腹腔镜袖状胃切除术治疗肥胖症的疗效研究.doc

腹腔镜袖状胃切除术治疗肥胖症的疗效分析 摘要 目的： 探讨腹腔镜袖状胃切除术(Laparoscopic sleeve gastrectomy,LSG )治疗肥胖症及 相尖代谢性疾病的手术安全性及近期疗效。 方法： 收集2013年2月至2015年3月在山西大医院行LSG术的13例肥胖症患者的术 前病历资料及术后随访资料?分析并评价患者术前及术后体重、体重指数(body mass index,BMI )、超重体重百分比(the percentage of excess weight loss,EWL% )、糖脂代 谢指标及其他相尖代谢性疾病检测指标的变化。 结果： 手术顺利完成?无中转开腹?术中无大量出血?术后无胃出血、胃漏、胃食管反 流等严重并发症。术后随访，病人体重、BMI较术前下降明显(p0.05 )，EWL%呈 逐渐上升趋势；部分患者随访至术后12个月发现体重下降趋势减缓，进入平台期。 随访过程中还发现肥胖症相尖代谢性疾病，如糖尿病、高胰岛素血症、高甘油三酯血 症、低高密度脂蛋白症、高血压等较术前明显改善。 结论： 单纯性肥胖或合并相尖代谢性疾病患者行LSG术治疗后早期效果明显?因病例 数少和随访时间短，中远期效果仍待观察。 尖键词：肥胖症；腹腔镜袖状胃切除术；临床疗效 Therapeutic analysis of laparoscopic sleeve gastrectomy forobesity Abstract Objective : To evaluate the surgical safety and the short-term effect of Laparoscopic sleeve gastrt- my (LSG) for the obesity and related metabolic diseases. Methods : The clinical date of 13 obesity patients performed laparoscopic sleeve gastrectomy surgery between February 2013 and March 2015 in Shanxi Dayi hospital were analyzed retr- opectively.Including preoperative and postoperative weight,body mass index(BMI)jhe percentage of excess body weight loss (EWL%),glucose and lipid metabolism indicators and other related metabolic disorders. Results : All the operations were successfully performed in all the 13 patients with no conversion to open surgery.no intraoperative bleeding.no serious postoperative complications stom- ch bleeding,stomach leak,gastroesophageal reflux and so on,During the postoperative foil- ow?up.the weight, BMI of patients decreased significantly compared with preoperative (p0?05), EWL% showed a gradual upward trend;some patients slowed down the weight 1- oss trend and got platform at 12th month after surger.The follow-up found that obesity related metabolic diseases,diabetes,hyperinsulinemia.hypertriglyceridemiajow high-density lipoprotein disorders,hypertension improved significantly compared with the preoperative. Conclusions : The short-term effect of LSG for obesity and related metabolic diseases is significant, but because