探讨腹腔镜袖状胃切除术（LSG）对肥胖型2型糖尿病（T2DM）的治疗效果。

回顾性分析2015年12月至2016年10月在吉林大学中日联谊医院减重与代谢外科接受LSG治疗的34例肥胖型T2DM患者的临床资料。所有患者均签署手术知情同意书，符合医学伦理学规定。测量并比较患者术前和术后1、3、6个月的肥胖指标，包括体重、体质量指数（BMI）、多余体重减少百分比（%EWL），和糖尿病指标，包括空腹血糖（FPG）、糖化血红蛋白（HbA1c）、餐后2小时血糖（2hPG）。

所有患者均在腹腔镜下完成手术，无中转开腹发生。手术时间（69.0±9.2）min，术中出血量（18.0±2.7）ml。患者在术后第1日即可下地活动，术后第3日可饮水，术后第4日开始全流食饮食，后逐步恢复正常饮食，患者平均住院时间（8.0±3.0）日。患者术前、术后1、3、6个月的体重分别为（96.9±15.5）kg、（86.8±13.7）kg、（80.6±12.5）kg、（75.5±11.2）kg；术前及术后1、3、6个月患者BMI分别为（33.9±4.3）kg/m²、（30.4±3.9）kg/m²、（29.9±11.5）kg/m²、（26.5±3.5）kg/m²；术后1、3、6个月患者%EWL分别为（33.2±12.7）%、（54.0±21.3）%、（70.1±26.7）%。与术前相比，术后1、3、6个月患者体重及BMI均明显降低（P<0.05），%EWL呈明显升高趋势（P<0.05）。术后1个月患者HbAlc由术前（8.2±1.9）%降至（6.4±0.6）%（P<0.05），FPG由术前（9.1±2.7）mmol/L降至（7.4±4.0）mmol/L（P<0.05）。随访至术后6个月，T2DM临床完全缓解率88.2%(30/34)；部分缓解率11.8%(4/34)。

对于肥胖型2型糖尿病的患者，LSG短期内可明显有效减轻患者的体重和改善患者的糖尿病情况。

To investigate the efficacy of laparoscopic sleeve gastrectomy (LSG) for the treatment of obese type 2 diabetes mellitus (T2DM).

Clinical data of 34 patients with obese type 2 diabetes mellitus undergoing metabolic surgery in China-Japan Friendship Hospital affiliated to Jilin Univerity between December 2015 and October 2016 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patient's body weight indexes (body weight, BMI, %EWL), blood glucose indexes[fasting plasma glucose (FPG), glycosylated hemoglobin (HbAlc), 2-hour postprandial blood glucose (2hPG)] were measured at 1, 3, 6 months after operation and compared with preoperative levels.

All the patients completed operation under laparoscopy. The average operative time was (69.0±9.2) min, and the average blood loss (18.0±2.7) ml. The patient was able to ambulate lst day after surgery, and water was available on the 3rd day after the operation. The whole diet was started on the 4th day after the operation, and the normal diet was gradually restored, and the average length of hospital stay was (8.0±3.0) day. At preoperative and postoperative 1, 3 and 6 months the weight of patients respectively were (96.9±15.5) kg, 86.8±13.7) kg, (80.6±12.5) kg, (75.5±11.2) kg, the BMI of patients respectively were (33.9±4.3) kg/m², (30.4±3.9) kg/m², (29.9±11.5) kg/m², (26.5±3.5) kg/m², at postoperative 1, 3 and 6 months %EWL of patients respectively were (33.2±12.7) %, (54.0±21.3) %, (70.1±26.7) %, The body weight and BMI at 1,3,6 months after surgery were significantly lower (all P<0.05). At the same time, %EWL showed significant increasing trend (P<0.05). 1 month after surgery, HbAlc was reduced to (6.4±0.6) % from the preoperative period (8.2±1.9) % (P<0.05), and the FPG was reduced to (7.4±4.0) mmol/L from preoperative (9.1±2.7) mmol/L (P<0.05).Clinical complete remission rate of T2DM was 88.2% (30/34), and clinical partial remission rate was 11.8% (4/34)at the 6-month follow-up.

For obese type 2 diabetes, LSG can significantly reduce the patient's weight and improve diabetes effedively in the short term.