肥胖症的患病率已发展为全球性流行病,成为当今社会不可忽视的慢性疾病。肥胖与多种代谢性疾病的发生密切相关,不仅严重危害身心健康,也对社会带来了显著的经济负担。因此,如何有效治疗肥胖及其相关合并症已成为社会关注的核心问题。袖状胃切除术(sleeve gastrectomy, SG)是一种常见的减重与代谢手术,主要通过减少胃容量、调节胃肠激素分泌、重塑胃肠道微生物群来改善体重和代谢功能。SG经历了数十年的发展,手术技术日渐成熟。尽管该手术操作简便,但其对胃的解剖结构与生理功能的改变,及其在手术效果中的具体作用仍尚不明晰。本文通过收集并分析相关文献,探讨胃容积变化、胃动力变化及胃分泌功能变化在SG术后体重减轻和代谢改善中的作用机制。The prevalence of obesity has developed into a global epidemic and become a chronic disease that cannot be ignored in today’s society. Obesity is closely related to the occurrence of multiple metabolic diseases, which not only seriously endangers physical and mental health but also brings a significant economic burden to society. Therefore, how to effectively treat obesity and its related comorbidities has become a core issue of social concern. Sleeve gastrectomy (SG) is a common bariatric and metabolic surgery, which mainly improves body weight and metabolic function by reducing gastric capacity, regulating the secretion of gastrointestinal hormones, and reshaping the gastrointestinal microbiota. SG has undergone decades of development, and the surgical techniques have become increasingly mature. Although this surgery is relatively simple to perform, the changes it causes to the anatomical structure and physiological functions of the stomach, as well as its specific role in the surgical outcomes, remain unclear. This article collects and analyzes relevant literature to explore the mechanisms by which changes in gastric volume, gastric motility, and gast
目的探讨腹腔镜袖状胃切除术(LSG)在糖尿病合并肥胖症治疗中的应用价值。方法回顾性分析2022年7月至2024年6月医院收治的76例糖尿病合并肥胖症患者资料,根据手术方式的不同分为研究组和参考组,各38例。参考组行腹腔镜Roux-en-Y胃旁路术(LRYGB)治疗,研究组行LSG治疗。对比两组围术期指标、糖脂代谢指标、体质量指数(BMI)、腰臀比(WHR)及并发症发生情况。结果与参考组相比,研究组术中出血量少,手术时间、肠道功能恢复时间、住院时间和术后离床时间均较短(P<0.05)。两组术后3个月时低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)、空腹血糖(FBG)、甘油三酯(TG)、餐后2 h血糖(2 h PG)、总胆固醇(TC)检测值均较术前低,高密度脂蛋白胆固醇(HDL-C)均高于术前(P<0.05);两组间手术前后以上各项指标对比,差异无统计学意义(P>0.05)。两组术后3个月时BMI、WHR均低于术前(P<0.05);两组间手术前后BMI、WHR对比,差异无统计学意义(P>0.05)。两组术后各项并发症发生率比较,差异无统计学意义(P>0.05)。结论LSG术治疗糖尿病合并肥胖症的效果和安全性与LRYGB术相当,但前者能减小手术创伤,缩短术后恢复时间。
