Shafipour Pouya, Der-Sarkissian Jack K, Hendee Fadi N, Coleman Karen J
Pouya Shafipour MS, MD, is a Family Physician at the Motion Picture and Television Fund Medical Group in Los Angeles, CA. E-mail:
Perm J. 2009 Fall;13(4):56-63. doi: 10.7812/TPP/08-067.
Unfortunately, many of the traditional methods for weight loss, such as dietary restriction, exercise, meal replacement, psychosocial and behavioral interventions, and medications, have limited effectiveness in long-term weight maintenance and regulation of chronic diseases such as type 2 diabetes. This has led to the development of surgical approaches to weight loss, generally referred to as bariatric surgery. Most bariatric surgery studies have shown excellent weight-loss rates for up to two years after surgery, with patients losing an average of 61 % of their excess weight (losing 100% of excess weight would return patients to their ideal weight). There is also some evidence that most patients maintain some level of weight loss for up to ten years after surgery. The purpose of this article is to provide primary care physicians and other clinicians with some background regarding bariatric surgical procedures and their risks and benefits. We also summarize the bariatric surgery process at Kaiser Permanente Southern California (KPSC), and then provide a detailed case study as an example of how KPSC screens patients referred for surgery, prepares them for the surgery, and cares for them once they have undergone surgery.
不幸的是，许多传统的减肥方法，如饮食限制、运动、代餐、心理社会和行为干预以及药物治疗，在长期维持体重和调节2型糖尿病等慢性疾病方面效果有限。这导致了减肥手术方法的发展，一般称为减重手术。大多数减重手术研究表明，术后长达两年的减肥效果极佳，患者平均减掉61%的超重体重（减掉100%的超重体重可使患者恢复到理想体重）。也有一些证据表明，大多数患者在术后长达十年内都能维持一定程度的体重减轻。本文的目的是为初级保健医生和其他临床医生提供一些关于减重手术程序及其风险和益处的背景知识。我们还总结了南加州凯撒永久医疗集团（KPSC）的减重手术过程，然后提供一个详细的案例研究，作为KPSC如何筛选转诊手术患者、为手术做准备以及在患者接受手术后进行护理的示例。
