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病态肥胖患者的腰痛及手术后体重减轻的影响。

Low-back pain in morbidly obese patients and the effect of weight loss following surgery.

作者信息

Melissas John, Volakakis Evaggelos, Hadjipavlou Alexander

机构信息

Bariatric Unit, Department of Surgical Oncology, Medical School, University of Crete, Greece.

出版信息

Obes Surg. 2003 Jun;13(3):389-93. doi: 10.1381/096089203765887714.

Abstract

BACKGROUND

Although low-back pain (LBP) is a common health problem and a source of significant discomfort, disability and work absences, its incidence, severity and outcome have not been extensively investigated in morbidly obese patients undergoing bariatric surgery.

METHODS

50 morbidly obese candidates for vertical banded gastroplasty (VBG) were asked to fill in a questionnaire, to assess the incidence and severity of any existing LBP symptoms. 50 non-obese patients, admitted to our surgical unit for management of several benign conditions, were also asked to fill in the same questionnaire and served as controls. 24 months after VBG, the morbidly obese patients were again evaluated for their LBP symptoms.

RESULTS

LBP was identified in 29 morbidly obese patients (58%) preoperatively and in only 12 (24%) of the lean controls (P<0.01). 2 years after VBG, with a significant excess weight loss (P<0.0001), only 10 patients continued to have LBP but less frequently and requiring reduced doses of medications compared with the preoperative condition. In the remaining 19 patients with preoperative positive LBP history, the postoperative weight loss was associated with complete resolution of the symptoms.

CONCLUSION

The frequency of LBP is significantly higher in morbidly obese patients than in lean subjects. Surgical weight reduction results in significant improvement and even disappearance of this obesity co-morbidity.

摘要

背景

尽管腰痛(LBP)是一个常见的健康问题,会导致严重不适、残疾和旷工,但在接受减肥手术的病态肥胖患者中,其发病率、严重程度和预后尚未得到广泛研究。

方法

50名拟行垂直束带胃成形术(VBG)的病态肥胖患者被要求填写一份问卷,以评估任何现有腰痛症状的发生率和严重程度。50名因多种良性疾病入住我们外科病房的非肥胖患者也被要求填写相同的问卷,并作为对照。VBG术后24个月,对病态肥胖患者的腰痛症状再次进行评估。

结果

术前在29名病态肥胖患者(58%)中发现腰痛,而在瘦对照组中只有12名(24%)有腰痛(P<0.01)。VBG术后2年,随着体重显著减轻(P<0.0001),只有10名患者继续有腰痛,但与术前相比,发作频率降低,所需药物剂量减少。在其余19名术前有阳性腰痛病史患者中,术后体重减轻与症状完全缓解相关。

结论

病态肥胖患者腰痛的发生率明显高于瘦人。手术减重可显著改善甚至消除这种肥胖合并症。

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