【摘要】 目的 观察腹腔镜下袖状胃切除术（LSG）治疗伴月经失调的重度肥胖的效果。方法 伴月经失调的重度肥胖患者107例[其中合并多囊卵巢综合征（PCOS）者56例]，均采用LSG治疗，比较手术前后体质量、BMI、多余体质量减轻百分比、月经周期、月经失调改善率。结果 与术前比较，术后1、3、6、12个月体质量、BMI降低，月经周期减短（P均<0.05）；与术后1个月比较，术后3、6、12个月体质量、BMI降低和多余体质量减轻百分比增加，术后6、12个月月经周期减短（P均<0.05）；与术后3个月比较，术后6、12个月体质量、BMI降低和多余体质量减轻百分比增加（P均<0.05）；与术后6个月比较，术后12个月体质量、BMI降低和多余体质量减轻百分比增加（P均<0.05）。107例伴月经失调的重度肥胖患者中，术后有86例恢复正常月经周期，月经失调改善率80.4%；其中56例合并PCOS患者，通过LSG均得到有效治疗，月经周期均恢复正常水平，月经失调改善率达100%;51例不伴有PCOS患者，月经失调改善率为64.3%。随着BMI、体质量的减轻，月经周期明显缩短，但并不呈线性关系，月经周期的改善先于体质量的下降；当体质量下降约10%、BMI下降至37 kg/m2、多余体质量减轻约21%时，月经周期已明显缩短；术后约2个月，月经周期恢复正常。结论 LSG在有效减重的同时，可明显改善重度肥胖患者的月经周期失调症状，尤其是对于伴有PCOS的患者。更多还原

【Abstract】 Objective To observe the effect of laparoscopic sleeve gastrectomy(LSG)in the treatment of severe obe-sity with menstrual disorders.Methods A total of 107 severely obese patients with menstrual disorders[including 56cases with polycystic ovary syndrome(PCOS)]were treated with LSG. The weight,BMI,percentage of excess bodyweight loss,menstrual cycle,and the improvement rate of menstrual disorders after surgery were compared with those be-fore operation.Results The body weight,BMI decreased,and menstrual cycle was shortened at 1,3,6,and12 months after operation in comparison with those before operation(all P<0. 05);the body weight,BMI decreased,andthe percentage of excess body weight loss increased at 3,6,and 12 months after operation,and the menstrual cycle wasshortened at 6 and 12 months after operation in comparison with those at 1 month after operation(all P<0. 05);the bodyweight and BMI decreased and the percentage of excess body weight loss increased at 6 and 12 months after operation incomparison with those at 3 month after operation(all P<0. 05);the body mass and BMI decreased,and the percentage ofexcess body weight loss increased at 12 months after operation in comparison with those at 6 month after operation(all P<0. 05). Among the 107 severely obese patients with menstrual disorders,86 cases returned to normal menstrual cycle afteroperation,and the improvement rate of menstrual disorder was 80. 4%;among them,56 patients with PCOS were effective-ly treated by LSG,and their menstrual cycle returned to normal level,and the improvement rate was 100%;among 51 pa-tients without PCOS,the improvement rate of menstrual disorders was 64. 3%. With the reduction of BMI and body weight,the menstrual cycle was significantly shortened,but the relationship was not linear,and the improvement of men-strual cycle preceded the decline of body weight;when the body weight decreased by about 10%,the BMI dropped to37 kg/m2,and the excess body weight decreased by about 21%,the menstrual cycle was significantly shortened;at about2 months after the operation,the menstrual cycle returned to normal.Conclusion LSG can significantly improve thesymptoms of menstrual disorders in severely obese patients while effectively reducing weight,especially for patients withPCOS.更多还原