摘要
目的对比4K腹腔镜代谢手术—腹腔镜Roux-en-Y胃旁路术(laparoscopic Roux-en-Y gastric bypass,LRYGB)与腹腔镜袖状胃切除术(laparoscopic sleeve gastrectomy,LSG)在高海拔地区肥胖合并阻塞性睡眠呼吸暂停低通气综合征(Combine with Obstructive Sleep Apnoea Hyporentilation Syndrome,OSAHS)患者中的呼吸及代谢指标改善情况。方法前瞻性方便选取2021年1月—2024年1月青海红十字医院收治的68例肥胖合并OSAHS患者,以不同治疗方法分为两组。LRYGB组(32例)接受LRYGB治疗,LSG组(36例)则接受LSG治疗。对比两组患者的手术相关指标、呼吸功能、代谢指标及并发症发生率。结果LSG组患者的手术时间、住院天数短于LRYGB组,术中出血量少于LRYGB组,差异均有统计学意义(P均<0.05)。术后,两组患者呼吸功能水平均优于术前,差异有统计学意义(P<0.05);但两组患者呼吸功能改善程度比较,差异无统计学意义(P>0.05)。两组患者的代谢指标水平优于术前,差异有统计学意义(P<0.05);但两组患者代谢指标改善程度比较,差异无统计学意义(P>0.05)。LSG组并发症发生率为13.89%(5/36),LRYGB组为12.50%(4/32),两组比较,差异无统计学意义(χ^(2)=0.036,P>0.05)。结论在高海拔地区肥胖合并OSAHS患者中,4K腹腔镜下的LRYGB与LSG均能显著改善患者的呼吸功能及代谢指标,且两种手术方法的疗效相当,但相比较LRYGB,LSG的手术时间更短、术中出血量更少,且后期恢复较快。
Objective To compare the improvement of respiratory and metabolic indicators in obese patients with obstructive sleep apnoea hypoventilation syndrome(OSAHS)in high altitude areas by two 4K laparoscopic metabolic surgeries-laparoscopic Roux-en-Y gastric bypass(LRYGB)and laparoscopic sleeve gastrectomy(LSG).Methods A total of 68 obese patients with OSAHS admitted to Qinghai Red Cross Hospital from January 2021 to January 2024 were prospectively and conveniently selected and divided into two groups according to different treatment methods.The LRYGB group(32 cases)received LRYGB treatment,and the LSG group(36 cases)received LSG treatment.The operation-related indicators,respiratory function,metabolic indicators and complication incidence were compared between the two groups.Results The operation time and hospital stay in the LSG group were shorter than those in the LRYGB group,and the intraoperative blood loss was less than that in the LRYGB group,and differences were statistically significant(all P<0.05).After surgery,the level of respiratory function in the two groups was better than before surgery,the difference was statistically significant(P<0.05),but there was no significant difference in the improvement of respiratory function between the two groups(P>0.05).The level of metabolic indexes between the two groups was better than that before surgery,the difference was statistically significant(P<0.05),but there was no statistical significance in the improvement degree of metabolic indexes between the two groups(P>0.05).The complication incidence in the LSG group was 13.89%(5/36),and that in the LRYGB group was 12.50%(4/32),and there was no statistically significant difference in the complication incidence between the two groups(χ^(2)=0.036,P>0.05).Conclusion In obese patients with OSAHS in high altitude areas,both LRYGB and LSG under 4K laparoscopy can significantly improve the respiratory function and metabolic indicators of patients,and the efficacy of the two surgical methods is equivalent.However,compared with LRYGB,LSG has a shorter operation time,less intraoperative blood loss and a faster postoperative recovery.
作者
周庆
支永发
康金科
马明杰
任孝德
ZHOU Qing;ZHI Yongfa;KANG Jinke;MA Mingjie;REN Xiaode(Department of Gastrointestinal Surgery,Qinghai Red Cross Hospital,Xining,Qinghai,810000,China)
出处
《中外医疗》
2025年第5期30-35,共6页
China & Foreign Medical Treatment
基金
青海省卫生健康委员会指导性计划课题(2021-wjzdx-61)
青海省卫生健康委员会指导性计划课题(2022-wjzdx-89)。
作者简介
周庆(1982-),男,本科,副主任医师,研究方向为胃肠外科疾病诊疗。
