摘要
目的探讨单吻合口胃回肠(single anastomosis sleeve ileal,SASI)旁路术对肥胖症及其代谢合并症(如2型糖尿病、高脂血症等)的减重效果、代谢改善作用及术后安全性。方法回顾性分析2023年1月至2023年12月期间于南京大学医学院附属鼓楼医院减重代谢外科接受SASI旁路术的肥胖症患者[身体质量指数(body mass index,BMI)≥32.5 kg/m^(2)或BMI≥27.5 kg/m^(2)合并代谢疾病]的临床资料。记录术后6个月及12个月时的减重效果如总体质量减少百分比(percentage of total weight loss,%TWL)、多余体质量减少百分比(percentage of excess weight loss,%EWL)、多余BMI减少百分比(percentage of excess BMI loss,%EBMIL),术后12个月时的代谢疾病缓解及并发症发生情况。结果共纳入82例患者,术后12个月时%TWL、%EWL及%EBMIL下降幅度均大于术后6个月[%TWL:(27.1±4.6)%/(23.6±3.8)%,t=2.379,P=0.026;%EWL:(72.1±5.8)%/(56.6±7.3)%,t=2.593,P<0.001;%EBMIL:(71.6±6.7)%/(58.3±4.9)%,t=2.607,P<0.001]。在术后12个月时,48例合并高血压患者中有40例(83.3%)缓解、51例合并2型糖尿病患者中有49例(96.1%)缓解、33例合并高脂血症和29例合并睡眠呼吸暂停综合征患者均完全缓解。SASI旁路术后12个月内有3例(3.7%)患者术后出现黑便,2例(2.4%)患者出现不全性肠梗阻,有10例(12.1%)患者有营养不良表现。结论本研究结果提示,SASI旁路术在肥胖症及其合并代谢疾病患者中表现出显著的减重和代谢改善效果且安全性可控。
Objective To investigate the effects of single anastomosis sleeve ileal(SASI)bypass on weight loss,metabolic improvements,and postoperative safety in patients with obesity and its metabolic comorbidities(such as type 2 diabetes and hyperlipidemia).Methods A retrospective analysis was conducted.The clinical data of patients with obesity[body mass index(BMI)≥32.5 kg/m^(2)or BMI≥27.5 kg/m^(2)with metabolic diseases]who underwent SASI bypass in the Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School from January 2023 to December 2023.Weight loss outcomes,including the percentage of total weight loss(%TWL),percentage of excess weight loss(%EWL),and percentage of excess BMI loss(%EBMIL),were recorded at 6 and 12 months postoperatively.Metabolic disease remission and complications at 12 months postoperatively were also documented.Results A total of 82 patients were included in the study.At 12 months postoperatively,the reductions in%TWL,%EWL,and%EBMIL were significantly greater than those observed at 6 months postoperatively[%TWL:(27.1±4.6)%vs.(23.6±3.8)%,t=2.379,P=0.026;%EWL:(72.1±5.8)%vs.(56.6±7.3)%,t=2.593,P<0.001;%EBMIL:(71.6±6.7)%vs.(58.3±4.9)%,t=2.607,P<0.001],remission was observed in 40 out of 48 patients(83.3%)with comorbid hypertension,49 out of 51 patients(96.1%)with comorbid type 2 diabetes mellitus,and all patients with comorbid hyperlipidemia(33 cases)and obstructive sleep apnea syndrome(29 cases)achieved complete remission.Within 12 months after SASI bypass,3 patients(3.7%)experienced melena,2 patients(2.4%)developed incomplete intestinal obstruction,and 10 patients(12.1%)showed malnutrition.Conclusion The findings of this study indicate that SASI bypass demonstrates significant weight loss and metabolic improvement effects in patients with obesity and metabolic diseases,with a controllable safety profile.
作者
康星
俞杭
褚薛慧
孙喜太
KANG Xing;YU Hang;CHU Xuehui;SUN Xitai(Department of Pancreatic and Metabolic Surgery,Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School,Nanjing 210008,P.R.China)
出处
《中国普外基础与临床杂志》
2025年第9期1126-1129,共4页
Chinese Journal of Bases and Clinics In General Surgery
关键词
单吻合口胃回肠旁路术
肥胖症
2型糖尿病
减重代谢手术
single anastomosis sleeve ileal bypass
obesity
type 2 diabetes mellitus
bariatric and metabolic surgery
