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目的探讨代谢手术治疗肥胖伴或不伴2型糖尿病的疗效。方法回顾性分析2013年1月至2014年12月在复旦大学附属中山医院接受代谢手术治疗的26例患者的临床资料。其中男11例,女15例;年龄19~64岁。16例被诊断为肥胖合并2型糖尿病;5例被诊断为糖尿病前期(空腹血糖受损及糖耐量减低);5例被诊断为单纯性肥胖症。收集并对比26例患者手术前后的代谢参数指标。结果分别有16例、13例和10例患者完成术后3个月、6个月和1年随访。术后患者体重与BMI呈下降趋势(P<0.05)。术后3个月空腹血糖(5.5±1.3)mmol/L,餐后2小时血糖(8.6±3.8)mmol/L,糖化血红蛋白(6.46±0.76)%;术后6个月空腹血糖(4.8±0.7)mmol/L,餐后2小时血糖(7.2±3.4)mmol/L,糖化血红蛋白(5.56±0.49)%;术后1年血糖水平高于术后6个月。术后3个月、6个月和1年,肝脏脂肪含量平均下降分别为21.6%、25.1%和25.1%。结论代谢手术能明显降低患者体重、改善糖代谢情况。对于重度单纯性肥胖伴或不伴2型糖尿病患者,手术治疗是减轻体重及肝脏脂肪含量、治疗糖尿病行之有效的手段。
Objective To investigate the efficacy of metabolic surgery in the treatment of obesity with or without type 2 diabetes mellitus. Methods The clinical data of 26 patients undergoing metabolic surgery at Zhongshan Hospital Affiliated to Fudan University from January 2013 to December 2014 were retrospectively analyzed. Including 11 males and 15 females; aged 19 to 64 years. Sixteen were diagnosed as obese with type 2 diabetes; five were diagnosed with pre-diabetes (impaired fasting glucose and impaired glucose tolerance); and five were diagnosed with simple obesity. Metabolic parameters of 26 patients were collected and compared before and after surgery. Results were 16 cases, 13 cases and 10 patients were completed after 3 months, 6 months and 1 year follow-up. Body weight and BMI decreased after operation (P <0.05). The fasting blood glucose (5.5 ± 1.3) mmol / L, postprandial blood glucose (8.6 ± 3.8) mmol / L and HbA1c (6.46 ± 0.76)% at 3 months postoperatively ) mmol / L, postprandial blood glucose (7.2 ± 3.4) mmol / L, and glycated hemoglobin (5.56 ± 0.49)% at 2 hours postprandial. Blood glucose level at 1 year after operation was higher than that at 6 months after operation. At 3 months, 6 months and 1 year after operation, the average decrease in liver fat content was 21.6%, 25.1% and 25.1%, respectively. Conclusion Metabolic surgery can significantly reduce the weight of patients, improve glucose metabolism. For severe simple obesity with or without type 2 diabetes, surgical treatment is to reduce body weight and liver fat content, the treatment of diabetes is an effective means.