英国新闻听力 十二指肠旁路吻合术（在线收听）

当人们用尽各种可能的方法来减肥时，一些人求助于手术减肥。有一种胃旁路手术称为十二指肠切除手术，其原理是身体从食物中吸取更少的卡路里从而达到减肥的目的。但在意大利的罗马城市，这种手术被挖掘出另外一种完全不同的用途—治疗II型糖尿病患者。

注释：

1,gastric bypass 胃旁路手术 

2,chronic adj. 慢性的，延续很长的 

3,coma n. 昏迷 

4,metabolic adj. 代谢作用的，新陈代谢的 

5,exposed to 接触 

6,drawback n. 缺点，障碍

Duodenal Bypass

CLAUDIA HAMMOND: When people have tried everything they can to lose weight, some turn to the surgeon’s knife for help. A type of gastric bypass surgery called duodenal exclusion, means that the body absorbs fewer calories from food and then people lose weight. But now a surgeon in the Italian city of Rome has found a rather different use for this kind of surgery for people with type two diabetes. This is the kind of diabetes that often starts later in life, when the body’s hormones find it hard to control sugar levels. It’s usually thought of as a chronic disease which can be managed but not cured. But then a group of surgeons and diabetes specialist got together and found that after gastric bypass surgery, the symptoms of diabetes disappeared in more than eighty percent of their patients. Our reporter in Rome, Anna Wallace, went to find out how the surgery works at the catholic University’s hospital Gemelli, there she met a patient who’s had the surgery Sonya Pierre Santini.

SONYA: (local language)

TRANSLATOR: I had a very high blood sugar levels. I went into a diabetic coma twice, and basically one morning I just woke up and I couldn’t see. It was like I was blind. But things gradually improved over about 15 to 20 days. I was suffering from diabetes though for about four years, I had to inject myself with insulin four times a day and also took a diabetes drug, but I just couldn’t control things. By that time I weighed about 98 Kilos, but I went on a diet and dropped to 92. Then I came to this hospital and they suggested I undergo this bypass surgery.

FRENCESCO: My name is Francesco Rubino. My interest is to treat metabolic diseases particularly obesity and now increasingly diabetes. So, this is a very serious disease and the opportunity that you can treat this disease effectively with an operation makes a lot of sense to me. Imagine having a patient condemned to a lifetime of medical therapy, taking pills, and in spite of that, not getting good results; as opposed to getting an operation and hopefully forget about that once and forever.

ANNA WALLACE: Why do you think surgery works in this particular case?

FRENCESCO: The anatomy of the bowels change in a way that some segments of the small bowel are no longer exposed to the passage of food. In addition to reducing the absorption of some of these nutrients, of course you reduce the stimulation that these nutrients exert in the excluded segments of the bowel. So the exclusion of some segments of the bowel may alter some gut hormones that are very important in the regulation of blood sugar. And it’s this mechanism that may be responsible for the very powerful effect you see in diabetes.

ANNA WALLACE: Using this knowledge, Francesco Rubino has been developing his own version of a duodenal bypass to specifically treat diabetes. As well as losing a significant amount of weight Sonya has not needed to take any diabetes medication or insulin since.

SONYA: (local language)

TRANSLATOR: It’s was incredible. After the surgery, my blood sugar levels dropped pretty much immediately. I’ve never need to take diabetes medication since. Even though I was slightly obese, I didn’t have the operation because of that. I had it for the diabetes because it was completely uncontrollably. But now I eat what I like, I’ve lost over 30 kilos, and I have a completely different life.

ANNA WALLACE: We’ve come into an office now, and Sonya and other patients have found that the diabetes have gone into remission within a few days of the operation. How long do you think this would last? Because she is 44 at the moment, she had the operation two years ago.

FRENCESCO: We know that in many different centers patients have been treated over the years, and those who had diabetes and it got into remission, have stayed so for 15 years or so. And usually in medicine, when we have something that works for more than 10 years it’s likely to continue to work.

ANNA WALLACE: It all sounds very positive, but obviously there are some side effects and some risk factors. Can you just run me through the downside of this?

FRENCESCO: Certainly surgery has some drawbacks. A Surgery operation by itself is an invasive procedure, there is an immediate risk of complications, but also chances of getting complications later on, which we need to assess. With Sonya, certainly with that operation there is a significant mal absorption of fat which something positive, but there is also mal absorption of nutrients which are important like vitamins, for instance. There are some other side effects having an impact on the quality of life. Let’s say, it is very important, rerouting of the intestine creates change in the kind of bacteria that naturally grow on the bowel, with a shift towards the bacteria that creates more air, so Sonya was complaining about there is distention. That’s a typical complication. That’s why we’re trying to devise new operations that try to avoid all those kinds of complications while retaining the efficiency.

