腹腔镜胃袖状切除术对肥胖症患者的治疗效果及对肠道菌群的影响

Effects of laparoscopic sleeve gastrectomy in treatment of obese patients and its influence on intestinal flora

  • 摘要:
    目的 探讨腹腔镜胃袖状切除术对肥胖症患者的治疗效果和对肠道菌群的影响。
    方法 选取30例住院肥胖症患者作为研究对象,患者均接受腹腔镜胃袖状切除术治疗。观察患者手术时间、术中出血量和术后住院时间、肛门排气时间及术后近期并发症发生情况。出院后随访6个月,观察患者术前和术后1、3、6个月时体质量、体质量指数(BMI)和腰围等指标,并观察患者相关合并疾病的改善情况和肠道菌群的变化。
    结果 30例肥胖症患者术后1、3、6个月时的体质量、BMI和腰围均低于或小于术前,差异有统计学意义(P < 0.05)。随访结果显示,患者的相关合并疾病均得到明显改善。与术前相比,患者术后总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平降低,高密度脂蛋白胆固醇水平升高,差异有统计学意义(P < 0.05)。在门水平上,与术前比较,术后1、3、6个月时拟杆菌门相对丰度均升高,差异有统计学意义(P < 0.05); 在属水平上,与术前比较,术后1、3、6个月时拟杆菌属、普雷沃菌属相对丰度均升高,拟普雷沃菌属相对丰度则降低,差异有统计学意义(P < 0.05)。
    结论 腹腔镜胃袖状切除术对肥胖症患者具有较好的治疗效果,可在短期内减轻患者体质量,并有效调节患者肠道菌群。

     

    Abstract:
    Objective To investigate the effect of laparoscopic sleeve gastrectomy in treatment of obese patients and its influence on intestinal flora.
    Methods Thirty obese hospitalized patients were collected. All patients received laparoscopic sleeve gastrectomy. The operation time and intraoperative blood loss, postoperative hospitalization duration, anal exhaust time and occurrence of postoperative complications wereobserved. The patients were followed up for 6 months after discharge, and body weight, body mass index (BMI), waist circumference and other indicators at 1 month, 3 months and 6 months after the operation were observed, and the improvement of related diseases and changes of intestinal flora were observed.
    Results The body mass, BMI and waist circumference of 30 obese patients at 1 month, 3 and 6 months after surgery were lower or smaller than those before surgery (P < 0.05). The follow-up results showed that the related co-morbidities of the patients were significantly improved. Compared with pre-operation, the levels of total cholesterol, triglyceride and low-density lipoprotein cholesterol decreased after operation, while the level of high-density lipoprotein cholesterol increased (P < 0.05). At the hilum level, the abundance of Bacteroidetes at 1 month, 3 months and 6 months after the operation increased significantly after surgery compared with the preoperation(P < 0.05). At the genus level, the abundance of Bacteroidetes and Prevotella was higher than those before operation, and the abundance of Prevotella Pseudomonas was lower than those before operation (P < 0.05).
    Conclusion Laparoscopic sleeve gastrectomy has a good therapeutic effect for obese patients, which can reduce the body mass of patients in a short period of time and effectively regulate the intestinal flora of patients.

     

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