摘要
外科手术治疗肥胖症和2型糖尿病正在成为治疗代谢疾病的最有效治疗措施之一。在外科领域不断地尝试探索中,陆续出现了多种代谢外科手术方式。各种减重手术对肥胖及其相关代谢并发症均有较好的改善,肥胖症与很多慢性疾病相关,比如2型糖尿病、阻塞性睡眠呼吸暂停综合征、高血压病、血脂异常相关心血管疾病(心肌梗塞、中风)、非酒精性脂肪肝、多囊卵巢综合征、骨关节炎、不孕不育等,在减重手术后代谢综合症短期内即可得以有效缓解或治愈。但此类手术机制目前尚不十分明确,各种假说针对包括术后热卡摄入减少、胃肠道激素改变或前肠-后肠理论、血清胆汁酸与肠道细菌菌群的改变等机制进行探讨,但都并不能完全解释不同减重手术方式都能改善代谢综合征的原因,但相信在未来,随着大宗临床数据研究报告支持以及作用机制研究的进一步深入,了解调控机制,进行精确的对因治疗,可更好的让患者获益。
Surgical treatment of obesity and type 2 diabetes is becoming one of the most effective treatments for metabolic diseases.In the field of surgery,a variety of metabolic surgical methods have emerged.Various weight-loss operations have improved obesity and its related metabolic complications.Obesity is related to many chronic diseases,such as type 2 diabetes,obstructive sleep apnea syndrome,hypertension,dyslipidemia cardiovascular diseases(myocardial infarction,stroke),non-alcoholic fatty liver disease(NAFLD),polycystic ovary syndrome,osteoarthritis,infertility,etc.Metabolic diseases are associated with obesity could be cured or significantly alleviated in the short term after bariatric surgery.However,the mechanism of this kind of operation is still not very clear.Various hypotheses,including the reduction of calorie intake after operation,the theory of foregut-hindgut,the change of serum bile acid and intestinal bacterial flora,could not fully explain different weight-loss operation methods could manage metabolic syndrome.However,we believe that in the future,with the support of a large number of clinical data studies and the research of the mechanism of action.In-depth study,we would get the exact answer and would benefit more patients.
作者
傅涛
金炜东
Fu Tao;Jin Weidong(Department of General Surgery,General Hospital of central theater command,Wuhan 430070,China)
出处
《中华普外科手术学杂志（电子版）》
2020年第6期639-642,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
中国博士后科学基金特别资助(2018T111159)
湖北省卫生和计划生育委员会青年人才项目(WJ2017H0043)。
关键词
肥胖症
糖尿病
2型
代谢手术
减肥手术
机制研究
Obesity
Diabetes mellitus,type 2
Metabolic surgery
Bariatric surgery
Mechanism study
作者简介
通信作者:金炜东,Email:jwdong1972@163.com。
