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胃旁路手术后因未遵医嘱补充维生素和矿物质导致的营养不良:对此我们能做些什么?

Malnutrition secondary to non-compliance with vitamin and mineral supplements after gastric bypass surgery: What can we do about it?

作者信息

Ahmad Dina S, Esmadi Mohammad, Hammad Hazem

机构信息

Department of Internal Medicine, University of Missouri School of Medicine, Columbia, MO, U.S.A.

出版信息

Am J Case Rep. 2012;13:209-13. doi: 10.12659/AJCR.883335. Epub 2012 Aug 29.

Abstract

BACKGROUND

Nutritional deficiency due to loss of follow up and non-compliance with routine mineral and multivitamin supplements is not uncommonly encountered following bariatric surgery. In this report, and utilizing a case study, we will address issues related to loss of long term medical follow up and the measures that can be taken to prevent it in this patient population.

CASE REPORT

The case of a 38-year-old female patient who was recently managed for severe vitamin deficiency and iron deficiency anemia following bariatric surgery is presented. Non-compliance with routine vitamin and mineral supplements was believed to be the main culprit of her condition. Articles published in English addressing issues related to non-compliance with supplementations and regular follow up after bariatric surgery were accessed from PubMed and are discussed.

CONCLUSIONS

Multiple factors affecting long term follow up and compliance have been studied including age, financial costs, distance from the clinic and psychiatric comorbidities. Preventive measures have also been tested and some of them have shown significant benefit. More research is needed to identify other modifiable factors and preventive measures influencing compliance and long term follow up following bariatric surgery.

摘要

背景

减肥手术后,因失去随访以及未按常规补充矿物质和多种维生素而导致营养缺乏的情况并不罕见。在本报告中,我们将通过一个病例研究,探讨与长期医疗随访缺失相关的问题,以及针对该患者群体可采取的预防措施。

病例报告

本文介绍了一名38岁女性患者的病例,该患者近期因减肥手术后出现严重维生素缺乏和缺铁性贫血而接受治疗。未按常规补充维生素和矿物质被认为是导致其病情的主要原因。我们从PubMed上检索了以英文发表的、涉及减肥手术后未遵医嘱补充营养和定期随访相关问题的文章,并进行了讨论。

结论

已经对影响长期随访和依从性的多个因素进行了研究,包括年龄、经济成本、与诊所的距离以及精神疾病合并症。也已经对预防措施进行了测试,其中一些措施显示出显著效果。需要更多研究来确定其他可改变的因素以及影响减肥手术后依从性和长期随访的预防措施。

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