目的 观察内镜下（联合开腹手术）食管空肠覆膜支架转流术对肥胖症并2型糖尿病（T2DM）模型犬的治疗效果。方法 对肥胖症并T2DM模型犬（实验组，n=5）实施内镜下（联合开腹手术）食管空肠覆膜支架转流术，分别于术前和术后4、8、12周时测定空腹血糖和胰岛素，行静脉葡萄糖耐量试验（IVGTT），采用稳态模型评估β细胞功能(HOMA-β)和胰岛素抵抗(HOMA-IR）。以仅行胃镜检查和剖腹探查术的正常Beagle犬作为对照组(n=5)。结果实验组术后4周时的空腹血糖、IVGTT-2 h血糖、空腹胰岛素和IVGTT-2 h胰岛素即已显著低于术前水平（P<0.01），术后12周时，实验组空腹血糖浓度与对照组比较，差异无统计学意义（P>0.05）。与术前比较，术后实验组HOMA-IR逐渐下降（P<0.01），HOMA-β则缓慢上升（P<0.01，P<0.05），至术后12周时，实验组HOMA-IR和HOMA-β与对照组比较，差异均无统计学意义（P>0.05）。结论 对肥胖症并T2DM模型犬实施内镜下（联合开腹手术）食管空肠覆膜支架转流术，可模拟并改良经典的Roux-en-Y胃转流术，治疗T2DM安全有效。

Objective To observe the effect of endoscopic esophagus-jejunum stent bypass (combined with laparotomy) on type 2 diabetes mellitus (T2DM) complicated with obesity in model dogs. Methods Five model dogs with T2DM complicated with obesity (experiment group) underwent endoscopic esophagus-jejunum stent bypass (combined with laparotomy). Before treatment and 4 weeks, 8 weeks and 12 weeks after treatment, fasting plasma glucose and fasting insulin were measured, intravenous glucose tolerance test (IVGTT) was performed, and β cell function and insulin resistance were evaluated with homeostasis model assessment (HOMA-β and HOMA-IR). Besides, another 5 normal Beagle dogs undergoing endoscopy and exploratory laparotomy were served as control group. Results Four weeks after treatment, the fasting plasma glucose, IVGTT-2 h plasma glucose, fasting insulin and IVGTT-2 h insulin were significantly lower than those before treatment in experiment group (P<0.01). There was no significant difference in fasting plasma glucose between experiment group and control group 12 weeks after treatment (P>0.05). HOMAIR gradually decreased (P<0.01) and HOMA-β gradually increased (P<0.01, P<0.05) in experiment group after treatment. There was no significant difference in HOMA-IR and HOMA-β between experiment group and control group 12 weeks after treatment (P>0.05). Conclusion Endoscopic esophagus-jejunum stent bypass (combined with laparotomy) can simulate and improve classic Roux-en-Y gastric bypass in model dogs with T2DM complicated with obesity, and can treat T2DM effectively and safely.