中文摘要：

目的 比较袖状胃切除术及Roux-en-Y胃旁路术对肥胖伴有代谢综合征的近期疗效的循证支持。方法 以英文关键词“metabolic surgery”“bariatric surgery”“Roux-en-Y gastric bypass”“sleeve gastrectomy”“obesity”“T2DM”，及中文关键词“代谢手术”“减重手术”“胃旁路术”“袖状胃切除术”“肥胖”“2型糖尿病”等为检索词检索PubMed、EMBASE、Cochrane library、万方、CNKI数据库数据库检索自2011年1月-2016年6月间中英文袖状胃切除术及Roux-en-Y胃旁路术治疗合并肥胖的代谢综合征患者疗效相关文献，设立纳入与排除标准筛选文献，进行质量评价、提取数据和数据统计分析。结果 纳入Meta分析标准的文章有13篇，其中5篇为随机对照试验，8项病例对照研究涉及袖状胃切除术与Roux-en-Y胃旁路术疗效比较，共纳入病例18 850例：其中袖状胃切除术组2 559例，Roux-en-Y胃旁路术组16 291例。袖状胃切除术与Roux-en-Y胃旁路术术后1年2型糖尿病缓解率分别为78.7%和83.0%，二者差异无统计学意义（RR=0.94，95%CI：0.81-1.09，P〉0.05），但短期随访Roux-en-Y胃旁路术手术体重指数降低效果显著优于袖状胃切除术（MD=-2.03,95%CI：-3.25--0.81,P〈0.05）。上述2种术式均能改善高血脂及高血压的发生率，但二者间差异并无统计学意义。结论 两种术式均为治疗肥胖合并代谢综合征的有效措施，均可降低包括T2DM、高血压、高血脂的发病率，并明显降低体重，Roux-en-Y胃旁路术治疗肥胖的疗效优于袖状胃切除术。

英文摘要：

Objective To assess the evidencebased support of shortterm efficacy of sleeve gastrectomy and Roux-en-Y gastric bypass in obesity with metabolic syndrome by laparoscopy. Methods Electronic literature search was performed on PubMed, EMBASE, Cochrane Library, CNKI database for the efficacy of sleeve gostrectomy and Roux-en-Y gastric bypass in the treatment of obese patients with metabolic syndrome from Jan. 2011 to Jun. 2016. The inclusion and exclusion criteria were selected for quality evaluation, data extraction. Review Manager 5.3 software was used to conduct the statistical analysis. Results Thirteen articles were included in the Metaanalysis, including 5 randomized controlled trails, eight casecontrol studies with 18,850 cases, including 2,559 cases in the sleeve gastrectomy group and 16,291 cases in the Roux-en-Y gastric bypass group. The results of the Metaanalysis showed that there was no significant difference in the remission rate of type 2 diabetes mellietus between sleeve gastrectomy and Roux-en-Y gastric bypass group （78.7% vs 83.0%; RR=0.94, 95%CI：0.81-1.09, P〉0.05）, the reduction of body mass index was significantly higher in Roux-en-Y gastric bypass group than sleeve gastrectomy group from the shortterm followup （MD=-2.03, 95%CI： -3.25-0.81, P〈0.05）. Both two surgeries can reduce the incidence of high blood lipids and hypertension, but there was no significant difference between them as well as type 2 diabetes mellitus remission. Conclusion Both sleeve gastrectomy and Roux-en-Y gastric bypass are effective in treating obesity complicated with metabolic syndrome, and can reduce the incidence of type 2 diabetes mellitus, hypertension and hyperlipidemia and reduce the body weight. Roux-en-Y gastric bypass is superior to sleeve gastrectomy in the treatment of obesity.