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术前知识对腹腔镜胃旁路术后体重减轻的影响。

Effect of preoperative knowledge on weight loss after laparoscopic gastric bypass.

作者信息

Orth Whitney S, Madan Atul K, Ternovits Craig A, Tichansky David S

机构信息

Department of Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.

出版信息

Obes Surg. 2008 Jul;18(7):768-71. doi: 10.1007/s11695-007-9317-6. Epub 2008 May 10.

DOI:10.1007/s11695-007-9317-6
PMID:18470575
Abstract

INTRODUCTION

Gastric bypass surgery has been demonstrated to be an effective treatment for morbid obesity. Unfortunately, not all patients have the same weight loss after surgery. It may be that the more informed patients will have more weight loss than less informed patients. No study has investigated the relationship between initial preoperative knowledge and weight loss after laparoscopic gastric bypass surgery.

METHODS

All patients who underwent laparoscopic gastric bypass for a 6-month period were included in this study. Our preoperative education process includes a 21-question true/false test given at the appointment immediately before surgery. Patients repeat the test until all questions are answered correctly. We compared percentage of excess body weight loss (EBWL) between patients who correctly answered all the questions the first time (pass patients) and patients who did not correctly answer all the questions the first time (fail patients).

RESULTS

There were 104 patients involved in this study; although complete data were only available on 98 patients. The average preoperative body mass index was 48 kg/m(2). Forty-eight percent of patients answered all the questions correctly the first time. Follow-up ranged from 1 to 2 years on all 98 patients. Pass patients had an average of 73% EBWL, whereas fail patients had an average of 76% EBWL (p = NS).

CONCLUSIONS

Preoperative knowledge, assessed by a test, did not predict success after laparoscopic gastric bypass surgery. Patients who do not, at first, have full knowledge of bariatric surgery should not be discriminated against undergoing surgery if they are eventually properly educated.

摘要

引言

胃旁路手术已被证明是治疗病态肥胖的有效方法。不幸的是,并非所有患者术后体重减轻情况相同。可能了解更多信息的患者比了解较少信息的患者体重减轻更多。尚无研究调查腹腔镜胃旁路手术后初始术前知识与体重减轻之间的关系。

方法

本研究纳入了所有在6个月期间接受腹腔镜胃旁路手术的患者。我们的术前教育过程包括在手术前预约时进行的一项包含21个问题的对错测试。患者重复进行测试,直到所有问题都回答正确。我们比较了首次正确回答所有问题的患者(通过测试的患者)和首次未正确回答所有问题的患者(未通过测试的患者)之间的多余体重减轻百分比(EBWL)。

结果

本研究共纳入104例患者;不过仅有98例患者有完整数据。术前平均体重指数为48kg/m²。48%的患者首次就正确回答了所有问题。对所有98例患者的随访时间为1至2年。通过测试的患者平均EBWL为73%,而未通过测试的患者平均EBWL为76%(p=无统计学意义)。

结论

通过测试评估的术前知识并不能预测腹腔镜胃旁路手术后的效果。起初对减肥手术没有充分了解的患者,如果最终接受了适当的教育,在接受手术时不应受到歧视。

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Long-term mortality after gastric bypass surgery.胃旁路手术后的长期死亡率。
N Engl J Med. 2007 Aug 23;357(8):753-61. doi: 10.1056/NEJMoa066603.
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Insurance mandated preoperative dietary counseling does not improve outcome and increases drop-out rates in patients considering gastric bypass surgery for morbid obesity.保险强制要求的术前饮食咨询并不能改善结果,反而会增加考虑接受胃旁路手术治疗病态肥胖症患者的退出率。
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