目的 探讨空回肠旁路术（jejuno-ileal bypass，JIB）对2型糖尿病的治疗效果。方法 回顾性分析2016年10月至2019年1月荆门市中医医院116例接受JIB治疗的2型糖尿病病人的临床资料。观察术前和术后3个月病人体质量指数（BMI）、糖化血红蛋白（HbA1c）、口服葡萄糖耐量试验（OGTT）和糖尿病并发症的变化。结果 血糖改变：手术前和手术后3个月对照，无论术前病人是否肥胖，所有病人都停用或减少了胰岛素等降糖药物的用量，且病人手术前后HbA1c改变及各时相的血糖改变差异均有统计学意义（P<0.01）。体重改变：正常体重组手术前后BMI无显著改变（P>0.05）；超重组手术前后BMI有显著改变（P<0.05）；肥胖组手术前后BMI无显著改变（P>0.05）。全组病人术前多种糖尿病并发症及并存症均有不同程度的缓解。结论 腹腔镜下JIB治疗2型糖尿病降糖疗效确切，对超重病人兼有显著减重作用，而对正常体重病人和肥胖者的减重作用不明显。手术操作简捷、微创。
Abstract
Objective To explore the efficacy of jejuno-ileal bypass (JIB) for type 2 diabetes.Methods Clinical data were reviewed for 116 patients with type 2 diabetes undergoing JIB. The changes of body mass index (BMI), glycated hemoglobin (HbA1c), oral glucose tolerance test (OGTT) and diabetic complications pre-operation and at Month 3 post-operation were recorded.Results Glycemic changes:control pre-operation and at Month 3 post-operation. Regardless of having or not obesity pre-operation, all of them discontinued or reduced the use of glucose-lowering agent such as insulin, The changes in HbA1c before and after surgery and differences in blood glucose levels at different timepoints had significant statistical significance (P<0.01). Changes in body weight were observed. BMI was not significantly changed before and after normal recombination surgery (P>0.05); BMI changed markedly before and after recombination surgery (P<0.05) while it showed no obvious change before and after surgery in obese group (P>0.05). Preoperative diabetic complications and comorbidities were alleviated to varying degrees.Conclusion Effective in reducing blood sugar in type 2 diabetes, laparoscopic JIB has significant weight loss effects in overweight patients, but not significant in normal weight patients and obese people. It offers the advantages of simper handling, mini-invasiveness and faster patient recovery.
关键词
空回肠旁路术 /
2型糖尿病
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Key words
Jejuno-ileal bypass /
Type 2 diabetes
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中图分类号：
R656.7
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参考文献
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