Mathus-Vliegen Elisabeth M H
Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Dig Dis. 2008;26(1):40-4. doi: 10.1159/000109385. Epub 2008 Feb 15.
Obesity is a chronic metabolic disorder with considerable health risks, which can be approved by a sustained modest weight loss. This can be achieved by medical treatment through behavioral therapy, diet, exercise and pharmacotherapy. Surgery is often needed for the severely obese. Intragastric balloon treatment stands in between, being more drastic than medical treatment but less invasive than surgery. In the light of the high premature deflation rate and the high incidence of gastric ulcers, a safer balloon had to be awaited, constructed according to predefined criteria. This new balloon (BioEnterics Intragastric Balloon) promoted a weight loss of 5-9 BMI units in 6 months with an impressive improvement of obesity-associated comorbidities. A weight regain of 25-40% has to be considered in a 1-year balloon-free follow-up period. A failure rate of 15% was observed in studies that defined a successful weight loss. With respect to safety, there was no mortality. Gastrointestinal complications, mainly consisting of esophagitis, were present in 5.5%. Intolerance of the balloon resulted in its removal in 7%. Balloons deflated in 8% with an uneventful outcome in all except 5 patients, who had to be operated. Balloon treatment is a valuable method, but nonresponse, intolerance and weight regain have to be taken into account.
肥胖是一种具有相当大健康风险的慢性代谢紊乱疾病，持续适度减重可改善这种状况。这可以通过行为疗法、饮食、运动和药物治疗等医学手段来实现。重度肥胖者通常需要进行手术。胃内球囊治疗介于两者之间，比医学治疗更为激进，但比手术侵入性小。鉴于高过早放气率和胃溃疡高发病率，必须等待一种根据预定义标准制造的更安全的球囊。这种新球囊（BioEnterics胃内球囊）在6个月内使体重指数降低5 - 9个单位，肥胖相关合并症有显著改善。在无球囊的1年随访期内，体重会反弹25% - 40%。在定义为成功减重的研究中，观察到失败率为15%。在安全性方面，无死亡病例。胃肠道并发症主要为食管炎，发生率为5.5%。7%的患者因对球囊不耐受而将其取出。8%的球囊自行放气，除5名必须接受手术的患者外，其余结果均平稳。球囊治疗是一种有价值的方法，但必须考虑无反应、不耐受和体重反弹等情况。
