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论著·临床研究 | 更新时间:2024-05-09
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腹腔镜胃袖状切除术治疗肥胖症的效果及对血清瘦素、脂联素水平的影响
Effect of laparoscopic sleeve gastrectomy for the treatment of obesity and its influence on serum leptin and adiponectin levels

广西医学 页码:243-247

作者机构:张乐,博士,副主任医师,研究方向为减重手术、疝、胃食管反流。

基金信息:北京市外籍高层次人才资助计划(J202011)

DOI:10.11675/j.issn.0253⁃4304.2024.02.11

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目的 分析腹腔镜胃袖状切除术(LSG)治疗肥胖症的效果及对血清瘦素、脂联素水平的影响。方法 纳入50例行LSG治疗的肥胖症患者,统计患者的手术情况(手术时间、术中出血量、术后肛门排气时间、术后住院时间)。术后随访6个月,比较患者术前和术后1个月、3个月、6个月的血清瘦素、脂联素水平及减重指标[体重、体质指数、多余体重减少百分比(EWL%)、腰围]。统计患者术后6个月内不良反应的发生情况及合并症的改善情况。结果 50例患者均顺利完成手术,手术时间为70~160(118.6 ± 20.4)min,术中出血量为24~75(48.3 ± 18.7)mL,术后肛门排气时间为2~4(2.3 ± 0.5)d,术后住院天数为4~10(8.2 ± 2.4)d。患者的血清瘦素、脂联素水平及体重、体质指数、EWL%、腰围均有随时间变化的趋势(P < 0.05),其中,术后1个月、3个月、6个月,患者血清瘦素水平、体重、体质指数、腰围低于术前,血清脂联素水平高于术前,术后EWL%呈逐渐升高的趋势(P<0.05)。术后6个月,仅有1例患者出现肺部感染,患者的合并疾病均得到明显改善。结论 LSG治疗肥胖症的效果显著,可明显改善患者的血清瘦素和脂联素水平,还可以改善肥胖症的合并疾病,临床效果较好。

Objective To analyze the effect of laparoscopic sleeve gastrectomy (LSG) for the treatment of obesity and its influence on serum leptin and adiponectin levels. Methods A total of 50 patients with obesity undergoing LSG for treatment were enrolled. Surgical status (operation duration, intraoperating bleeding volume, postoperative and exhaust time, and postoperative length of hospital stay) was analyzed. Patients were followed up for 6 months after operation, serum leptin and adiponectin levels, as well as weight loss indices (weight, body mass index, percentage of excess weight loss [EWL%], wast circumference) in patients were compared between before operation and 1 month, 3 months, and 6 months after operation. The occurrence of adverse reactions and improvement of comorbidity within 6 months after operation were analyzed in patients. Results Operation was successfully completed in all 50 patients, and the operation duration was 70-160 (118.6 ± 20.4) minutes, intraoperative bleeding volume was 24-75 (48.3 ± 18.7) mL, postoperative anal exhaust time was 2-4 (2.3 ± 0.5) days, and postoperative length of hospital stay was 4-10 (8.2 ± 2.4) days. There was a tendency of patients' serum leptin and adiponectin levels, and weight, body mass index, EWL%, waist circumference over time (P<0.05), therein serum leptin level, weight, body mass index, waist circumference of patients after 1, 3, and 6 months of operation were lower than those before operation, whereas serum adiponectin level was higher than that before operation, and EWL% exhibited an increasing trend after 1, 3, and 6 months after operation (P<0.05). After 6 months of operation, only 1 patient suffered from pulmonary infection, and patients' concomitant diseases were all ameliorated. Conclusion LSG for treating obesity exerts a significant effect, which can prominently ameliorate patients' serum leptin and adiponectin levels, and improve concomitant diseases of obesity, exerting relatively favorable clinical effects.

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