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腹腔镜袖状胃切除术对自身肥胖患者代谢综合征参数的影响。

The influence of laparoscopic sleeve gastrectomy on metabolic syndrome parameters in obese patients in own material.

机构信息

1st Department of General and Endocrinological Surgery, University Hospital in Bialystok, Medical University of Bialystok, M.Skłodowskiej-Curie 24A, 15-276 Bialystok, Poland.

出版信息

Obes Surg. 2012 Jan;22(1):13-22. doi: 10.1007/s11695-011-0530-y.

Abstract

Popularity of laparoscopic sleeve gastrectomy (LSG) has been growing gradually. The aim of this study was to determine changes in metabolic syndrome parameters as well as insulin, total cholesterol, and LDL cholesterol, and to describe the influence of body weight loss on co-morbidities in obese patients after LSG with 1-year follow-up. The material consists of 130 patients who underwent LSG (2007-2010) in order to treat morbid obesity and who had met before the surgery at least three criteria necessary for the diagnosis of metabolic syndrome according to the International Diabetes Federation. The influence of LSG on co-morbidities was also analyzed. During 1-year follow-up after LSG, we obtained a statistically significant decrease in BMI (from 53.18 ± 7.5 kg/m(2) to 31.4 ± 3.75 kg/m(2), p < 0.00001) and a reduction in waist circumference. Twelve months after the surgery, excess weight loss (EWL) was 59.42 ± 7.21% and excess body mass index loss (EBL) was 61.03 ± 6.50%. One year after LSG, the amount of patients with diagnosed metabolic syndrome decreased in 61 patients (53.08%). After 1 year, none of the patients met five criteria of metabolic syndrome. According to efficiency in body mass loss presented by %EWL and %EBL, LSG is gaining approval as a method of obesity and metabolic syndrome treatment, although it is a relatively new procedure. LSG is rather an easy procedure; the time of performance and hospitalization are shorter which entails normalization in all parameters of metabolic syndrome and decreases the percentage of obese patients with metabolic syndrome.

摘要

腹腔镜袖状胃切除术(LSG)的应用日渐广泛。本研究旨在探讨 LSG 术后 1 年对肥胖患者代谢综合征(MS)相关参数及胰岛素、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)的影响,并评估其对合并症的改善作用。

研究共纳入 130 例行 LSG 的肥胖患者,这些患者均因病态肥胖而接受手术治疗,且术前均符合国际糖尿病联盟(IDF)提出的 MS 诊断标准中的至少 3 项标准。同时分析了 LSG 对合并症的影响。

LSG 术后 1 年,患者 BMI(由 53.18±7.5kg/m²降至 31.4±3.75kg/m²)及腰围均明显下降,差异有统计学意义(P<0.00001)。术后 12 个月时,患者的 EWL 及 EBL 分别为 59.42±7.21%和 61.03±6.50%。术后 1 年,61 例(53.08%)患者的 MS 被诊断为缓解。术后 1 年,无一例患者符合 MS 全部 5 项诊断标准。

LSG 术后 1 年,无论以 EWL 还是 EBL 评估,患者的体质量均有明显下降,且代谢综合征的各项参数也逐渐趋于正常,提示 LSG 作为肥胖及 MS 的治疗手段正得到广泛认可。虽然 LSG 是一种相对较新的术式,但操作简单,手术时间及住院时间均较短。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cad1/3257432/ce767fd62a70/11695_2011_530_Fig1_HTML.jpg

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