腹腔镜胃旁路术治疗肥胖合并多囊卵巢综合征疗效荟萃分析

doi:10.16139/j.1007-9610.2026.02.06

摘要/Abstract

摘要：

目的：系统评估腹腔镜Roux-en-Y胃旁路术（LRYGB）对肥胖合并多囊卵巢综合征（PCOS）病人的疗效。方法：通过检索PubMed、Embase、Web of Science及Scopus数据库，筛选出截至2025年1月1日前的相关研究。依预设纳入和排除标准筛选后共纳入6项研究128例病人。结果：LRYGB术后月经紊乱病人显著减少(OR=0.07; 95%CI: 0.04~0.14; P<0.05)；多毛症（OR=0.14; 95%CI: 0.06~0.32; P<0.05）、性激素结合球蛋白（SHBG）（MD=23.24; 95%CI: 7.97~38.51; P<0.05）、游离雄激素指数(FAI)（MD=-3.89; 95%CI: -5.33~-2.45； P<0.05）、总睾酮(MD=-25.55; 95%CI: -30.08~-21.01; P<0.05)和体质量指数(BMI)（MD=-17.22；95% CI: -19.32~-15.11；P<0.000 1）均显著改善。结论：LRYGB可作为一种有效的治疗手段改善肥胖合并PCOS人群的体重和代谢情况。

关键词: 减重手术, 腹腔镜Roux-en-Y胃旁路术, 多囊卵巢综合征, 肥胖症

Abstract:

Objective To systematically evaluate the therapeutic effect of laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients with obesity comorbid with polycystic ovary syndrome (PCOS). Methods A systematic literature search was conducted across four databases (PubMed, Embase, Web of Science, and Scopus) for studies published up to January 1, 2025. Following screening against predefined eligibility criteria, a total of 6 studies comprising 128 patients were ultimately included. Results Following LRYGB, there was a significant reduction in the number of patients with menstrual irregularities (OR=0.07; 95%CI: 0.04~0.14; P<0.05). Additionally, significant improvements were observed in hirsutism (OR=0.14; 95%CI: 0.06~0.32; P<0.05), sex hormone-binding globulin (SHBG) (MD=23.24; 95%CI: 7.97~38.51; P<0.05), free androgen index (FAI) (MD=-3.89; 95%CI: -5.33~-2.45; P<0.05), total testosterone levels (MD=-25.55; 95%CI: -30.08~-21.01; P<0.05), and body mass index (BMI) (MD=-17.22; 95%CI: -19.32~-15.11; P<0.000 1). Conclusions LRYGB can serve as an effective therapeutic intervention to improve body weight and metabolic profiles in the population with obesity comorbid with PCOS.

Key words: Bariatric surgery, Laparoscopic Roux-en-Y gastric bypass (LRYGB), Polycystic ovary syndrome(PCOS), Obesity

中图分类号:

王书翰, 任振, 韦笑韩, 刘虎, 潘晨, 吴立胜. 腹腔镜胃旁路术治疗肥胖合并多囊卵巢综合征疗效荟萃分析[J]. 外科理论与实践, 2026, 31(02): 129-136.

WANG Shuhan, REN Zhen, WEI Xiaohan, LIU Hu, PAN Chen, WU Lisheng. Meta-analysis of the therapeutic effect of LRYGB in patients with obesity-related polycystic ovary syndrome[J]. Journal of Surgery Concepts & Practice, 2026, 31(02): 129-136.

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Studies	①	②	③	④	⑤	⑥	⑦	⑧	⑨	Total score
Eid, et al [12]	1	1	1	0	1	1	1	1	1	8
Jamal, et al[13]	1	1	0	0	1	1	X	1	1	6
Eid, et al[14]	1	1	0	0	1	1	X	0	1	5
Turkmen, et al[15]	1	1	1	0	1	1	X	1	1	7
Kyriacou, et al[16]	1	1	1	1	1	1	X	1	1	8
Turkmen, et al [17]	1	1	1	0	1	1	0	1	1	7

Author	Year of publication	Source of cases	Number of PCOS cases (n)	Age (years)	Preoperative BMI (kg/m²)	Follow-up duration (months)	Outcome indicators
Eid, et al[12]	2005	USA	24	34±9.7	50±7.5	27.5	①②③
Jamal, et al[13]	2012	USA	20	32±5.8	52.8±9.08	12	①②③
Eid, et al[14]	2014	USA	14	36.3±8.4	44.8±1.6	12	①②③⑥
Turkmen, et al[15]	2015	Sweden	9	31.4±7.41	47.2±8.85	12	①④⑤
Kyriacou, et al[16]	2014	UK	48	29.92±7.12	50.9±7	24	②
Turkmen, et al[17]	2016	Sweden	13	29.92±7.12	47.15±7.57	6	①②④⑤⑥