袖状胃切除术与迷你胃旁路手术对2型糖尿病疗效的比较研究
Comparative study between effect of sleeve gastrectomy and mini-gastric bypass on type 2 diabetes mellitus.
作者信息
Abdel-Rahim M Mahmoud, Magdy M Mostafa, Mohamad A Abdel-Maksoud
机构信息
Department of Surgery, Mataria Teaching Hospital, Cairo, Egypt.
Department of Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
出版信息
Diabetes Metab Syndr. 2018 Nov;12(6):949-954. doi: 10.1016/j.dsx.2018.06.001. Epub 2018 Jun 12.
OBJECTIVE
Comparative study between the effect of LSG and LMGB on patients with type 2 DM and BMI ≥ 35 kg/m.
STUDY DESIGN
A prospective comparative study which included 40 obese patients with type 2 DM(20 patients were operated for laparoscopic sleeve gastrectomy (LSG) and 20 patients for laparoscopic mini-gastric bypass (LMGB)), with mean age at LSG group 42.95 ± 7.63 with range of 31-59 years, at LMGB group was 42.9 ± 6.17 with range of 34-58 years.
RESULTS
In SG cases; complete remission occurred in 11 patients with percentage of 55% and failure of remission occurred in 9 patients with percentage of 45%. No cases developed partial remission in SG cases. In MGB cases; 15 developed diabetic remission with percentage of 75% (11 (55%) patients developed complete remission, 4 (20%) patients developed partial remission). Failure of remission occurs in 5 patients in MGB cases with percentage of 25%.
CONCLUSION
Based on our results, LSG and LMGB are efficient operations for reducing weight in morbidly obese patients and also in diabetic control in T2DM. LMGB might be superior to LSG in %EWL and T2DM remission after 1.5 year follow up.
目的
比较腹腔镜袖状胃切除术（LSG）和腹腔镜迷你胃旁路术（LMGB）对2型糖尿病且体重指数（BMI）≥35kg/m²患者的疗效。
研究设计
一项前瞻性对照研究，纳入40例肥胖的2型糖尿病患者（20例行腹腔镜袖状胃切除术（LSG），20例行腹腔镜迷你胃旁路术（LMGB）），LSG组平均年龄42.95±7.63岁，范围31 - 59岁，LMGB组平均年龄42.9±6.17岁，范围34 - 58岁。
结果
在LSG病例中，11例实现完全缓解，占比55%，9例缓解失败，占比45%。LSG病例中无部分缓解情况。在MGB病例中，15例实现糖尿病缓解，占比75%（11例（55%）完全缓解，4例（20%）部分缓解）。MGB病例中有5例缓解失败，占比25%。
结论
基于我们的研究结果，LSG和LMGB对于病态肥胖患者减重以及2型糖尿病的血糖控制均是有效的手术方式。随访1.5年后，在%EWL（额外体重减轻百分比）和2型糖尿病缓解方面，LMGB可能优于LSG。
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