目的 观察合理营养联合运动干预对肥胖症患者血脂水平的影响，为控制肥胖寻找有效的方法。 方法 将2006年12月-2008年7月收治的72例单纯肥胖症患者随机分为试验组及对照组，每组各36例。试验组按照营养师的要求进行饮食和运动治疗，对照组自行控制饮食和运动，观察期为6个月。在治疗前后分别测量两组患者身高、体重、身体质量指数（BMI）、血压及总胆固醇（TC）、甘油三酰（TG）、低密度脂蛋白胆固醇（LDL-C）及高密度脂蛋白胆固醇（HDL-C），并进行比较。 结果 经过6个月营养联合运动的干预治疗，试验组与对照组相比较，体重、BMI 、TG、TC和LDL-C均降低，而HDL-C升高，差异有统计学意义（Plt;0.05）。 结论 营养联合运动治疗能够有效降低肥胖症患者的体重和BMI，改善其血脂状况，起到调节异常内分泌代谢的作用。
Objective To investigate the operating skills for treatment of morbidly obese patients with gallstone by using laparoscopic technique meanwhile. Methods From Oct.2006 to Nov.2009, 178 morbidly obese patients undergoing laparoscopic adjustable gastric banding （LAGB）, in which 18 cases combined with gallstone underwent laparoscopic cholecystectomy （LC） meanwhile. Results All of 18 morbidly obese patients with gallstone underwent LAGB and LC successfully, the operating time was (126±24) min and bleeding volume was (50±16) ml. No serious infectious complications occurred, but 3 cases with low-grade nausea and vomiting, 2 cases with adipose tissue liquefaction in incision, and one case with few seroperitoneun， all were cured conservatively. Conclusion Morbidly obese patients with gallstone undergoing LAGB and LC at the same time by changing site of incision is a safe and effective procedure and a feasible technique.
目的探讨胃转流术治疗2型糖尿病的疗效及分析影响疗效的相关因素。 方法回顾性分析2009年1月至2012年7月期间我院收治的33例行胃转流术治疗的2型糖尿病患者的临床资料及随访情况。 结果33例患者治愈率为54.55%（18/33），总有效率为90.91%（30/33），无效3例。分析治愈及未治愈患者术前的临床资料发现，与未治愈患者比较，治愈患者的年龄更小、病程更短、2 h BG更低、BMI更大及空腹C肽更高（P＜0.05）。 结论从本组有限资料的初步结果看，胃转流术治疗2型糖尿病临床效果确切，而对于低龄、病程短、BMI及空腹C肽较高和2 h BG较低的2型糖尿病患者可获得更好的治疗效果。
ObjectiveTo investigate the short-term effect of laparoscopic sleeve gastrectomy (LSG) in treatment of obesity in China. MethodsLiteratures about the effect of LSG in treatment of obesity were searched from WanFang, CNKI, PubMed, and Web of Science, then these literatures were filtered according to the inclusive and exclusive criteria and evaluated. Meta analysis was performed based on data extracted from these literatures. ResultsThree hundreds and eighty three cases of LSG were retrieved from 12 literatures. Compared with the preoperative, the body mass index (BMI) was lower in 6 months after LSG (MD=7.56, 95% CI: 5.77-9.34, P < 0.000 01), and compared with 6 months after LSG, the BMI was lower in 12 months after LSG (MD=3.19, 95% CI: 2.20-4.18, P < 0.000 01). Compared with 1 months after LSG, the excess weight loss (EWL%) was higher in 6 months after LSG (MD=-42.77, 95% CI:-45.77--39.77, P < 0.000 01), and compared with 6 months after LSG, EWL% was higher in 12 months after LSG (MD=-19.71, 95% CI:-25.54--13.87, P < 0.000 01). After the LSG, BMI decreased, but EWL% increased over time. ConclusionsIn China, LSG has obviously short-term curative effect in the treatment of obesity.
ObjectiveTo systematically review the clinical effects of green tea extracts on simple obesity. MethodsSystematic retrieval were conducted in PubMed, The Cochrane Library (Issue 8, 2012), CNKI, VIP, CBM, and WanFang Data to collect the randomized controlled trials (RCTs) on green tea extracts in treating patients with simple obesity. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed the methodological quality of the included studies. Meta-analysis was then performed using RevMan 5.0. ResultsA total of 11 RCTs involving 693 patients were included. Results of meta-analysis displayed that compared with the control group, patients in the green tea extracts group significantly had a obvious decrease of body mass (WMD=-0.32, 95%CI-0.46 to-0.17, P < 0.000 1) as well as body mass index (BMI) (WMD=-0.07, 90%CI-0.09 to-0.05, P < 0.000 01) with significant differences. ConclusionCurrent evidence shows that, green tea extracts could effectively treat simple obesity.
