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減重代謝手術效果評價系統(tǒng)的應用

來源:泰然健康網 時間:2024年12月25日 00:47

摘要:

目的: 應用減重代謝手術效果評價系統(tǒng)(bariatric analysis and reporting outcome system,BAROS)評價肥胖病人減重代謝手術的效果。方法: 入組105例減重代謝術肥胖病人。按術后隨訪時間分為4組,分別為術后3~12個月(40例)、13~36個月(38例)、37~60個月(16例)和>61個月(11例)。采用中文版本BAROS,分析病人術后的多余體重下降率(percentage of excess weight loss, %EWL)、肥胖相關合并癥改善、生活質量及術后并發(fā)癥和再手術,評價病人手術效果。結果: 所有病人均完成BAROS評價,隨訪(26.26±25.51)(3~114)個月。與術前相比,各組術后體質量指數均明顯降低(P值均<0.001)。各組%EWL依次為57.3%±17.6%、83.5%±11.4%、84.9%±8.2%和88.2%±8.9%(P<0.001)。肥胖相關合并癥在術后都得到較好改善,其中2型糖尿病緩解率69.77%,高脂血癥緩解率98.15%。生活質量平均得分1.59±0.49。生活質量評定為“好”和“非常好”的病人為86.70%,無評價為“差”和“非常差”的病人,各組之間生活質量評價構成比差異無統(tǒng)計學意義( χ2=7.506,P=0.277)。共18例出現并發(fā)癥,1例再手術。BAROS評價結果顯示手術效果評定為“極好”和“很好”為89.6%,無評價為“失敗”的病人,各組間效果評價構成比差異無統(tǒng)計學意義( χ2=6.682,P=0.670)。結論: BAROS可用于肥胖病人減重代謝手術的效果評價,術后短期與中、長期的病人均達到較好的評價效果。

關鍵詞: 肥胖, 減重代謝手術, 手術效果評價

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

中圖分類號: 

R589.2

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