Zago S, Kornmuller A M, Agagliati D, Saber B, Ferrari D, Maffeis P, Labate M, Bauducco E, Manghisi L, Martignone L, Spanu M, Rovera G M
Ospedale Valdese di Torino, ASL 1, Turin.
Minerva Med. 2006 Feb;97(1):51-64.
The therapeutic model for severe obesity includes bariatric surgery, representing the safest way to keep weight down and to prevent relapses. The selection of patients for the most suitable type of surgery implies multidisciplinary approach (nutritionist, dietist, clinical psychologist and surgeon). The intragastric balloon may represent a relatively invasive method to help the medical team to select and prepare severely obese patients for restrictive bariatric surgery.
In our study we considered 48 severely obese patients: initial weight 111+/-14.8 kg, BMI 43+/-5.02, excess weight 77.47+/-16.14%. These patients have been treated with intragastric balloon (BIB) filled to a volume of 500 cc for 6 months. We considered variations induced by BIB treatment on a number of parameters--clinical, anthropometric, food intake, partition of nourishing elements and psychological and psychometric data.
At the end of the treatment the patients showed significant reductions of excess weight (67.35+/-20.19%), of weight (103.4+/-16.72 kg) and food intake, without modification of the items in the EDI2 test, but with important motivational support for a change in life style between the beginning and the end of the treatment, clearly resulting from the medical, dietist and clinical-psychological follow-up.
BIB is a relatively invasive means capable of modifying eating habits in the short term; it induces weight loss, may help to reduce the anaesthesiological risk and to foster a change in the patient's behaviour. In our experience treatment with BIB is useful from the educational point of view and can be used to select patients for bariatric surgery only within a multidisciplinary team. Further clinical studies are necessary.
重度肥胖的治疗模式包括减肥手术,这是保持体重下降并防止复发的最安全方法。为患者选择最合适的手术类型需要多学科方法(营养师、饮食学家、临床心理学家和外科医生)。胃内球囊可能是一种相对侵入性的方法,可帮助医疗团队为重度肥胖患者选择并准备限制性减肥手术。
在我们的研究中,我们纳入了48例重度肥胖患者:初始体重111±14.8千克,体重指数43±5.02,超重77.47±16.14%。这些患者接受了填充至500立方厘米体积的胃内球囊(BIB)治疗6个月。我们考虑了BIB治疗对一些参数的影响——临床、人体测量、食物摄入量、营养成分分配以及心理和心理测量数据。
治疗结束时,患者的超重(67.35±20.19%)、体重(103.4±16.72千克)和食物摄入量均显著降低,EDI2测试中的项目未发生改变,但治疗开始和结束之间在生活方式改变方面获得了重要的动机支持,这显然源于医学、饮食学和临床心理学随访。
BIB是一种相对侵入性的手段,能够在短期内改变饮食习惯;它能导致体重减轻,可能有助于降低麻醉风险并促进患者行为改变。根据我们的经验,从教育角度来看,BIB治疗是有用的,并且仅能在多学科团队中用于选择减肥手术患者。还需要进一步的临床研究。