摘要
目的探讨腹腔镜胃旁路术（LGBP）治疗单纯性肥胖症患者的效果及其影响因素。方法回顾性分析2010年5月至2011年12月间南京医科大学第一附属医院普通外科实施LGBP的41例单纯性肥胖症患者的临床资料，观察手术时间、术中及术后并发症，以及术前、术后的体质量指数（BMI）有多余体质量减少率（EWL）的改善情况，分析与手术疗效相关的因素。结果41例患者全部成功接受腹腔镜下手术。无中转开腹和围手术期死亡病例。手术时间（229±96）min，术中出血（15±3）ml，术后住院时间（5．7±1．7）d。术后1、3、6、9及12个月，患者EWL分别为24．2％、45．6％、60．1％、66．5％和69．0％。术后近期疗效（EWL）与术前BMI呈负相关（P〈0．01），而与患者年龄、性别及腰臀比无相关性（Ｐ〉0．05）。中心型肥胖（腰臀比大于或等于I）与外周型肥胖（腰臀比小于1）以及有无接受规范化手术治疗的患者，术后近期疗效的差异均无统计学意义（均P〉0．05）；但行规范化治疗者手术时间及术后住院时间均明显缩短（均P〈0．01）。结论LGBP治疗单纯性肥胖症的近期效果显著，其疗效与患者术前BMI呈负相关。规范化治疗尽管未能提高近期治疗效果，但可明显缩短手术时间及术后住院时间。
Objective To evaluate the outcomes and factors related to weight loss after laparoscopic gastric bypass （LGBP） in obese patients. Methods Forty-one obese patients who underwent LGBP from May 2010 to December 2011 in the First Affiliated Hospital of Nanjing Medical University were followed up. The operative time, intraoperative complications, postoperative complications, preoperative body mass index （BMI）, postoperative BMI, and excess weight loss rate （EWL） were determined and their correlation with efficacy were analyzed. Results All the surgeries were successful without conversions or perioperative deaths. The average operative time was （229±96） rain, intraoperative blood loss was （ 15±3 ） ml, postoperative hospital stay was （5.7± 1.7） d. Patients were fallowed up for 3-12 months. The average EWL at 1, 3, 6, 9, and 12 months after operation was 24.2%, 45.6%, 60.1%, 66.5% and 69.0%. The EWL was negatively correlated with preoperative BMI （P〈0.01）, but not correlated with age, gender, and waist-hip ratio （all P〉0.05）. Postoperative short- term EWL did not differ between central obesity patients and peripheral obesity patients, and before and after standardized treatment （both P〉0.05）. After standardization, however, operative time and postoperative hospital stay were significantly reduced（P〈O.01 ）. Conclusions LGBP is an effective and feasible treatment for obesity patients. Short-term efficacy after surgery is negatively correlated with preoperative BMI. Standardization may reduce operative time and postoperative hospital stay, but not associated with imoroved short-term outcomes.
出处
《中华胃肠外科杂志》
CAS
2012年第11期1120-1124,共5页
Chinese Journal of Gastrointestinal Surgery
