摘要：Objective To evaluate the outcome of weight loss by laparoscopic adjustable gastric banding (LAGB) on obesity patients and the improvement of comorbidity. Methods From June 2003 to June 2009, the data 172 obesity patients(119 women, 53 men, mean age 28.5 years, mean body mass index 38.5 kg/m<'2) were analyzed. Comorbidities included 28 cases with diabetes, 36 with hypertension, 85 with dyslipidemia, 56 with sleep apnea and 138 with fatty liver. Results Mean body mass index (BMI) at 1,3,6,12, 24, 36 and 48 months was 37.2 kg/m2,35.9 kg/m2, 34.5 kg/m2, 32.9 kg/m2, 30.7 kg/m2, 29.2 kg/m2 and 28.1 kg/m2rn, respectively. The percentage of excess weight loss (%EWL) at 1, 3, 6, 12, 24, 36, and 48 months was 10.1%, 16.2%, 25.1%, 37.4%, 51.3%, 59.0% and 62.1%, respectively. At 24, 36 and 48 months, respectively, 50.7%, 63.6% and 70.0% of patients had more than 50% excess weight loss. Complications included 6 cases of port infection, 3 of other port problem, 7 of gastric pouch dilatations, 4 of slippages and 1 of chronic intestinal obstruction. Bands of 5 patients were explanted. No death occurred. Blood glucose of 60.7% patients with diabetes was controlled well without any drug. The blood pressure of 22 hypertensive patients became normal. The blood fat of 49 hypedipidemia cases returned to normal. The symptom of 29 patients with sleep apnea disappeared. All the patients with fatty liver were improved in different degree. Conclusion Gastric banding provides good weight loss and significant reduction in comorbidities with few and minor complications.%目的 探讨腹腔镜可调节胃束带术治疗单纯性肥胖的减重效果及并发疾病的改善情况.方法 对2003年6月至2009年6月间行腹腔镜可调节胃束带术的172例肥胖症患者的随访资料进行总结分析.结果 本组患者体质量指数平均38.5 kg/m2,合并糖尿病28例,高血压36例,高血脂85例,呼吸睡眠暂停综合征56例,脂肪肝138例.术后1、3、6、12、24、36和48个月检测体质量指数分别为平均37.2、35.9、34.5、32.9、30.7、29.2和28.1 kg/m2,多余体质量减少率平均分别为10.1%、16.2%、25.1%、37.4%、51.3%、59.0%和62.1%.在术后24、36和48个月时,分别有50.7%、63.6%和70.0%的患者多余体质量减少率大于50.0%.21例(12.2%)术后出现并发症,包括调节泵处感染6例,调节泵翻转2例,调节泵处不愈性溃疡1例,胃小囊扩张7例,胃束带滑脱4例和慢性肠梗阻1例;5例行胃束带取出术.没有围手术期死亡.合并糖尿病者术后17例(60.7%)不服药即可控制血糖;合并高血压者22例(61.1%)血压恢复正常;合并高血脂者49例(57.6%)血脂恢复正常;合并呼吸睡眠暂停综合征患者29例(51.8%)症状消失;所有脂肪肝患者均有不同程度的好转.结论 腹腔镜可调节胃束带术能取得良好的减肥效果,并发症较少,肥胖伴发疾病能得到治愈或症状明显改善.
