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减重代谢手术效果评价系统的应用

泰然健康网
2024-12-25 00:47

摘要：

目的： 应用减重代谢手术效果评价系统（bariatric analysis and reporting outcome system,BAROS）评价肥胖病人减重代谢手术的效果。方法： 入组105例减重代谢术肥胖病人。按术后随访时间分为4组,分别为术后3~12个月（40例）、13~36个月（38例）、37~60个月（16例）和>61个月（11例）。采用中文版本BAROS,分析病人术后的多余体重下降率（percentage of excess weight loss, %EWL）、肥胖相关合并症改善、生活质量及术后并发症和再手术,评价病人手术效果。结果： 所有病人均完成BAROS评价,随访（26.26±25.51）（3~114）个月。与术前相比,各组术后体质量指数均明显降低（P值均<0.001）。各组%EWL依次为57.3%±17.6%、83.5%±11.4%、84.9%±8.2%和88.2%±8.9%（P<0.001）。肥胖相关合并症在术后都得到较好改善,其中2型糖尿病缓解率69.77%,高脂血症缓解率98.15%。生活质量平均得分1.59±0.49。生活质量评定为“好”和“非常好”的病人为86.70%,无评价为“差”和“非常差”的病人,各组之间生活质量评价构成比差异无统计学意义（ χ2=7.506,P=0.277）。共18例出现并发症,1例再手术。BAROS评价结果显示手术效果评定为“极好”和“很好”为89.6%,无评价为“失败”的病人,各组间效果评价构成比差异无统计学意义（ χ2=6.682,P=0.670）。结论： BAROS可用于肥胖病人减重代谢手术的效果评价,术后短期与中、长期的病人均达到较好的评价效果。

关键词: 肥胖, 减重代谢手术, 手术效果评价

Abstract:

Objective To use the Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire and to evaluate the effect of bariatric and metabolic surgery (BMS) on obese patients. Methods A total of 105 patients with BMS were enrolled and stratified into 4 groups according to postoperative duration: 3-12 months (n=40), 13-36 months (n=38), 37-60 months (n=16) and >61 months (n=11). The Chinese version of BAROS was used to evaluate the results of operation including percentage of excess weight loss (%EWL), improvement of co-morbidities associated with obesity, quality of life (QOL), postoperative complications and reoperation. Results All patients completed BAROS questionnaire and were followed-up with duration of (26.26±25.51) (3-114) months. Postoperative body mass index decreased significantly compared with those preoperative in all groups (P<0.001). %EWL of patients in group 3-12 months was 57.3%±17.6%, and 83.5%±11.4% in group 13-36 months, 84.9%±8.2% in group 37-60 months and 88.2%±8.9% in group >61 months (P<0.001). The co-morbidities with obese improved significantly and remission rate was 69.77% in cases with type 2 diabetes, 98.15% in cases with hyperlipidemia. Mean score of QOL was (1.59±0.49). QOL was evaluated good and very good in 86.70% cases without any case evaluated as poor or very poor. Difference in QOL(%) among all groups was not statistically significant( χ2=7.506, P=0.277). There were 18 cases with complications and one case had reoperation. Evaluation of operative results using BAROS score showed 89.6% cases as excellent and good and no case as failure of operation. There was no statistically significant difference among groups ( χ2=6.682, P=0.670). Conclusions BAROS can be used to analyze the effect of BMS and the results of short-term and middle/long term in this study were encouraged.

Key words: Obesity, Bariatric and metabolic surgery, Evaluation of operative effect

中图分类号:

R589.2