腹腔镜迷你胃转流术治疗2型糖尿病

Laparoscopic mini-gastric bypass for the treatment of type 2 diabetes mellitus

摘要:

目的 回顾2010年5月-2012年6月进行的12例腹腔镜迷你胃转流术治疗2型糖尿病的资料并进行疗效分析。方法 患者确诊2型糖尿病，全身麻醉下进行腹腔镜迷你胃转流术12例。其中，男性8例，女性4例；年龄42～59岁，平均（47±10）岁，术中计算手术时间、出血量，分别在术前以及术后15 d、1、3及6个月对检测患者空腹血糖、餐后2 h血糖（2h PBG）、空腹C肽、胰岛素抵抗指数、空腹胰岛素（Fins）、糖化血红蛋白（HbA1c）的水平、营养状况以及并发症进行随访。结果 患者手术顺利，平均手术时间（140±55）min，术中出血平均（90±25）mL；腹腔镜迷你胃转流术后15 d、1、3及6个月与术前相比空腹血糖、2 h PBG、空腹C肽及胰岛素抵抗指数改善显著（P <0.05），HbA1c术后3个月明显改善（P <0.05）；Fins差异无显著性（P >0.05），患者术后恢复较好，没有并发症发生，术后3个月不用任何降糖药物，血糖控制良好，补充相关微量元素的情况下没有发生营养不良和贫血。结论 腹腔镜迷你胃转流术治疗2型糖尿病安全、有效，是术后胰岛细胞功能明显改善的一种术式。

Abstract:

【Objective】 To review 12 cases of type 2 diabetes mellitus using laparoscopic Mini-gastric bypass from May 2010 to June 2012 and to analyze the clinical outcome. 【Methods】 The patient was diagnosed as type 2 diabetes mellitus definitely, underwent laparoscopic mini-gastric bypass in general anesthesia in vein. There were 8 male and 4 female patients, with average age of (47±10) years. Intraoperative calculating operation time, blood loss,the post-operative recovery, serum glucose, 2-hour postprandial blood glucose (2HBG), C-peptide, Homa-IR, glycated hemoglobin(HbA1c) levels, nutrition status and complications were analyzed. 【Results】 The 12 cases were successfully performed on without any complications. The operation time was (140±55) min and (90±25) mL blood was lost in 15 days, 3 and 6 months compared with preoperative fasting glucose, 2 hPG, fasting C-peptide, insulin resistance index, improved significantly (P <0.05), HbA1c was significantly improved 3 months after (P <0.05); Fins had no statistically significance (P >0.05). In the 3 months postoperative the post-operative level of serum glucose was normal without any antidiabetic medicine, in the condition of added trace elements no malnutrition or anemia occurred. 【Conclusion】 Laparoscopic mini-gastric bypass surgery can treat type 2 diabetes safely, effectively, islet cell function was improved significantly after a surgery.