Roux-en-Y胃旁路手术治疗病态肥胖症后复杂术后管理的术前预测因素
Preoperative factors predictive of complicated postoperative management after Roux-en-Y gastric bypass for morbid obesity.
作者信息
Gonzalez R, Bowers S P, Venkatesh K R, Lin E, Smith C D
机构信息
Emory Bariatrics and Endosurgery Unit, Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322, USA.
出版信息
Surg Endosc. 2003 Dec;17(12):1900-4. doi: 10.1007/s00464-003-8810-9. Epub 2003 Oct 13.
INTRODUCTION
This study was undertaken to determine preoperative predictive factors of complicated postoperative management after Roux-en-Y gastric bypass (RYGB) for morbid obesity.
METHODS
Between January 1999 and January 2002, 158 patients who underwent a RYGB received a standardized preoperative evaluation and data were collected prospectively. Complicated postoperative management was defined as patients requiring postoperative ICU admission for > or =48 h, or those needing transfer from the floor to the ICU. Patients with complicated management were compared with those in whom ICU admission was not necessary.
RESULTS
Twenty-three patients (14.5%) required prolonged ICU admission (mean stay of 6.3 +/- 1.7 days). After multivariate analysis, body mass index (BMI) >50 kg/m2, forced expiratory volume (FEV1) <80% predicted, previous abdominal surgeries, and abnormal EKG were found to be independently associated with an increased likelihood of complicated postoperative care.
CONCLUSION
BMI >50 kg/m2, FEV1 <80% predicted, previous abdominal surgeries, and abnormal EKG increase the likelihood of complicated postoperative management after RYGB for morbid obesity.
引言
本研究旨在确定病态肥胖患者接受Roux-en-Y胃旁路术（RYGB）后术后复杂管理的术前预测因素。
方法
在1999年1月至2002年1月期间，158例行RYGB的患者接受了标准化的术前评估，并前瞻性收集数据。术后复杂管理定义为术后需要入住重症监护病房（ICU）≥48小时的患者，或需要从普通病房转入ICU的患者。将术后管理复杂的患者与无需入住ICU的患者进行比较。
结果
23例患者（14.5%）需要延长ICU住院时间（平均住院时间为6.3±1.7天）。多因素分析后发现，体重指数（BMI）>50kg/m²、预计第一秒用力呼气容积（FEV1）<80%、既往腹部手术史以及心电图异常与术后复杂护理的可能性增加独立相关。
结论
BMI>50kg/m²、预计FEV1<80%、既往腹部手术史以及心电图异常会增加病态肥胖患者接受RYGB后术后复杂管理的可能性。
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