| Purpose：30cases of non-obese（BMI<35kg/m2）T2DM patients were treated byLaparoscopic gastric bypass and laparoscopic gastric bypass, the clinical evaluation andsafety of operations referred the above were compared with eath other on the results.Methods:30patients with T2DM were selected into the group, according to the criteria,and all the patients were underwent laparoscopic gastric bypass and modified one. The BMI,fasting plasma glucose,2-hour postprandial blood glucose, fasting plasma C-peptide andglycosylated hemoglobin were detected preoperation, the conditions in hospital、indicators ofdiabetes mellitus and the complications of the operations were compared, patients werefollowed up for1month,3months,6months,12months, the BMI, fasting plasma glucose,2-hour postprandial blood glucose, fasting plasma C-peptide and glycosylated hemoglobinfollowed-up were evaluated in pre-operation and post-operation.Result:(l) The number,Age,BMI,fasting glucose,2-hour postprandial blood glucoseand glycosylated of patients of the both groups were compared, and the result demonstratedpreoperative indicators were not significantly ameliorated(P>0.05).(2)The time of improved laparoscopic gastric bypass surgery (150min±20min), theamount of bleeding (40ml±10ml) compared to the time of laparoscopic gastric bypasssurgery (210min±25min), the amount of bleeding (80ml±20ml),statistically decreased,P <0.05, statistically significant,while the number hospital days and the number of cases ineath group, P>0.05,stated not statistically significant.(3)1month after operation, there were no significant changes(P>0.05) in postoperativeBMI（27.62±2.64）, glycosylated hemoglobin(8.93%士1.02%)in the group of laparoscopicgastric bypass and BMI（27.39±2.81）, glycosylated hemoglobin(8.87%士1.14%) in thegroup of improved laparoscopic gastric bypass compared with preoperative BMI（29.38±2.67）, glycosylated hemoglobin(9.69%士1.85%)in the group of laparoscopicgastric bypass and BMI（29.12±2.78）, glycosylated hemoglobin(9.63%士1.39%) in thegroup of improved laparoscopic gastric bypass (p>0.05). Postoperative fasting plasmaglucose(8.67士0.80),2-hour postprandial blood glucose(10.53士1.61), fasting plasmaC-peptide(5.23士1.71) in the group of laparoscopic gastric bypass and fasting plasma glucose(8.39士1.64),2-hour postprandial blood glucose(10.39士1.67), fasting plasmaC-peptide(5.24士1.83)in the group of improved laparoscopic gastric bypass compared withpreoperative BMI(26.46士2.88kg/m2) also didn’t change compared with preoperativefasting plasma glucose(11.76士3.65),2-hour postprandial blood glucose(16.88士5.37),fasting plasma C-peptide(5.12士3.23)in the group of laparoscopic gastric bypass andfasting plasma glucose(8.39士1.64),2-hour postprandial blood glucose(16.69士3.52),fasting plasma C-peptide(5.14士3.46)in the group of improved laparoscopic gastricbypass,P<0.05with statistical significance.3months,6months,12months after operations,BMI, fasting glucose,2-hour postprandial blood glucose, glycosylated hemoglobin, fastingC-peptide in both groups compared with preoperative indicators P <0.05with statisticalsignificance.(4)30patients in two groups postoperative effects were followed up,19cases (cure rate63%) patients with type2diabetes were cured, nine cases of laparoscopic gastric bypassgroup (cure rate60%),10cases of modified laparoscopic gastric bypass group (cure rate67%);9patients with hypoglycemic drugs and insulin dosage reduced by50%comparedwith the preoperative condition be eased, including5cases in laparoscopic gastric bypassgroup,4cases in the improved laparoscopic gastric bypass group; the total efficiency is93%, the efficiency of laparoscopic gastric bypass group is93%, and modifiedlaparoscopic gastric bypass group is93%.Conclusion:(l) The glucose metabolism improved in patients with type2diabetes afterlaparoscopic gastric bypass surgery, it shows that the laparoscopic gastric bypass surgery isan effective treatment of a non-obese type2diabetes.(2)The glucose metabolism improved in patients with type2diabetes after modifiedlaparoscopic gastric bypass surgery, it shows that the modified laparoscopic gastric bypasssurgery is an effective treatment of a non-obese type2diabetes.(3)The effect in controlling of blood glucose metabolism in the patients with type2diabetes treated by modified Laparoscopic gastric bypass surgery or laparoscopic gastricbypass, is just the same. Compared with laparoscopic gastric bypass, the modifiedlaparoscopic gastric bypass surgery has the advantages in time-saving, less bleeding, buthas the reflux shortcomings... |
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