摘要：

目的： 應(yīng)用減重代謝手術(shù)效果評(píng)價(jià)系統(tǒng)（bariatric analysis and reporting outcome system,BAROS）評(píng)價(jià)肥胖病人減重代謝手術(shù)的效果。方法： 入組105例減重代謝術(shù)肥胖病人。按術(shù)后隨訪時(shí)間分為4組,分別為術(shù)后3~12個(gè)月（40例）、13~36個(gè)月（38例）、37~60個(gè)月（16例）和>61個(gè)月（11例）。采用中文版本BAROS,分析病人術(shù)后的多余體重下降率（percentage of excess weight loss, %EWL）、肥胖相關(guān)合并癥改善、生活質(zhì)量及術(shù)后并發(fā)癥和再手術(shù),評(píng)價(jià)病人手術(shù)效果。結(jié)果： 所有病人均完成BAROS評(píng)價(jià),隨訪（26.26±25.51）（3~114）個(gè)月。與術(shù)前相比,各組術(shù)后體質(zhì)量指數(shù)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(guān)合并癥在術(shù)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(zhì)量平均得分1.59±0.49。生活質(zhì)量評(píng)定為“好”和“非常好”的病人為86.70%,無(wú)評(píng)價(jià)為“差”和“非常差”的病人,各組之間生活質(zhì)量評(píng)價(jià)構(gòu)成比差異無(wú)統(tǒng)計(jì)學(xué)意義（ χ2=7.506,P=0.277）。共18例出現(xiàn)并發(fā)癥,1例再手術(shù)。BAROS評(píng)價(jià)結(jié)果顯示手術(shù)效果評(píng)定為“極好”和“很好”為89.6%,無(wú)評(píng)價(jià)為“失敗”的病人,各組間效果評(píng)價(jià)構(gòu)成比差異無(wú)統(tǒng)計(jì)學(xué)意義（ χ2=6.682,P=0.670）。結(jié)論： BAROS可用于肥胖病人減重代謝手術(shù)的效果評(píng)價(jià),術(shù)后短期與中、長(zhǎng)期的病人均達(dá)到較好的評(píng)價(jià)效果。

關(guān)鍵詞: 肥胖, 減重代謝手術(shù), 手術(shù)效果評(píng)價(jià)

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(hào): 

R589.2

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