CLAUDIA HAMMOND: Anna Wallace reporting from Rome. 

十二指肠旁路吻合术

克劳迪娅?哈蒙德：当人们用尽各种可能的方法来减肥时，一些人求助于手术减肥。有一种胃旁路手术称为十二指肠切除手术，其原理是身体从食物中吸取更少的卡路里从而达到减肥的目的。但在意大利的罗马城市，这种手术被挖掘出另外一种完全不同的用途—治疗II型糖尿病患者。这是病症是成人发病型，当人体的激素不能控制血糖水平时就会发作。它常常被看作是一种可控制但不可治愈的慢性病。一群外科医生和糖尿病专家聚集在一起后，发现实施胃旁路手术后超过80%的患者糖尿病症状消失了。我方在罗马的记者安娜?华莱士前往天主教大学Gemelli医院探究这种手术的运作原理，在医院她遇见了做过手术的病人桑娅?皮埃尔?珊提尼。

桑娅：（当地语言）

翻译：我过去血糖水平很高。我两次陷入糖尿病昏迷，一次早上起床的时候什么都看不见。感觉就像失明了一样。但在术后大约15到20天内情况逐渐好转。我多年以来遭受着糖尿病的折磨，每天必须注射四次胰岛素，还需要服用治疗糖尿病的药物，但仍然不能控制病情。那时我体重98公斤，在控制饮食后体重下降到92公斤。后来我来到医院，他们建议我做这种旁路手术。

弗朗西斯科：我是弗朗西斯科?鲁比诺，专门治疗新陈代谢性疾病，尤其是肥胖和日益增加的糖尿病。这是一种很严重的疾病，仅通过手术就能有效治疗这种疾病的机会对我而言意义无穷。试想一下：一个患者终身受着药物治疗及服用药物的痛苦，病情却毫无好转；相反的，通过一个手术就有希望将这种疾病一次性的永久清除，这是多么美好的事情啊。

安娜?华莱士：为什么你认为手术在这种特例中行得通？

弗朗西斯科：肠的剖析会发生变化，小肠的一些部分不再接触到通过的食物。这除了会减少一些营养的吸收外，当然也会减少营养对这些不接触食物的肠道部分的刺激。这些肠道的除外部分可能会产生一些抵抗对控制血糖非常重要的激素—胰岛素的因子。这种抵抗现象可能是造成糖尿病的主要病因。

安娜?华莱士：在这些知识的基础上，弗朗西斯科?鲁比诺一直在研发自己的十二指肠旁路吻合术版本来专门治疗糖尿病。除了相当可观的体重减轻外，桑娅不必再服用任何治疗糖尿病的药物或者注射胰岛素了。

桑娅：（当地语言）

翻译：这真是难以置信。手术后我的血糖水平马上就降低了很多。从今以后我再也不用服用治疗糖尿病的药物了。尽管我有些肥胖，我没有利用这个手术来减肥。但因为糖尿病病情完全不受控制，我便利用这个手术来治疗糖尿病。我现在想吃就吃，体重大概减少了30多公斤，我的生活变得完全不同。

安娜?华莱士：我们来到了办公室，桑娅和其他病人发现在手术不久后糖尿病已经被治愈了。这种情况能持续多久？她现在已经44岁了，而且在两年前就做了手术。

弗朗西斯科：我们知道在很多中心，病人已经治疗了数年了，那些糖尿病患者病症去除了，并且这个状态持续了15年左右。通常来说，如果药物能够持续10年的效力，很有可能其效力仍会持续。

安娜?华莱士：这些听起来都是有利的方面，但很明显，手术肯定会有些副作用及风险因素。你能谈谈这些不利因素吗？

弗朗西斯科：手术当然有一些缺点。手术本身就是一个入侵的过程，可能会有随即而来的并发症风险，当然也可能以后才出现并发症，这些需要我们的评估。以桑娅为例，术后对脂肪吸收的减少是积极方面，但对营养，例如对那些重要的维他命等的吸收的减少则是负面影响。还有一些其他影响生活质量的副作用。很重要的一点是，肠部的变更造成了自然生长在肠内的细菌的变化，其变成了会造出更多空气的细菌，因此桑娅总是抱怨有胀气。这是一种典型的并发症。这些是我们要设计出一种新的手术来避免所有并发症并保留功效的原因。

克劳迪娅?哈蒙德：感谢安娜?华莱士从罗马带来的报道。