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1、腹腔镜袖状胃切除术治疗肥胖症的疗效分析摘要目的:探讨腹腔镜袖状胃切除术(Laparoscopic sleeve gastrectomy,LSG )治疗肥胖症及 相尖代谢性疾病的手术安全性及近期疗效。方法:收集2013年2月至2015年3月在山西大医院行LSG术的13例肥胖症患者的术 前病历资料及术后随访资料分析并评价患者术前及术后体重、体重指数(body mass index,BMI )、超重体重百分比(the percentage of excess weight loss,EWL% )、糖脂代 谢指标及其他相尖代谢性疾病检测指标的变化。结果:手术顺利完成无中转开腹术中无大量出血术后无胃出血
2、、胃漏、胃食管反 流等严重并发症。术后随访,病人体重、BMI较术前下降明显(p0.05 ),EWL%呈 逐渐上升趋势;部分患者随访至术后12个月发现体重下降趋势减缓,进入平台期。 随访过程中还发现肥胖症相尖代谢性疾病,如糖尿病、高胰岛素血症、高甘油三酯血 症、低高密度脂蛋白症、高血压等较术前明显改善。结论:单纯性肥胖或合并相尖代谢性疾病患者行LSG术治疗后早期效果明显因病例 数少和随访时间短,中远期效果仍待观察。尖键词:肥胖症;腹腔镜袖状胃切除术;临床疗效Therapeutic analysis of laparoscopic sleeve gastrectomy forobesityAbst
3、ractObjective :To evaluate the surgical safety and the short-term effect of Laparoscopic sleeve gastrt- my (LSG) for the obesity and related metabolic diseases.Methods :The clinical date of 13 obesity patients performed laparoscopic sleeve gastrectomy surgery between February 2013 and March 2015 in
4、Shanxi Dayi hospital were analyzed retr- opectively.Including preoperative and postoperative weight,body mass index(BMI)jhe percentage of excess body weight loss (EWL%),glucose and lipid metabolism indicators and other related metabolic disorders.Results :All the operations were successfully perform
5、ed in all the 13 patients with no conversion to open surgery.no intraoperative bleeding.no serious postoperative complications stom- ch bleeding,stomach leak,gastroesophageal reflux and so on,During the postoperative foil- owup.the weight, BMI of patients decreased significantly compared with preoperative (p35Kg/m2或BMI30Kg/m2但存在肥胖症相尖代 谢性疾病,如:高血压、高血脂、冠心病、2型糖尿病、退行性尖节病、呼吸睡眠暂 停综合症等;年龄1&65岁;经改变生活方式、饮食调节和药物治疗1年以上疗 效不明显或难以耐受内科治疗;(4)了解手术冈险,依从性好,积极配合改变术后饮食 及生活习惯。排除标准:(1)内分泌失调导致的继发性肥胖;(2)存在酒精或药物依赖性;主要 器官功能严重异常。L2手术方法所有病例均行常规腹腔镜袖状胃切除术麻