中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2018, Vol. 40 ›› Issue (5): 610-616.doi: 10.3881/j.issn.1000-503X.10717

• 减重综合治疗论坛 • 上一篇    下一篇

腹腔镜袖状胃切除术治疗肥胖症及其合并症的疗效分析

李子建1,于健春1(),康维明1,马志强1,叶欣1,朱惠娟2,于康3,陈伟3,刘燕萍3,李涛4,肖毅5,罗金梅5,张抒扬6   

  1. 1中国医学科学院,北京协和医学院,北京协和医院基本外科,北京 100730
    2中国医学科学院,北京协和医学院,北京协和医院内分泌科,北京 100730
    3中国医学科学院,北京协和医学院,北京协和医院营养科,北京 100730
    4中国医学科学院,北京协和医学院,北京协和医院心理科,北京 100730
    5中国医学科学院,北京协和医学院,北京协和医院呼吸内科,北京 100730
    6中国医学科学院,北京协和医学院,北京协和医院心内科,北京 100730
  • 收稿日期:2018-07-18 出版日期:2018-10-30 发布日期:2018-11-07
  • 通讯作者: 于健春 E-mail:yu-jch@163.com

Effectiveness of Laparoscopic Sleeve Gastrectomy in Treating Obesity and Its Co-morbidities

LI Zijian1, YU Jianchun1(), KANG Weiming1, MA Zhiqiang1, YE Xin1, ZHU Huijuan2, YU Kang3, CHEN Wei3, LIU Yanping3, LI Tao4, XIAO Yi5, LUO Jinmei5, ZHANG Shuyang6   

  1. 1 Department of General Surgery, CAMS and PUMC,Beijing 100730,China
    2 Department of Endocrinology, CAMS and PUMC,Beijing 100730,China
    3 Department of Nutrition, CAMS and PUMC,Beijing 100730,China
    4 Department of Psychology, CAMS and PUMC,Beijing 100730,China
    5 Department of Respiratory Medicine, CAMS and PUMC,Beijing 100730,China
    6 Department of Cardiology,PUMC Hospital, CAMS and PUMC,Beijing 100730,China;
  • Received:2018-07-18 Online:2018-10-30 Published:2018-11-07
  • Contact: Jianchun YU E-mail:yu-jch@163.com

摘要:

目的 总结腹腔镜袖状胃切除术(LSG)后的长期减重效果及合并症改善情况,评估手术安全性。方法 回顾性分析2012年8月至2017年8月在北京协和医院基本外科行LSG手术的病态肥胖患者的临床资料,总结术后长期有效率即减重效果[多余体质量减轻百分比(%EWL)]及合并症改善情况,评估围手术期和术后远期并发症的发生情况。结果 共75例肥胖患者完成LSG,男28例,平均体质量指数(BMI)(47.3±7.5)kg/m 2;女47例,平均BMI(41.1±7.0)kg/m 2。常见合并症是肝功异常(53.3%)、血脂异常(52.0%)、阻塞性睡眠呼吸暂停(45.3%)、2型糖尿病(38.7%)和高血压(37.3%),术后3年缓解率分别是75.0%、58.3%、83.3%、75.0%和58.3%。术后1、2、3年的平均%EWL分别是81.6±34.7、80.9±30.2、79.7±30.8;达到成功减重(%EWL>50%)的比例分别为81.7%(n=49)、81.0%(n=34)、79.3%(n=23)。术后近期严重并发症(Clavien-Dindo分级>Ⅱ级)发生率为2.6%;远期并发症中轻度胃食管反流最多(8%),口服抑酸剂可缓解。 结论 LSG可在术后长期有效减轻中国肥胖患者的体质量,改善其合并症;手术本身相对安全,值得推广。

关键词: 肥胖症, 腹腔镜袖状胃切除术, 长期减重, 合并症改善, 并发症

Abstract:

Objective To analyze the effectiveness and safety of laparoscopic sleeve gastrectomy (LSG) in treating obesity and its co-morbidities.Methods The clinical data of obese patients undergoing LSG in Peking Union Medical College Hospital from August 2012 to August 2017 were retrospectively analyzed. Medium-term outcome measures included excess weight loss (%EWL),co-morbidity improvement,and complications.Results Seventy-five obese patients comprising 28 men[ body mass index(BMI):(47.3±7.5)kg/m 2) ] and 47 women [BMI (41.1±7.0) kg/m 2] were enrolled in this analysis. The common co-morbidities were liver dysfunction (53.3%),dyslipidemia (52.0%),obstructive sleep apnea (45.3%),type 2 diabetes mellitus (38.7%),and arterial hypertension (37.3%),which were improved by 75.0%,58.3%,83.3%,75.0% and 58.3% three years after surgery. The mean %EWL at 1,2,and 3 years after surgery was 81.6±34.7,80.9±30.2 and 79.7±30.8,respectively. The proportions of patients achieving successful weight loss were 81.7% (n=49),81.0% (n=34),and 79.3% (n=23) at 1,2,and 3 years (%EWL>50%). Early severe complications (Clavien-Dindo classification>Ⅱ) occurred in 2.6% of patients,and the most common late complications was gastroesophageal reflux disease,which could be relieved by acid suppressants. .Conclusion LSG is effective and safe in treating obesity and its co-morbidities.

Key words: obesity, laparoscopic sleeve gastrectomy, long-term weight loss, co-morbidities improvement, complications

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