【摘要】 目的 观察腹腔镜胃旁路术治疗T2DM的疗效及对患者生活质量的影响。方法 回顾性分析腹腔镜下胃旁路手术治疗T2DM 患者的临床资料。术后随访，监测BMI、FPG、HbA1c、血脂、C-P等指标及T2DM相关并发症情况。运用生活质量调查表(SF-36)分析。结果 68例中，46例(67.6%)术后仅用生活方式治疗HbA1c≤6.5 %，FPG≤7.0 mmol/L，2 hPG≤10 mmol/L;18例(26.5%)口服降糖药或皮下注射胰岛素量较术前减少，血糖控制良好，FPG降幅>1.39 mmol/L, HbA1c降幅>1%。术后1年糖尿病并发症改善27例，其中合并高血压14例(53.8%)、高脂血症15例(71.4%)、视力减退或合并DR 3例(21.4%)、尿蛋白阳性7例(41.2%)、DF或DPN 3例(27.3%)。SF-36量表对手术前及手术后1年的生理健康和精神健康调查统计分析显示，术后患者生理机能、生理职能、一般健康状况、精力、精神健康、社会功能及情感职能较术前改善(P< 0.05)，生活质量明显提高。 结论 腹腔镜下胃旁路手术治疗T2DM效果显著，能提高患者的生活质量。

　　【关键词】糖尿病，2型;腹腔镜胃旁路术;生活质量

　　【Abstract】 Objective：To study the effect of laparoscopic Roux-en-Y gastric bypass (LRYGB) for the patients with Type 2 Diabetes Mellitus (T2DM) and the impact on the patients’life quality. Methods The data of 68 patients with T2DM undergoing LRYGB from May 2010 to May 2012 were retrospectively analyzed. All the patients followed were investigated with SF-36 questionnaire and the data of weight, BMI, FPG, HbA1c, lipid, insulin , C-peptide and the complications of T2DM were recorded and analyzed. Results Among 68 cases, 46 (67.6%) patients was treated only by lifestyle after operation, with HbA1c≤6.5 %，FPG≤7.0 mmol/L，2 hPG≤10 mmol/L; compared with pre-operation, 18 (26.5%) patients required less oral hypoglycemic agents or subcutaneous injection of insulin, with decreasing amplitude of FPG>1.39 mmol/L, decreasing amplitude of HbA1c>1%. Diabetic complications in 27 patients were improved in 1 year after operation, among them, 14 cases of hypertension(53.8%), 15 cases of hyperlipidaemia (71.4%), 3 cases of retinopathy (21.4%)，7 cases of nephropathy (41.2%) and 3 cases of neuropathy(27.3%). The physiological function, general and mental health, social function and emotional function of the patients with T2DM received LRYGB had improved significantly, which enhanced the quality of life. Conclusion Laparoscopic gastric bypass can treat T2DM effectively, and further improve patients’ life quality.

　　【Key words】 Diabetes mellitus，type 2;Laparoscopic roux-en-ygastric bypass;Quality of life