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腹腔镜可调胃束带术治疗病态肥胖青少年的前瞻性试验:减肥、代谢和生活质量结果的中期报告。

A prospective trial for laparoscopic adjustable gastric banding in morbidly obese adolescents: an interim report of weight loss, metabolic and quality of life outcomes.

机构信息

Department of Pediatrics and Surgery, Section of Pediatric Surgery, Rush University Medical Center, Chicago, IL 60612, USA.

出版信息

J Pediatr Surg. 2010 Jan;45(1):74-8; discussion 78-9. doi: 10.1016/j.jpedsurg.2009.10.013.

Abstract

UNLABELLED

BACKGROUND AND MATERIALS AND METHODS: The outcome of patients completing 12 months of follow-up in a prospective longitudinal trial of the safety/efficacy of laparoscopic adjustable gastric banding (LAGB) for morbidly obese adolescents aged 14 to 17 years using a Food and Drug Administration Institutional Device Exemption for the use of the LAPBAND was analyzed. Baseline and outcome data were abstracted from a prospective database.

RESULTS

Baseline (mean +/- SD) body mass index was 50 +/- 10 kg/m(2), and excess weight was 178 +/- 53 lb in 20 patients. Comorbidities included hypertension (45%), dyslipidemia (80%), insulin resistance (90%), metabolic syndrome (95%), and biopsy-proven nonalcoholic steatohepatitis (88%). At mean (SD) follow-up of 26 (9) months, % excess weight loss was 34% +/- 22% (n = 20) and 41% +/- 27% (n = 12), and the metabolic syndrome was resolved in 63% and 82% of the patients at 12 and 18 months, respectively. Hypertension normalized in all patients, along with improvement in lipid abnormalities and quality of life scores (P < .05). At 12 months, of the 5 patients with less than 20% excess weight loss, dyslipidemia and metabolic syndrome were resolved in 2 patients.

CONCLUSION

At intermediate follow-up of a LAGB-based obesity treatment program, weight loss led to resolution or improvement of major obesity-related comorbidities in most patients, supporting the efficacy of LAGB as a surgical adjunct to a comprehensive obesity treatment program and its long-term evaluation.

摘要

背景和材料与方法

本研究分析了使用食品和药物管理局机构设备豁免对 14 至 17 岁病态肥胖青少年进行腹腔镜可调节胃束带术(LAGB)安全性/疗效的前瞻性纵向试验中完成 12 个月随访的患者的结果。基线和结局数据均从前瞻性数据库中提取。

结果

基线(平均值±标准差)体重指数为 50±10kg/m²,20 例患者超重 178±53 磅。合并症包括高血压(45%)、血脂异常(80%)、胰岛素抵抗(90%)、代谢综合征(95%)和活检证实的非酒精性脂肪性肝炎(88%)。在平均(标准差)26(9)个月的随访中,%超重减轻率为 34%±22%(n=20)和 41%±27%(n=12),12 个月和 18 个月时,分别有 63%和 82%的患者代谢综合征得到缓解。所有患者的高血压均正常化,血脂异常和生活质量评分也得到改善(P<.05)。在 12 个月时,5 例患者的超重减轻不足 20%,其中 2 例患者的血脂异常和代谢综合征得到缓解。

结论

在 LAGB 为基础的肥胖治疗方案的中期随访中,体重减轻导致大多数患者的主要肥胖相关合并症得到缓解或改善,支持 LAGB 作为综合肥胖治疗方案的手术辅助手段及其长期评估。

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