对称三孔法腹腔镜袖状胃切除术对肥胖合并亚临床甲状腺功能减退的影响

doi:10.3969/j.issn.1005-6483.20241125

摘要/Abstract

摘要： 目的探讨伴有亚临床甲状腺功能减退症的肥胖病人行对称三孔法腹腔镜袖状胃切除术后促甲状腺激素（TSH）的变化。方法选取2019年7月~2022年7月行对称三孔法腹腔镜袖状胃切除术的肥胖病人60例。根据术前甲状腺功能分为观察组15例（伴有亚临床甲状腺功能减退）和对照组45例（甲状腺功能正常）。观察组在术前及术后均未干预其甲状腺功能。比较两组病人术前及术后6个月体重、身体质量指数（BMI）及甲状腺功能的变化。结果观察组术前体重、BMI分别为（107.53±10.27）kg、（37.53±3.44）kg/m2，术后6个月体重、BMI分别为（90.85±10.23）kg、（31.33±2.48）kg/m2；对照组术前体重、BMI分别为（106.77±10.49）kg、（37.89±3.35）kg/m²，术后6个月体重、BMI分别为（86.79±9.49）kg、（31.02±2.53）kg/m2。两组术前、术后同一时间点的体重、BMI比较，差异无统计学意义（P>0.05）；两组术后6个月的体重、BMI均低于同组术前（P＜0.05）。观察组、对照组术前TSH分别为（6.07±1.68）μIU/ml、（2.22±1.02）μIU/ml，两组比较差异有统计学意义（P<0.05）。观察组术后6个月的TSH较术前明显下降[（2.88±0.56）μIU/ml比（6.07±1.68）μIU/ml]，差异有统计学意义（P<0.05）。两组术前、术后6个月的游离T4（FT4）、游离T3（FT3）比较，差异均无统计学意义（P>0.05）。结论腹腔镜袖状胃切除术对肥胖合并亚临床甲状腺功能减退有良好的治疗效果，可显著降低TSH水平。

关键词: 腹腔镜袖状胃切除术, 肥胖, 亚临床甲状腺功能减退

Abstract: Objective To investigate the changes in thyroid-stimulating hormone (TSH) in obese patients with subclinical hypothyroidism following symmetric three-port laparoscopic sleeve gastrectomy.Methods Clinical data of 60 cases of obese patients who underwent symmetric three-port laparoscopic sleeve gastrectomy between July 2019 and July 2022 were collected.Based on preoperative thyroid function,the patients were divided into an observation group(15 cases,with subclinical hypothyroidism) and a control group(45 cases,with normal thyroid function).Thyroid function was not intervened in the observation group either before or after surgery.Changes in body weight,body mass index (BMI),and thyroid function were compared between the two groups preoperatively and at 6 months postoperatively.Results Preoperative weight and BMI in the observation group were (107.53±10.27) kg and (37.53±3.44) kg/m2,respectively,which decreased to (90.85±10.23) kg and (31.33 ±2.48) kg/m2 at 6 months postoperatively.In the control group,preoperative weight and BMI were (106.77±10.49) kg and (37.89±3.35) kg/m2,respectively,decreasing to (86.79±9.49) kg and (31.02±2.53) kg/m2 at 6 months postoperatively.There were no statistically significant differences in weight or BMI between the two groups at the same time points (preoperatively or at 6 months postoperatively) (P>0.05).However,both groups showed significant reductions in weight and BMI at 6 months postoperatively compared to their preoperative levels (P<0.05).Preoperative TSH levels were (6.07±1.68)μIU/ml in the observation group and (2.22±1.02)μIU/ml in the control group,with a statistically significant difference between the groups (P<0.05).At 6 months postoperatively,TSH levels in the observation group decreased significantly compared to preoperative levels [(2.88±0.56)μIU/ml vs(6.07±1.68) μIU/ml,P<0.05].There were no statistically significant differences in free T4 (FT4) or free T3 (FT3) levels between the two groups either preoperatively or at 6 months postoperatively(P>0.05).Conclusion Laparoscopic sleeve gastrectomy has a beneficial therapeutic effect on obesity combined with subclinical hypothyroidism,which can significantly reduce TSH levels.

Key words: laparoscopic sleeve gastrectomy, obesity, subclinical hypothyroidism

于春林张孝堂. 对称三孔法腹腔镜袖状胃切除术对肥胖合并亚临床甲状腺功能减退的影响[J]. 临床外科杂志, 2025, 33(11): 1184-1186.

YU Chunlin, ZHANG Xiaotang. Effect of symmetrical three-hole laparoscopic sleeve gastrectomy on obesity complicated with subclinical hypothyroidism[J]. JOURNAL OF CLINICAL SURGERY, 2025, 33(11): 1184-1186.

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