Orhan Gökçen, Biçer Yeşim, Aka Serap Aykut, Sargin Murat, Simşek Serap, Senay Sahin, Aykaç Zuhal, Eren E Ergin
Department of Cardiovascular Surgery, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Zaman Sok. Güngör Apt. 4/9, Dumlupinar Mah., Kadiköy, Istanbul, Turkey.
Eur J Cardiothorac Surg. 2004 Feb;25(2):212-7. doi: 10.1016/j.ejcts.2003.11.003.
Obesity is a major public health problem with an increasing prevalence. Although coronary artery bypass grafting (CABG) operations are now performed with low morbidity and mortality rates, obesity is still assumed to be an important risk factor for morbidity and mortality at these operations but there is no precise approach to define it as a risk factor. The aim of this study is to evaluate the effects of obesity on the clinical outcome of the CABG operations.
A total of 1206 patients, who underwent isolated CABG operation under cardiopulmonary bypass were evaluated retrospectively. The patients were divided into three groups. Group I was normal weight, with body mass index (BMI) of 18-24.9 kg/m(2), group II was overweight, with a BMI of 25-29.9 kg/m(2), and group III was obese, with a BMI of >30 kg/m(2). The clinical data of three groups were evaluated in aspects of postoperative morbidity and mortality.
Except for the superficial wound infections, there were no differences in postoperative mortality and morbidity rates between the three groups. Obesity was not found to be an important risk factor for postoperative morbidity and mortality.
Despite the perception that obesity increases the risk of mortality and morbidity in CABG operations, the clinical outcome of these patients are not so different from other patients. We may say that obese patients can be safely operated.
肥胖是一个患病率不断上升的主要公共卫生问题。尽管目前冠状动脉旁路移植术（CABG）的手术发病率和死亡率较低，但肥胖仍被认为是这些手术中发病和死亡的重要危险因素，但尚无将其定义为危险因素的精确方法。本研究的目的是评估肥胖对CABG手术临床结果的影响。
对总共1206例在体外循环下行单纯CABG手术的患者进行回顾性评估。患者分为三组。第一组为正常体重，体重指数（BMI）为18 - 24.9kg/m²，第二组为超重，BMI为25 - 29.9kg/m²，第三组为肥胖，BMI>30kg/m²。从术后发病率和死亡率方面评估三组的临床资料。
除浅表伤口感染外，三组术后死亡率和发病率无差异。未发现肥胖是术后发病和死亡的重要危险因素。
尽管人们认为肥胖会增加CABG手术的死亡和发病风险，但这些患者的临床结果与其他患者并无太大差异。我们可以说肥胖患者可以安全地进行手术。
