探讨腹腔镜袖状胃切除术（LSG）在治疗肥胖症中的应用价值。

回顾性分析2013年2月至2015年2月在山西大医院接受LSG治疗的10例肥胖症患者的临床资料。所有患者均签署知情同意书，符合医学伦理学规定。其中男5例，女5例；年龄（40±13）岁；体质指数（BMI）（42±8）kg/m²。记录术前和术后1、6、12、18个月患者的体质量、BMI、多余体质量减少百分比（EWL%）、血压值、空腹血糖（FPG）、糖化血红蛋白（HbA1c）、空腹胰岛素、甘油三酯（TG）和高密度脂蛋白胆固醇（HDL-C）水平。手术前后临床指标的比较采用配对t检验。

术后1个月，LSG患者的BMI为（40±6）kg/m²，明显低于术前的（42±8）kg/m²（t=11.173，P<0.05）；5例术前合并有2型糖尿病的LSG患者的FPG和HbA1c分别为（8.4±1.2）mmol/L和（6.7±0.5）%，明显低于术前的（10.1±1.5）mmol/L和（7.8±0.6）%（t=7.611、15.241，P<0.05）；4例术前合并有高胰岛素血症的LSG患者的空腹胰岛素水平为（21.1±2.3）U/L，明显低于术前的（26.4±2.3）U/L（t=6.355，P<0.05）；8例术前合并有高血压病的LSG患者的收缩压和舒张压分别为（140±12）和（92±6）mmHg，明显低于术前的（155±16）和（99±9）mmHg （t=7.933、4.931，P<0.05）；之后，上述指标均继续保持下降趋势。

LSG治疗肥胖症短中期疗效确切，相关代谢性疾病的改善效果良好，但远期效果和复发情况仍有待于进一步研究以明确。

To investigate the clinical application value of laparoscopic sleeve gastrectomy (LSG) in treating obesity.

Clinical data of 10 obese patients undergoing LSG in Shanxi Dayi Hospital of Shanxi Medical University from February 2013 to February 2015 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. Among the 10 patients, 5 were males and 5 were females with an average age of (40±13) years old and an average BMI of (42±8) kg/m². Body weight, BMI, percentage of excess body weight loss (EWL%), blood pressure, fasting plasma glucose (FPG), glycosylated hemoglobin A1c (HbA1c), fasting insulin, triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) of these patients were collected before and 1, 6, 12, 18 months after operation. Comparisons of the data before and after operation were conducted using t test.

One month after operation, the average BMI of the LSG patients was (40±6) kg/m², which was significantly lower than (42±8) kg/m² before operation (t=11.173, P<0.05); the FPG and HbA1c of the 5 patients with preoperative type 2 diabetes mellitus were (8.4±1.2) mmol/L and (6.7±0.5)% respectively, which were significantly lower than (10.1±1.5) mmol/L and (7.8±0.6)% before operation (t=7.611, 15.241, P<0.05); the fasting insulin of the 4 patients with preoperative hyperinsulinemia was (21.1±2.3) U/L, which was significantly lower than (26.4±2.3) U/L before operation (t=6.355, P<0.05); the systolic and diastolic pressure of the 8 patients with preoperative hypertension were (140±12) and (92±6) mmHg respectively, which were lower than (155±16) and (99±9) mmHg before operation (t=7.933, 4.931, P<0.05); and after that, all the above indexes kept the downtrend.

LSG has a reliable short-term effect on obesity, with a good improvement of obesity-related metabolic diseases, but its long-term effect and recurrence remain to be further investigated.