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    黄柯, 朱孝成, 姚立彬, 李超, 孟松, 王辉, 洪健, 邵永. 腹腔镜袖状胃切除术治疗肥胖合并原发性高血压的疗效分析[J]. 徐州医科大学学报, 2020, 40(9): 655-660. DOI: 10.3969/j.issn.2096-3882.2020.09.007
    引用本文: 黄柯, 朱孝成, 姚立彬, 李超, 孟松, 王辉, 洪健, 邵永. 腹腔镜袖状胃切除术治疗肥胖合并原发性高血压的疗效分析[J]. 徐州医科大学学报, 2020, 40(9): 655-660. DOI: 10.3969/j.issn.2096-3882.2020.09.007
    Analysis of the efficacy of laparoscopic sleeve gastrectomy for obesity with essential hypertension[J]. Journal of Xuzhou Medical University, 2020, 40(9): 655-660. DOI: 10.3969/j.issn.2096-3882.2020.09.007
    Citation: Analysis of the efficacy of laparoscopic sleeve gastrectomy for obesity with essential hypertension[J]. Journal of Xuzhou Medical University, 2020, 40(9): 655-660. DOI: 10.3969/j.issn.2096-3882.2020.09.007

    腹腔镜袖状胃切除术治疗肥胖合并原发性高血压的疗效分析

    Analysis of the efficacy of laparoscopic sleeve gastrectomy for obesity with essential hypertension

    • 摘要: 目的 探讨腹腔镜袖状胃切除术(laparoscopic sleeve gastrectomy,LSG)治疗肥胖合并原发性高血压的疗效.方法 回顾分析2013年7月—2018年8月在徐州医科大学附属医院接受LSG的60例肥胖合并原发性高血压患者的临床资料及术后1年的随访资料,记录并比较术前及术后1年高血压的改善及缓解情况.结果 60例肥胖合并原发性高血压患者均顺利完成LSG,其中男性30例,女性30例,年龄16~60岁,平均年龄(36.9±9.7)岁.42例患者术后1年高血压完全缓解,缓解率为70%.患者体重由术前的平均(120.3±25.1)kg降至平均(84.5±14.9)kg(P<0.01);体重指数(BMI)由术前的平均(40.8±6.7)kg/m2降至平均(28.7±3.9)kg/m2(P<0.01);血压由术前的(154.8±16.7)/(101.0±14.2)mmHg降至(125.8±9.3)/(81.4±7.0)mmHg(P<0.01).LSG术后高血压的缓解与高血压病程长短、高血压分级、术前收缩压及舒张压水平、术前是否服药有关(P<0.05),而与患者年龄、性别、术前BMI、术前是否合并其他代谢综合征以及术后1年患者的额外体重减少百分率(percentage of excess weight loss,EWL%)无关(P>0.05).结论 LSG安全性高,减重效果显著,对于原发性高血压有确切的疗效.LSG对于术前高血压病程较长、高血压分级较高以及术前需口服降压药物控制血压的肥胖患者降压效果不佳.

       

      Abstract: ob<x>jective:To investigate the efficacy of laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity with essential hypertension. Methods: Retrospective analyze the clinical data and follow-up data of 60 patients with obesity and hypertension who underwent LSG in the Affiliated Hospital of Xuzhou Medical University from July 2013 to August 2018, record and compare the improvement and remission of hypertension before and after 1 year of operation. Results: 60 patients with obesity and hypertension were successfully completed laparoscopic sleeve gastrectomy (LSG), of which 30 males, 30 females, aged 16 to 60 years, mean age (36.9 ± 9.7) years old. 42 patients had complete remission of hypertension at 1 year after surgery, and the remission rate was 70%.The patients’ body weight decreased from (120.3±25.1) kg to (84.5±14.9)kg (t=18.331, P<0.001); body mass index (BMI) decreased from (40.8±6.7) kg/m2 to (28.7±3.9)kg/m2(t=19.988,P<0.001);blood pressure decreased from (154.8±16.7)/(101.0±14.2)mmHg to (125.8±9.3)/(81.4±7.0) ) mmHg (P < 0.001). The remission of hypertension after LSG is related to the duration of hypertension, grade of hypertension, the level of systolic and diastolic blood pressure before surgery, and whether or not to take medication before surgery (P <0.05), it is related to the age, gender, preoperative BMI, whether they were combined with other me<x>tabolic syndromes before surgery and the percentage of excess weight loss (% EWL) in patients at 1 year after surgery (P> 0.05). Conclusion:1. Laparoscopic sleeve gastrectomy has high safety, significant weight loss effect, and exact effect on hypertension; 2.LSG for obese patients with long duration, high grade, high degree of hypertension or need oral antihypertensive drugs to control blood pressure before operation, the antihypertensive effect is not good.

       

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