| Background:With the rapid development of economy,great changes have taken place in people’s diet structure.A large number of high calorie and high fat food was ingested by people,at the same time,the progress of science and technology changed the way people work and life,with aggravation of ageing population and the reduction of outdoor sports,the prevalence of metabolic syndrome(MS)of residents in our country is rising,and the age of onset showed a younger trend.According to reports,the incidence of overweight and obesity of residents in China,who are older than 18years old,increased to 30%and 12%in 2012 respectively from 23%and 7%in 2002;while for the residents under the age of 18,the incidence of overweight and obesity increased from 6%and 2%in 2002 respectively to 10%and 10%in 2012.The incidence of dyslipidemia increased from 19%in 2002 to 40%in 2012,meanwhile,the incidence of dyslipidemia was increasing year by year.Although there is no serious harm to health with simple dyslipidemia,but it is an important pathogenic factor for cardiovascular system diseases,and cardiovascular events will increase about ten million as a result of dyslipidemia in the coming decades in China,that means health problems and economic burden produced by dyslipidemia will continue to increase in our country.The relationship between weight and lipid metabolism is very close,therefore,obesity and dyslipidemia have become a major threat to national health.The main methods to improve dyslipidemia include weight loss,proper exercise,smoking cessation,and lipid-lowering drugs,bariatric surgery can improve patient’s obesity and dyslipidemia significantly.Bariatric surgery has a history of 70years,its efficacy has been widely accepted.There are four types of bariatric surgery recognised by the medical profession,however,both laparoscopic Roux-en-Y gastric bypass(LRYGB)and laparoscopic sleeve gastrectomy(LSG)are extensivest pplied in China.The treatment of LRYGB for severe obesity has been widely accepted,and it was used as the standard operation in bariatric surgery.Since the 1990s,LSG has gradually become an independent surgical procedure from the first stage of treatment of patients with severe obesity.LSG has the advantages of simple operation,no changes with the sequence of the digestive tract,rapid postoperative recovery,and few complications.Due to the late implementation of bariatric surgery in our country,we lack a large number and long-term clinical studies,at the same time there are some differences in physical fitness between Chinese and European and American people,unlike systemic obesity in Europe and the United States,obesity is mainly abdominal obesity in China.The efficacy of the two kinds of surgerys needs to be studied in our country.This research monitored the blood lipid index and body mass index of the obesity combined hyperlipidemia patients that acceptted LRYGB or LSG in our department,with the following-up of postoperative complications after surgery,to analyze and compare the safety and efficacy of LRYGB and LSG.Methods:Retrospectively analyze the clinical and follow-up data of 76 obesity patients with hyperlipidemia who underwent LRYGB or LSG in our department during February 2015 to February 2017.All the patients were divided into group LRYGB or LSG.There are 28 patients in the group LRYGB,the age is(38.67±14.30)years old,weight is(137.77±44.62)kg,and body mass index(BMI)is(40.28±13.13)kg/m~2;While 48 patients in group LSG,the age is(44.22±12.50)years old,weight is(124.13±31.48)kg and BMI is(38.37±8.48)kg/m~2.Through detailed medical history,hematology,radiology and other preoperative routine examinations to exclude surgical contraindications,LRYGB or LSG were given under general anesthesia conducted.Following-up to 1 year after surgery,and we need to consultate,detect,measure,calculate and record the improvement of body mass index and blood lipid index,including total triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL)and high-density lipoprotein(HDL),then consultate the postoperative complications.In this study,we apply the SPSS 21.0 statistical analysis software to analyze the data,each set of data are showd with(x±s),there is a significant statistic difference when p<0.05.Results:All the 76 patients in this study underwent laparoscopic surgery according to the preoperative surgical plan.The operating time of group LRYGB or LSG are(158.72±26.18)min and(73.70±11.57)min,respectively,the p value between the group LRYGB or LSG is 0.000(p<0.05).The time of hospitalization after LRYGB or LSG are(8.59±3.47)d and(6.37±2.07)d,respectively,the p value between group LRYGB and LSG is 0.048(p<0.05).There is no significant difference between the two groups in terms of intraoperative blood loss,postoperative bed rest time,postoperative exhaust time,and the time to full flow after surgery(p>0.05).Three patients in the group LRYGB occured postoperative anastomotic bleeding due to various causes(mainly with surgical procedures).One patient in the group LSG occured a postoperative sleeve gas leak due to improper diet.All the 76 patients in this study have significantly improvement on blood lipids index and body weight index from 3 months after operation(p<0.05),while the same index at the same time between the two groups have no significant difference(p>0.05).Conclusion:LRYGB and LSG can short-term effectively improve the blood lipids index and body weight index for obese patients with hyperlipidemia,meanwhile,they have higher security. |
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