摘要
目的探讨减重手术治疗超级肥胖(super-obesity,SO)病人的短期疗效及影响。方法回顾性分析2019年3月至2024年7月期间在武汉大学中南医院肥胖症与代谢病外科中心接受减重代谢手术的65例体重指数(body mass index,BMI)≥50 kg/m^(2) SO病人的临床资料,记录并分析其术前及术后1、3、6、12个月的BMI、多余体重减少百分比、总体重减少百分比、糖代谢、脂代谢、肝肾功能及尿酸的变化情况。结果65例SO病人均顺利完成减重手术,其中39例病人接受腹腔镜胃袖状切除术(laparoscopic sleeve gastrectomy,LSG),26例病人接受腹腔镜胃袖状切除术+空肠空肠旁路术(laparoscopic sleeve gastrectomy+jejunojejunal bypass,LSG+JJB),无中转开腹,术后无出血、胃漏、肺部感染及围手术期死亡等情况。术后随访6个月中,2组SO病人的BMI、糖代谢指标、脂代谢指标及肝肾功能指标均明显改善(均P<0.05)。(1)BMI:LSG组术前(53.68±2.69)kg/m^(2),术后6个月(38.89±3.57)kg/m^(2);LSG+JJB组术前(52.83±2.94)kg/m^(2),术后6个月(38.22±3.64)kg/m^(2)。(2)餐后2 h血糖:LSG组术前(9.96±4.08)mmol/L,术后6个月(6.45±2.04)mmol/L;LSG+JJB组术前(11.4±5.61)mmol/L,术后6个月(6.56±2.94)mmol/L。(3)尿酸:LSG组术前(508.95±133.89)μmol/L,术后6个月(389.11±102.13)μmol/L;LSG+JJB组术前(504.88±118.64)μmol/L,术后6个月(420.65±72.21)μmol/L。结论减重手术短期内治疗SO病人疗效显著,可有效改善和治愈肥胖相关的代谢疾病。
Objective To investigate the short-term efficacy and impact of bariatric surgery on super-obesity(SO)patients.Methods Clinical data of 65 SO patients with the body mass index(BMI)≥50 kg/m²who underwent bariatric metabolic surgery at Surgery Center for Bariatric&Metabolic Diseases,Zhongnan Hospital of Wuhan University,between March 2019 and July 2024 were retrospectively collected.Preoperative and postoperative(1,3,6,and 12 months postoperatively)parameters were recorded and analyzed,including BMI,percentage of excess weight loss(%EWL),percentage of total weight loss(%TWL),glucose metabolism,lipid metabolism,liver and kidney function,and uric acid levels.Results All 65 SO patients successfully underwent bariatric surgery without conversion to open surgery,postoperative bleeding,gastric leakage,pulmonary infections,or perioperative mortality.Among them,39 patients underwent laparoscopic sleeve gastrectomy(LSG),and 26 patients underwent laparoscopic sleeve gastrectomy+jejunojejunal bypass(LSG+JJB).During the 6-month postoperative follow-up,patients in both groups showed significant improvements in BMI,glucose metabolism,lipid metabolism,liver and kidney function(all P<0.05).In details,BMI in the LSG group decreased from 53.68±2.692 kg/m^(2)before surgery to 38.89±3.572 kg/m^(2)at 6 months postoperatively;BMI in the LSG+JJB group decreased from 52.83±2.942 kg/m^(2)before surgery to 38.22±3.642 kg/m^(2)at 6 months postoperatively.The 2-hour postprandial glucose in the LSG group decreased from 9.96±4.08 mmol/L before surgery to 6.45±2.04 mmol/L at 6 months postoperatively;2-hour postprandial glucose in the LSG+JJB group decreased from 11.4±5.61 mmol/L before surgery to 6.56±2.94 mmol/L at 6 months postoperatively.Uric acid in the LSG group decreased from 508.95±133.89μmol/L before surgery to 389.11±102.13μmol/L at 6 months postoperatively;Uric acid in the LSG+JJB group decreased from 504.88±118.64μmol/L before surgery to 420.65±72.21μmol/L at 6 months postoperatively.Conclusion Bariatric surgery has a significant short-term effect in the treatment of SO patients,and can effectively improve and cure obesity-related metabolic diseases.
作者
王天爱
胡梦杰
龚铖
吴天根
张铖
刘志苏
潘定宇
李震
Wang Tianai;Hu Mengjie;Gong Cheng;Wu Tiangen;Zhang Cheng;Liu Zhisu;Pan Dingyu;Li Zhen(Surgery Center for Bariatric&Metabolic Diseases,Zhongnan Hospital of Wuhan University,Department of Hepato-Biliary-Pancreatic Surgery,Zhongnan Hospital of Wuhan University,Mini-Invasive Procedure of Hepatobiliary&Pancreatic Disease of Hubei Province,Hubei Wuhan 430071,China)
出处
《腹部外科》
2025年第4期286-292,共7页
Journal of Abdominal Surgery
基金
国家自然科学基金(82270612)
武汉大学中南医院创新培育基金(CXPY2022087)。
关键词
超级肥胖
胃袖状切除术
空肠空肠旁路术
疗效
肥胖症
Super-obesity
Gastric sleeve resection
Jejunal bypass surgery
Treatment efficacy
Obesity
