Bennett John C, Wang Hongkun, Schirmer Bruce D, Northup C Joe
Department of Surgery, University of Virginia Health System, Charlottesville, Virginia 22908-0709, USA.
Surg Obes Relat Dis. 2007 May-Jun;3(3):387-91. doi: 10.1016/j.soard.2007.02.013.
Not all patients undergoing Roux-en-Y gastric bypass with an initial body mass index (BMI) >50 kg/m(2) attain a BMI of <35 kg/m(2) postoperatively. We hypothesized that even though many of these patients remain morbidly obese after surgery, they still realize an improvement in co-morbidities and quality of life.
Patients who had undergone Roux-en-Y gastric bypass and who had a preoperative BMI >50 kg/m(2) and postoperative BMI >35 kg/m(2) were identified. The records of 120 patients were reviewed for the presence of diabetes, hypertension, hyperlipidemia, and gastroesophageal reflux disease. Patients were queried about their use of medications, medical problems, and quality of life.
The average preoperative and postoperative BMI was 63.2 and 43.7 kg/m(2). Of the 120 patients, 77 responded to the survey. In the preoperative group, the rate of diabetes, hypertension, hyperlipidemia, and gastroesophageal reflux disease was 35%, 50.8%, 15%, and 34.2%, respectively. Postoperatively, 73.8%, 62.3%, 38.9%, and 87.8% of patients had been cured of these co-morbidities. The change in the incidence of diabetes, hypertension, and gastroesophageal reflux disease was significant at P = 0.0014, P = 0.037, and P <0.0001, respectively. More than 90% of patients considered themselves to be better postoperatively in the areas of overall health and ability to move about; 80-90% had improved ability to exercise, greater energy levels, more self esteem, and an improved physical appearance; 70-80% saw their ability to work and their social relationships as improved; and 56% believed their sexual relationships had improved.
Super-obese patients experience significant improvements in co-morbidities and quality of life after Roux-en-Y gastric bypass even if their BMI remains >35 kg/m(2).
并非所有初始体重指数（BMI）>50kg/m²的患者在接受Roux-en-Y胃旁路手术后BMI能降至<35kg/m²。我们推测，尽管这些患者中有许多人术后仍为病态肥胖，但他们的合并症和生活质量仍会有所改善。
确定接受过Roux-en-Y胃旁路手术、术前BMI>50kg/m²且术后BMI>35kg/m²的患者。回顾120例患者的病历，以确定是否存在糖尿病、高血压、高脂血症和胃食管反流病。询问患者的用药情况、医疗问题和生活质量。
术前和术后的平均BMI分别为63.2和43.7kg/m²。120例患者中，77例回复了调查。术前组中，糖尿病、高血压、高脂血症和胃食管反流病的发生率分别为35%、50.8%、15%和34.2%。术后，73.8%、62.3%、38.9%和87.8%的患者这些合并症得到治愈。糖尿病、高血压和胃食管反流病发病率的变化具有显著性，P值分别为0.0014、0.037和P<0.0001。超过90%的患者认为自己在整体健康和活动能力方面术后有所改善；80-90%的患者运动能力提高、精力更充沛、自尊心增强且外貌改善；70-80%的患者认为工作能力和社交关系有所改善；56%的患者认为性关系有所改善。
超级肥胖患者在接受Roux-en-Y胃旁路手术后，即使BMI仍>35kg/m²，其合并症和生活质量也会有显著改善。
