Malinowski Scott S
Department of Pharmacy Services, Division of Digestive Health and Nutrition, University of Mississippi Medical Center, Jackson, Mississippi 39216-4505, USA.
Am J Med Sci. 2006 Apr;331(4):219-25. doi: 10.1097/00000441-200604000-00009.
Bariatric surgery is an effective treatment for patients with clinically severe obesity. In addition to significant weight loss, it is also associated with improvements in comorbidities. Unfortunately, bariatric surgery also has the potential to cause a variety of nutritional and metabolic complications. These complications are mostly due to the extensive surgically induced anatomical changes incurred by the patient's gastrointestinal tract, particularly with roux-en-Y gastric bypass and biliopancreatic diversion. Complications associated with vertical banded gastroplasty are mostly due to decreased intake amounts of specific nutrients. Macronutrient deficiencies can include severe protein-calorie malnutrition and fat malabsorption. The most common micronutrient deficiencies are of vitamin B12, iron, calcium, and vitamin D. Other micronutrient deficiencies that can lead to serious complications include thiamine, folate, and the fat-soluble vitamins. Counseling, monitoring, and nutrient and mineral supplementation are essential for the treatment and prevention of nutritional and metabolic complications after bariatric surgery.
减重手术是治疗临床严重肥胖患者的有效方法。除了显著减重外，它还与合并症的改善有关。不幸的是，减重手术也有可能导致各种营养和代谢并发症。这些并发症主要是由于患者胃肠道发生的广泛手术引起的解剖学变化，特别是在Roux-en-Y胃旁路术和胆胰转流术时。与垂直捆绑胃成形术相关的并发症主要是由于特定营养素的摄入量减少。大量营养素缺乏可包括严重的蛋白质 - 热量营养不良和脂肪吸收不良。最常见的微量营养素缺乏是维生素B12、铁、钙和维生素D。其他可导致严重并发症的微量营养素缺乏包括硫胺素、叶酸和脂溶性维生素。咨询、监测以及营养素和矿物质补充对于减重手术后营养和代谢并发症的治疗和预防至关重要。
