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目的探讨腹腔镜下胃旁路手术治疗2型糖尿病的有效性及可行性。方法参照2011年中国《手术治疗糖尿病专家共识》,选择2型糖尿病患者实施胃旁路手术,并回顾性分析其中随访满12个月的52例患者的糖代谢指标、胰岛细胞功能指标。结果本组2型糖尿病患者术后治疗有效45例(86.5%),完全缓解38例(73.1%),部分缓解7例(13.5%),无效7例(13.5%)。术后空腹血糖、餐后2 h血糖、糖化血红蛋白较术前明显下降(P<0.05);胰岛素与术前比较有统计学差异,但是C肽无统计学意义。虽然术后有一定的手术相关并发症,但总体可控。结论腹腔镜下胃旁路手术是2型糖尿病患者一种有效可行的治疗方法,但需严格把握手术指征;术后胰岛素敏感性的提高发挥重要的治疗作用。
Objective To investigate the effectiveness and feasibility of laparoscopic gastric bypass surgery for type 2 diabetes mellitus. Methods According to the 2011 consensus on surgical treatment of diabetes in China, patients with type 2 diabetes mellitus were selected for gastric bypass surgery. The glucose metabolism and islet cell function were analyzed retrospectively in 52 patients who were followed up for 12 months. Results 45 cases (86.5%) were treated postoperatively, 38 cases (73.1%) were relieved completely, 7 cases (13.5%) partially relieved, and 7 cases (13.5%) partially relieved. Postoperative fasting blood glucose, postprandial 2 h blood glucose, glycosylated hemoglobin decreased significantly compared with preoperative (P <0.05); insulin was statistically significant compared with preoperative, but C peptide was not statistically significant. Although there are some surgical complications, but overall controllable. Conclusions Laparoscopic gastric bypass surgery is an effective and feasible treatment for patients with type 2 diabetes. However, surgical indications should be strictly followed. Postoperative improvement of insulin sensitivity plays an important therapeutic role.