腹腔镜下胃旁路术治疗非肥胖2型糖尿病临床疗效观察.docVIP

腹腔镜下胃旁路术治疗非肥胖2型糖尿病临床疗效观察 　　【摘要】目的观察腹腔镜下胃旁路术(LRYGB)对非肥胖2型糖尿病患者临床疗效。方法#8195;对2011年1月~2012年10月间本院实施LRYGB的2型糖尿病病患者中BMI28.0 kg/m216例患者的临床资料进行回顾性分析。结果#8195;平均手术时间145 min, 术中平均出血量35 ml, 术后平均9.3 d, 术后出现吻合口出血1例, 无死亡病例及严重的手术并发症。术后患者1个月空腹血糖及餐后血糖明显下降(P0.01), 术后3个月至半年降至正常水平。糖化血红蛋白在术后3个月开始明显下降(P0.01), 术后半年降至正常水平。体质量指数在术后1个月有明显下降, 术后6个月~12个月期间体质量指数趋于稳定, 无明显变化。结论#8195;LRYGB后2型糖尿病患者血糖代谢明显改善, 但其远期疗效还需进一步研究。 　　【关键词】2型糖尿病；胃旁路术；腹腔镜 　　 　　Effect of Laparoscopic Roux-en-Y Gastric Bypass in non-obese patients with type 2 diabetes mellitus ZHANG Xiang-wen, LIANG Huai-zhu, ZHAO Guo-hua, et al. Department of General Surgery, Dalian Municipal Hospital, Dalian 116033, China 　　【Abstract】#8195;Objective#8195;To evaluate the efficacy of Laparoscopic Roux-en-Y Gastric Bypass(LRYGB) in non-obese patients with type 2 diabetes mellitus. Methods#8195;LRYGB was performed in 16 T2DM patients with BMI28 kg/m2 in our hospital from January 2011 to October 2012. Preoperative date including BMI, fasting plasma glucose, 2 h postprandial glucose and glycosylated hemoglobin were compared with the date collected at 1,3,6 and 12 postoperative months. Results#8195;The mean operative time was 145 min, the mean bleeding was 35 ml, and the mean postoperative time was 9.3 days. Anastomosis bleeding occurred in 1 case. There were no mortality and significant surgical complications occurred. Both fasting plasma glucose and 2 h postprandial glucose were significantly decreased at 1 month after operation, and the changes were lasted for 12 month. Significant reduction in glycosylated hemoglobin from 3 months after operation was observed. Glycosylated hemoglobin dropped to normal level from 6 months post-operation. BMI obviously decreased after 1 month, and there was no drop from 6 month comparing with 12 month after operation. Conclusion#8195;LRYGB is an effective treatment to non-obese patients with type 2 diabetes mellitus. It has long-term efficacy and needs further research. 　　【Key words】#8195;Type 2 diabetes mel