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外科研究与新技术（中英文）

外科研究与新技术（中英文） ›› 2025, Vol. 14 ›› Issue (3): 216-220.doi: 10.3969/j.issn.2095-378X.2025.03.004

• 论著 • 上一篇    下一篇

腹腔镜袖状胃切除术对肥胖合并糖尿病及非酒精性脂肪肝病患者的糖脂代谢紊乱短期疗效分析

梁关友, 李涛   

  1. 新疆医科大学第一附属医院（第一临床医学院）肝脏· 腹腔镜外科,新疆 乌鲁木齐 830000
  • 收稿日期:2025-04-14 出版日期:2025-09-28 发布日期:2025-10-17
  • 通讯作者: 李 涛,电子信箱：lgy08081059@163.com
  • 作者简介:梁关友(1999—),男,硕士,住院医师,从事临床减重代谢工作

Short-term efficacy of laparoscopic sleeve gastrectomy on glucose and lipid metabolism disorders in obese patients with diabetes and non-alcoholic fatty liver disease

LIANG Guanyou, LI Tao   

  1. Department of Liver and Laparoscopic Surgery, First Affiliated Hospital of Xinjiang Medical University （First Clinical Medical College）, Urumqi 830000, Xinjiang, China
  • Received:2025-04-14 Online:2025-09-28 Published:2025-10-17

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摘要： 目的 观察腹腔镜袖状胃切除术对肥胖合并糖尿病及非酒精性脂肪肝病患者糖脂代谢紊乱的短期影响。方法 回顾性分析2020年1月—2023年12月期间收治的行腹腔镜袖状胃切除术患者130例,基于院内电子病历系统和门诊随访方式对130例患者进行为期6个月的术后随访。记录并计算患者术前及术后3、6个月的体征指标[体重、体重指数（BMI）、腰围]以及相关糖代谢指标（糖化血红蛋白、空腹血糖、餐后2 h血糖、胰岛β细胞功能指数、胰岛素抵抗指数）、血脂指标（总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、甘油三酯）以及肝功能相关指标（天冬氨酸转氨酶、丙氨酸转氨酶）。结果 截至末次随访,12例患者失访,剩余118例患者成功完成随访,随访率90.77%。患者体重、BMI、腰围、糖化血红蛋白、空腹血糖、餐后2 h血糖、胰岛β细胞功能指数、胰岛素抵抗指数、总胆固醇、低密度脂蛋白胆固醇、甘油三酯、天冬氨酸转氨酶、丙氨酸转氨酶在术后随时间呈下降趋势,高密度脂蛋白胆固醇在术后随时间呈上升趋势,且与术前相比,术后3个月和6个月体征、糖代谢、血脂、肝功能指标均存在统计学差异（P<0.05）;术后共计7例患者出现切口感染、1例患者出现腹腔感染,术后不良事件总发生率6.15%（8/130）。结论 腹腔镜袖状胃切除术有助于帮助肥胖患者控制体重,改善血糖、血脂稳态。

关键词: 腹腔镜袖状胃切除术, 肥胖症, 糖尿病, 非酒精性脂肪肝

Abstract: Objective To observe the short-term effects of laparoscopic sleeve gastrectomy on glucose and lipid metabolism disorders in obese patients with diabetes and non-alcoholic fatty liver disease. Methods A retrospective analysis was conducted on 130 patients who underwent laparoscopic sleeve gastrectomy from January 2020 to December 2023. Based on the hospital's electronic medical record system, the patients were followed up for 6 months after surgery. Patient's preoperative and postoperative 3 and 6 months physical signs [body weight, body mass index （BMI）, and waist circumference], glucose metabolism indicators （glycated hemoglobin, fasting blood glucose, 2-hour postprandial blood glucose, pancreatic beta cell function index, and insulin resistance index）, blood lipids （total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides）, and liver function indicators （aspartate aminotransferase, and alanine aminotransferase） were recorded and calculated. Results As of the last follow-up, 12 patients were lost to follow-up, and the remaining 118 patients successfully completed follow-up, with a follow-up rate of 90.77%. Patients' weight, BMI, waist circumference, glycated hemoglobin, fasting blood glucose, 2-hour postprandial blood glucose, pancreatic beta cell function index, insulin resistance index, total cholesterol, low-density lipoprotein cholesterol, triglycerides, aspartate aminotransferase, and alanine aminotransferase showed a decreasing trend over time after surgery, while high-density lipoprotein cholesterol showed an increasing trend. Compared with preoperative levels, there were statistically significant differences in physical signs, glucose metabolism, blood lipids, and liver function indicators at 3 and 6 months after surgery （P<0.05）. Postoperatively, a total of 7 patients developed incision infection and 1 patient developed abdominal infection, with an overall incidence of postoperative adverse events of 6.15% （8/130）. Conclusion Laparoscopic sleeve gastrectomy can help obese patients control their weight and improve blood glucose and lipid homeostasis.

Key words: Laparoscopic sleeve gastrectomy, Obesity, Diabetes, Non-alcoholic fatty liver disease

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