目的 比较胃袖状切除联合空肠-空肠旁路术(sleeve gastrectomy plus jejunojejunal bypass,SG+JJB)与胃袖状切除术(sleeve gastrectomy,SG)治疗肥胖及代谢病的疗效及安全性。方法 回顾分析2019年1月至2021年1月于解放军总医院第一医学中心接受SG或SG+JJB手术的40 kg/m2≤体重指数≤50 kg/m2的肥胖病人的临床资料,分为SG组(27例)与SG+JJB组(18例),对比分析两组随访2年减重效果及2型糖尿病、高血压、高尿酸血症等合并症的缓解效果及营养并发症情况。结果 SG组与SG+JJB组在随访各时间点的多余体重减少百分比比较:1个月时差异无统计学意义[(20.0±10.5)%比(23.6±8.5)%,P＞0.05],6个月[(35.7±16.5)%比(48.4±13.1)%]、12个月[(47.8±22.0)%比(66.8±16.6)%]、24个月[(50.1±23.4)%比(71.9±19.8)%]时差异均有统计学意义(均P＜0.05)。同时两种术式均有效改善2型糖尿病、高尿酸血症等代谢并发症,SG+JJB对改善阻塞性睡眠呼吸暂停综合征更有优势,两组病人在中期随访中无明显营养并发症。结论 SG+JJB是一种安全、有效的术式,根据随访2年的结果,其与SG相比,对于40 kg/m2≤体重指数≤50 kg/m2的肥胖病人具有更好的减重效果,并显著改善了2型糖尿病与阻塞性睡眠呼吸暂停综合征等病态肥胖合并症。
Abstract
Objective To compare the efficacy and security of sleeve gastrectomy plus jejunojejunal bypass (SG+JJB) versus sleeve gastrectomy (SG) for obesity and metabolic diseases.Methods From January 2019 to January 2021, the relevant clinical data were retrospectively reviewed for 45 obese patients with 40 kg/m2≤ body mass index (BMI) ≤50 kg/m2 undergoing SG or SG+JJB. They were assigned into two groups of SG(n=27) and SG+JJB (n=18). During 2-year follow-ups, two groups were compared in terms of weight loss and relief status of type 2 diabetes mellitus(T2DM),hypertension, hyperuricemia and nutritional complications.Results As compared with SG group, the percentage of excess weight loss was not statistically significant in SG+JJB group at Month 1 [(20.0±10.5)% vs.(23.6±8.5)%,P＞0.05].Yet at Month 6[(35.7±16.5)% vs.(48.4±13.1)%],Month 12[(47.8±22.0)% vs.(66.8±16.6)%] and Month 24[(50.1±23.4)% vs.(71.9±19.8)%], all differences were statistically significant (all P＜0.05). Meanwhile, both procedures were effective in improving T2DM and hyperuricemia. And SG+JJB was more advantageous in improving obstructive sleep apnea syndrome (OSAS). No nutritional complications occurred in neither groups during mid-term follow-ups.Conclusion SG+JJB is both safe and effective during 2-year follow-ups. For obese patients with 40 kg/m2≤BMI≤50 kg/m2, it offers better weight loss than SG and significantly improves the outcomes of T2DM with OSAS.
关键词
胃袖状切除联合空肠-空肠旁路术 /
胃袖状切除术 /
减重新术式 /
手术效果
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Key words
Sleeve gastrectomy plus jejunojejunal bypass /
Sleeve gastrectomy /
New procedures in bariatric surgery /
Surgical efficacy
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中图分类号：
R723.14
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参考文献
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脚注
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基金
联保综合研究课题(LB2022B10100)
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