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目的探讨腹腔镜胃旁路手术治疗2型糖尿病的临床效果及治疗体会。方法分析我院2010年8月-2012年2月开展腹腔镜胃旁路手术治疗糖尿病的20例病例资料,观察患者手术前后空腹血糖、体重指数、胰岛素抵抗(HOMA-IR)、糖化血红蛋白(HbAl c)、c肽等指标的改变。结果 20例患者术后1个月血糖均有明显下降,葡萄糖耐量明显增强(P<0.05),12例患者术后1个月体重指数变化明显,15例术后随访3-12月,血糖在正常范围,不需胰岛素或药物控制;4患者例术后6个月,HOMA-IR、HbAl c与手术前相比明显降低(P<0.05);糖尿病相关并发症均有不同程度缓解。结论胃旁路术能有效治疗2型糖尿病,手术安全可行,近期效果明显,长期效果仍待观察。
Objective To investigate the clinical effect and treatment experience of laparoscopic gastric bypass surgery for type 2 diabetes mellitus. Methods The data of 20 cases of diabetes mellitus treated by laparoscopic gastric bypass in our hospital from August 2010 to February 2012 were analyzed. The fasting blood glucose, body mass index, insulin resistance (HOMA-IR), HbA1c c), c peptide and other indicators of change. Results The blood glucose in one month after operation was significantly decreased and the glucose tolerance was significantly increased in 20 patients (P <0.05). The body mass index changed significantly at one month postoperatively in 12 patients. Fifteen patients were followed up for 3 to 12 months. Normal range, no insulin or drug control; 4 patients 6 months after surgery, HOMA-IR, HbAl c significantly lower than before surgery (P <0.05); diabetes-related complications were relieved to varying degrees. Conclusion Gastric bypass surgery can effectively treat type 2 diabetes mellitus, which is safe and feasible. The short-term effect is obvious. The long-term effect remains to be seen.