMI and plasm