ObjectiveTo explore the effect of laparoscopic sleeve gastrectomy (LSG) on obesity and its comorbidities.MethodThe literatures about LSG in the treatment of obesity and its comorbidities were collected and summarized.ResultsLSG could not only effectively reduce the weight of patients with obesity, but also obviously alleviate comorbidities related to obesity, such as type 2 diabetes mellitus, obstructive sleep apnea syndrome, polycystic ovary syndrome, essential hypertension, hyperlipidemia, and so on.ConclusionsLSG has a definite and effective long-term weight loss effect, which is equal to other common weight loss methods. It has been recognized by more and more patients and clinicians because it has advantages of simple operation, safety, high efficiency and fewer complications. However, therapeutic effects of some comorbidities, such as gastroesophageal reflux disease, are still controversial and need further tobe studied.
ObjectiveTo understand the present situation and effect of da Vinci robot in the treatment of obesity.MethodThe literatures about the application of da Vinci surgical robot in metabolic surgery for weight loss were reviewed.Resultsda Vinci surgical robot was a minimally invasive surgical system in recent years. Because of its unique structure, it broke through the limitations of traditional laparoscopic surgery, such as lack of field of vision, two-dimensional imaging, unstable lens, limited range of movement, and so on. It provided a solution way for metabolic surgery for weight loss with narrow operation space and high technical difficulty. At present, there were differences in operation time and postoperative complications between da Vinci surgical robot and laparoscopic weight loss.ConclusionsIn recent years, da Vinci surgical robot has been widely used in metabolic surgery for weight loss. It not only overcomes many limitations of laparoscopic assisted weight loss surgery, but also it is safe, feasible, and has a similar clinical effect. It provides a new choice for metabolic surgery for weight loss.
ObjectiveTo investigate the effect of stomach intestinal pylorus sparing surgery in metabolic surgery for weight loss.MethodThe literatures about stomach intestinal pylorus sparing surgery were reviewed by searching domestic and foreign literatures.ResultsIn recent years, stomach intestinal pylorus sparing surgery had been gradually applied in clinical practice. Compared with other weight-loss surgeries, it had better clinical effects in weight reduction and blood glucose control. It not only provided a new surgical treatment for patients with severe obesity, but also promoted the development of weight-loss metabolic surgery.ConclusionAs a new metabolic surgery, stomach intestinal pylorus sparing surgery is safe and feasible for weight loss.
Objective To investigate the clinical application value of unsymmetrical four-port laparoscopic sleeve gastrectomy (LSG). Methods The clinical data of 114 patients with obesity who were admitted to Mianyang Central Hospital from June 2021 to May 2022 were retrospective analyzed. All the 114 patients underwent unsymme-trical four-port LSG, and were observed their surgical and postoperative conditions, complications and follow-up the patient’s esthetic satisfaction of wounds at 3 months after surgery. Results All 114 patients underwent unsymmetrical four-port LSG successfully, without conversion to open surgery. The operative time was 68–160 min, average (104.2±26.1) minutes; volume of intraoperative blood loss was 2–50 mL, average (10.7±7.6) mL; the duration of postoperative hospital stay was 3–6 d, average (4.0±0.7) days. Of the 114 patients, 8 patients (7.0%) had fat liquefaction of wounds, 68 patients (59.6%) had postoperative nausea and vomiting in the 24 hours after operation, and all patients had no serious complications such as gastrointestinal bleeding, intraperitoneal hemorrhage, or gastric leakage. One hundred and fourteen patients were followed-up for 3–14 months, with a median follow-up of 6 months. Forty patients (35.1%) had hair loss, 3 patients (2.6%) had mild anemia. Of the 114 patients, 2 (1.8%) were dissatisfied with the cosmetic effects of wounds, 64 (56.1%) were satisfied, and 48 (42.1%) were very satisfied. The satisfaction rate was 98.2% (112/114). Conclusion The unsymmetrical four-port LSG is safe and feasible, it does not affect esthetic satisfaction of wounds.