Brolin R E, Gorman R C, Milgrim L M, Kenler H A
Department of Surgery, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903.
Int J Obes. 1991 Oct;15(10):661-7.
One hundred forty patients were followed for a mean 24.2 months after gastric bypass. Postop multivitamin (MV) prophylaxis was recommended for all patients and 90 of 140 patients (64 percent) were regularly compliant. Deficiencies in iron, vitamin B-12 or folate were recognized in 88 of 140 patients (63 percent). Thirty of 45 patients (67 percent) with iron deficiency developed anemia. Forty-three of the 52 patients who did not have deficiencies were regularly taking MV vs 47 of 88 patients who developed deficiencies (P less than 0.001). MV prophylaxis was successful in preventing folate (P less than or equal to 0.05) and vitamin B-12 deficiencies (P less than or equal to 0.02) but did not prevent development of iron deficiency or subsequent anemia. There was no correlation between taking prescribed supplements and resolution of either iron deficiency of anemia. B-12 and folate supplements corrected deficiencies in 73 percent of cases. We conclude that oral MV prophylaxis is useful in preventing folate and B-12 deficiency after gastric bypass. Additional prophylactic iron supplements should be provided for women to prevent iron deficiency and associated anemia.
140例患者在接受胃旁路手术后平均随访24.2个月。建议所有患者术后进行多种维生素（MV）预防，140例患者中有90例（64%）定期遵医嘱。140例患者中有88例（63%）被发现存在铁、维生素B12或叶酸缺乏。45例缺铁患者中有30例（67%）发生贫血。52例未出现缺乏的患者中有43例定期服用MV，而88例出现缺乏的患者中有47例（P<0.001）。MV预防成功预防了叶酸缺乏（P≤0.05）和维生素B12缺乏（P≤0.02），但未能预防缺铁或随后的贫血。服用规定补充剂与缺铁性贫血的缓解之间没有相关性。B12和叶酸补充剂在73%的病例中纠正了缺乏。我们得出结论，口服MV预防对预防胃旁路术后叶酸和B12缺乏有用。应为女性提供额外的预防性铁补充剂，以预防缺铁和相关贫血。
