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肥胖症手术患者:术后前往急诊科就诊的原因。

Bariatric surgery patients: reasons to visit emergency department after surgery.

作者信息

Gonzalez-Sánchez Juan A, Corujo-Vázquez Omar, Sahai-Hernández Mrisa

机构信息

University of Puerto Rico School of Medicine, Emergency Medicine Department.

出版信息

Bol Asoc Med P R. 2007 Oct-Dec;99(4):279-83.

Abstract

STUDY OBJECTIVE

Morbid obesity prevalence is reaching epidemic proportions in Western society. Long-term weight loss can be achieved by bariatric surgery. This surgery also has a positive impact in the reduction of obesity related co-morbid conditions. The purpose of this study is to determine the reasons that bariatric surgery patients had to visit the emergency department within a three month period after surgery.

METHODS

A retrospective chart review study was performed at the UPR Hospital in Carolina. Patients with the diagnosis of morbid obesity who had bariatric surgery were identified. Of the 283 patients who met the criteria, the following information was obtained: gender, age, height, weight, pre-operative BMI, obesity-related comorbid conditions, post operative length of stay (LOS), and reasons and length of stay of Emergency Department (ED) visits within a 3 month period after surgery. Statistical analysis was done with Statistical Package for Social Sciences (SPSS) Program.

RESULTS

The same profile of gender and BMI was obtained between the population that had the surgery and the sample that visited the ED, the group of patients between 20-29 years old was more likely to visit the ED. No correlation was found between a longer post operative length of stay and an increased probability of visiting the ED. Of the population, 5% had to visit ED within a three month period. The most common post operative complications were: Abdominal Pain (46.2%), Emesis (38.5%), and Dehydration (30.8%). Other less frequent complications were nausea, DVT, pneumonia, dizziness, gastritis, infected wound and upper GI bleeding.

CONCLUSION

The most common reasons that bariatric surgery patients had to visit the emergency department within a three month period after surgery were: abdominal pain, emesis, dehydration and nausea. These complications could most likely be attributed to patient poor compliance with diet, resulting in the classical symptoms of the dumping syndrome which is common in patients that have undergone bariatric surgery.

摘要

研究目的

病态肥胖的患病率在西方社会正达到流行程度。减肥手术可实现长期体重减轻。该手术对减少肥胖相关的合并症也有积极影响。本研究的目的是确定减肥手术患者在术后三个月内必须前往急诊科就诊的原因。

方法

在卡罗来纳州的UPR医院进行了一项回顾性病历审查研究。确定了接受减肥手术的病态肥胖诊断患者。在符合标准的283名患者中,获取了以下信息:性别、年龄、身高、体重、术前体重指数、肥胖相关合并症、术后住院时间(LOS)以及术后三个月内急诊科就诊的原因和住院时间。使用社会科学统计软件包(SPSS)程序进行统计分析。

结果

接受手术的人群和前往急诊科就诊的样本之间获得了相同的性别和体重指数分布,20至29岁的患者组更有可能前往急诊科就诊。未发现术后住院时间延长与前往急诊科就诊概率增加之间存在相关性。在该人群中,5%的患者在三个月内必须前往急诊科就诊。最常见的术后并发症为:腹痛(46.2%)、呕吐(38.5%)和脱水(30.8%)。其他较不常见的并发症为恶心、深静脉血栓形成、肺炎、头晕、胃炎、伤口感染和上消化道出血。

结论

减肥手术患者在术后三个月内必须前往急诊科就诊的最常见原因是:腹痛、呕吐、脱水和恶心。这些并发症很可能归因于患者饮食依从性差,导致倾倒综合征的典型症状,这在接受减肥手术的患者中很常见。

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