100例胃转流术治疗2型糖尿病患者术后并发症观察及防治体会(1)
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[摘要] 目的 观察总结胃转流术(Gastric bypass，GBP)治疗2型糖尿病术后常见并发症，探讨其防治方法。 方法 对100例胃转流术治疗2型糖尿病患者的临床资料进行回顾性分析。 结果 本组100例患者手术方法为胃转流术或胃转流术+胆囊切除术，术后胃瘫综合征(Postoperative gastroparesis syndrome，PGS)21例，术后切口脂肪液化20例，术后出血4例。 结论 术后胃瘫综合征是胃转流术治疗2型糖尿病术后最常见并发症，其次为切口脂肪液化，第三为术后出血，以上情况术前采取预防措施、术后采用积极治疗手段均可治愈。
[关键词] 胃转流术；2型糖尿病；术后并发症；术后胃瘫综合征
[中图分类号] R587.1 [文献标识码] B [文章编号] 1673-9701(2011)35-152-03
Observation and Experience in Prevention of Postoperative Complications for 100 Cases of Gastric Bypass in Treatment of Type 2 Diabetes Mellitus Patients
ZHU Linchao1 WANG Yun2 SUN Ying3 LIU Hongbin4
1.The First Affiliated Hospital of Zhengzhou University，Zhengzhou 450052，China；2.Chinese Medicine Hospital of Xin'an，Xin'an 471800，China；3.The Third People's Hospital of Henan Province，Zhengzhou 450006，China；4.Armed Police Corps Hospital of Henan，Zhengzhou 450000，China
[Abstract] Objective To observe and summarize the postoperative complication of Gastric bypass operation in treatment of type 2 diabetes mellitus，and explore its prevention and treatment. Methods A retrospectively analysis was undertaken to analysis 100 cases of type 2 diabetes mellitus treated by Gastric bypass. Results This group of 100 patients’ operation method was gastric bypass or gastric bypass and cholecystectomy. Observed the postoperative complications，there were 21 postoperative gastroparesis syndrome cases，20 postoperative Incision fat liquefaction cases and 4 postoperative bleeding cases. Conclusion Postoperative gastroparesis syndrome is the most common postoperative complications after Gastric bypass treatment for type 2 diabetes mellitus，followed by incision fat liquefaction， the third for postoperative bleeding. If we take preventive measures to above situation preoperatively，and adopt positive therapy means，all of them can be cured.
[Key words] Gastric bypas；Type 2 diabetes Mellitus；Postoperative complication；Postoperative gastroparesis syndrome
胃转流手术源于减肥手术，上个世纪50年代开始，一些肥胖外科医生发现，肥胖症伴糖尿病的患者，减肥手术后血糖水平明显改善，并且早于体重改变。1995年Pories在Annual of Surgery杂志首次报道肥胖症伴糖尿病患者实施GBP术后，血糖水平变化的长期随访结果。该统计数据显示糖尿病治愈率可高达80%(121/146)。随后Philip和Caterina 等人的多中心、大样本临床研究结果进一步证实了胃转流手术对糖尿病的治愈作用。此外，更多的学者已经开始研究GBP的降糖机制 ......
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