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目的系统评价Roux-en-Y胃转流术对肥胖及其合并疾病的治疗效果。方法计算机检索Pub Med、EMbase、h e Cochrane Library(2013年第11期)、CBM、CNKI、VIP和Wan Fang Data等数据库,检索时限均截至2013年11月,纳入所有Roux-en-Y胃转流术对肥胖及其合并疾病治疗效果的研究。由2位研究者按照纳入与排除标准筛选文献、提取资料和评价纳入研究的方法学质量后,使用Rev Man 5.3软件进行Meta分析。结果最终纳入25个自身前后对照试验,共2 966例超重或肥胖患者。Meta分析结果显示:与术前比较,Roux-en-Y胃转流术后超重或肥胖患者的体重指数明显下降[MD=–16.40,95%CI(–17.42,–15.38),P<0.000 01],2型糖尿病[RR=0.23,95%CI(0.17,0.31),P<0.000 01]和高血压[RR=0.34,95%CI(0.26,0.43),P<0.000 01]患病率明显降低,空腹血糖、血压和血脂水平均明显改善(P均<0.000 01)。结论 Roux-en-Y胃转流术能明显减轻肥胖患者体重,降低其合并2型糖尿病和心血管疾病的发生率。但因纳入研究在设计上的局限性,本研究结论尚需进一步开展大样本、高质量的随机对照试验加以验证。
Objective To evaluate the therapeutic effect of Roux-en-Y gastric bypass on obesity and its combined diseases. Methods The databases of Pub Med, EMbase, he Cochrane Library (2013-11), CBM, CNKI, VIP and Wan Fang Data were searched by computer. The retrieval time was up to November 2013 and included all Roux-en-Y gastric bypass Therapeutic effect of surgery on obesity and its combined diseases. After two investigators screened the literature for inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies, Meta-analysis was performed using RevMan 5.3 software. The results eventually included 25 self-control trials, totaling 2,966 overweight or obese patients. Meta analysis showed that the body mass index of overweight or obese patients after Roux-en-Y gastric bypass was significantly lower than that before operation [MD = -16.40,95% CI (-17.42, -15.38), P <0.000 01 ], Type 2 diabetes (RR = 0.23, 95% CI (0.17, 0.31), P <0.000 01] and hypertension (RR = 0.34, 95% CI 0.26, 0.43, P <0.000 01] Decreased, fasting blood glucose, blood pressure and blood lipid levels were significantly improved (P <0.000 01). Conclusion Roux-en-Y gastric bypass can significantly reduce weight and reduce the incidence of type 2 diabetes mellitus and cardiovascular diseases in obese patients. However, due to the design limitations of the included studies, the conclusion of this study needs to be further verified by large sample and high-quality randomized controlled trials.