腹腔镜减重与代谢手术治疗代谢综合征的效果分析

doi:10.3969/j.issn.1007-3205.2021.06.012

河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (6): 676-679,685.doi: 10.3969/j.issn.1007-3205.2021.06.012

腹腔镜减重与代谢手术治疗代谢综合征的效果分析

1.河北医科大学第二医院肥胖与糖尿病外科，河北石家庄 050000；2.河南科技大学附属黄河三门峡医院重症医学科，
河南三门峡 472000；3.河南科技大学附属三门峡市中心医院神经内科，河南三门峡 472000

出版日期:2021-06-25 发布日期:2021-07-05
作者简介:韩晓凯（1990-），男，山西昔阳人，河北医科大学第二医院主治医师，医学硕士，从事微创肥胖与糖尿病诊治研究。
基金资助:
河北省医学适用技术跟踪项目（G2018029)

Analysis on effect of laparoscopic bariatric and metabolic surgery on metabolic syndrome

1.Department of Metabolic and Bariatric Surgery, the Second Hospital of Hebei Medical University,
Shijiazhuang 050000, China； 2.Department of Critical Care Medicine, Huanghe Sanmenxia Hospital
Affiliated to Henan University of Science and Technology, Sanmenxia 472000, China；
3.Department of Neurology， Sanmenxia Central Hospital Affiliated to Henan
University of Science and Technology, Sanmenxia 472000, China

Online:2021-06-25 Published:2021-07-05

摘要/Abstract

摘要： 目的探讨代谢综合征患者行腹腔镜减重与代谢手术后的效果及影响。
方法回顾性分析行腹腔镜减重与代谢手术的代谢综合征患者100例的临床资料，记录术前及术后1年间的体重、体重指数（body mass index BMI)、多余体重百分比(percentage of excess body weight，EWI%)、三酰甘油（triglyceride，TC)、高密度脂蛋白（high density lipoprotein，HDL）、空腹血糖（fasting plasma glucose，FPG)、糖化血红蛋白(glycosylated hemoglobin，HbA1c)、胰岛素抵抗指数（homeostasis model assessment insulin resistance index，HOMA-IR）、Epworth嗜睡量表（epworth sleepiness scale，ESS）评分、最低血氧饱和度（lowest arterial O2 saturation，LSaO2)及2型糖尿病、高血压、脂肪肝、关节退行性改变的改善情况。
结果 100例患者均顺利完成手术，患者术后体重、BMI、TC、FPG、HbA1c、HOMA-IR、ESS评分逐渐降低，术后3个月、6个月、12个月体重、BMI明显低于术前，术后6个月、12个月TC明显低于术前，术后1个月、3个月、6个月、12个月FPG、HbA1c、HOMA-IR均明显低于术前，术后3个月、6个月、12个月ESS评分明显低于术前，差异有统计学意义（P＜0.05）。患者术后HDL、LSaO2逐渐升高，术后6个月、12个月HDL明显高于术前，术后3个月、6个月、12个月LSaO2明显高于术前，差异有统计学意义（P＜0.05）。术后12个月，2型糖尿病、高血压、脂肪肝、关节退行性改变发生率均明显低于术前，差异有统计学意义（P＜0.05）。

结论腹腔镜减重与代谢手术治疗以肥胖为基础的代谢综合征安全可靠、疗效显著。

关键词: 代谢综合征, 减重代谢手术, 肥胖

Abstract: Objective To explore the efficacy of laparoscopic bariatric and metabolic surgery for patients with metabolic syndrome and itseffect.
Methods The clinical data of 100 patients with metabolic syndrome who underwent laparoscopic bariatric and metabolic surgery were retrospectively analyzed. Body weight, body mass index(BMI), percentage of excess body weight, triglyceride(TC), high density lipoprotein(HDL), fasting plasma glucose(FPG), glycosylated hemoglobin(HbA1c), homeostasis model assessment insulin resistance index(HOMA-IR), Epworth sleepiness scale(ESS), lowest arterial O2 saturation(LSaO2), as well as improvement of type 2 diabetes mellitus(T2DM), hypertension, fatty liver and knee joint degeneration were recorded before and at 1 year after surgery.
Results The surgery was successfully completed for all 100 patients. The body weight, BMI, TC, FPG, HbA1c, HOMA-IR, and ESS scores of patient were gradually decreased after operation. The body weight and BMI at 3, 6 and 12 months after operation were significantly lower than those before operation. The TC at 6 and 12 months after operation was significantly lower than that before operation. FPG, HbA1c and HOMA-IR at 1, 3, 6 and 12 months after operation were significantly lower than those before operation. The ESS scores at 3, 6 and 12 months after operation were significantly lower than those before operation, and the difference was statistically significant(P＜0.05). HDL and LSaO2 of patient were increased gradually after operation; HDL at 6 and 12 months after operation was significantly higher than that before operation, and LSaO2 at 3, 6 and 12 months after operation was significantly higher than that before operation, suggesting significant differences(P＜0.05). At 12 months after operation, the incidence of T2DM, hypertension, fatty liver and degenerative change of joint were significantly lower than that before operation, and the difference was statistically significant(P＜0.05).
Conclusion Laparoscopic bariatric and metabolic surgery are safe, reliable and effective in the treatment of obesity-associated metabolic syndrome.

Key words: metabolic syndrome, metabolic and bariatric surgery, obesity

韩晓凯, 韩晓华, 张建娥, 李涛, 薛涵月, 康建省. 腹腔镜减重与代谢手术治疗代谢综合征的效果分析[J]. 河北医科大学学报, 2021, 42(6): 676-679,685.

HAN Xiao-kai, HAN Xiao-hua, ZHANG Jian-e, LI Tao, XUE Han-yue, KANG Jian-sheng. Analysis on effect of laparoscopic bariatric and metabolic surgery on metabolic syndrome[J]. Journal of Hebei Medical University, 2021, 42(6): 676-679,685.

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腹腔镜减重与代谢手术治疗代谢综合征的效果分析

Analysis on effect of laparoscopic bariatric and metabolic surgery on metabolic syndrome

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