Tedesco Maureen, Hua William Q, Lohnberg Jessica A, Bellatorre Nina, Eisenberg Dan
Department of Surgery, Stanford School of Medicine, Stanford, CA 94304, USA.
J Obes. 2013;2013:740312. doi: 10.1155/2013/740312. Epub 2013 Jun 12.
The rates of obesity and substance abuse are high among US veterans.
To examine weight loss and substance abuse rates following bariatric surgery in veterans with a history of substance abuse (SA).
A prospective database of consecutive bariatric operations was reviewed. Data for SA patients were compared to patients without a substance abuse history (NA). Behavioral medicine staff followed patients throughout the pre- and postoperative courses.
Of 205 bariatric surgery patients, there were 74 (36.1%) SA patients. The mean preoperative body mass index (BMI) was 46.2 ± 8.1 kg/m², and percent excess weight loss at 12 months was 71.8%, 58.0%, and 33.5% for Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, and laparoscopic gastric banding, respectively, not significantly different than the NA group (P = 0.15, 0.75, 0.96). Postoperative substance abuse in SA and NA patients was 8.1% and 1.5%, respectively (P = 0.234).
A prior history of substance abuse is common in veterans undergoing bariatric surgery; weight loss results are comparable to the general veteran bariatric cohort. Rates of substance abuse are low postoperatively, but higher in patients without a prior history of substance abuse. Close multidisciplinary followup throughout the postoperative course is likely to be integral to the patient's success.
美国退伍军人中肥胖和药物滥用的发生率很高。
研究有药物滥用史（SA）的退伍军人接受减肥手术后的体重减轻情况和药物滥用率。
回顾了连续减肥手术的前瞻性数据库。将有药物滥用史患者的数据与无药物滥用史（NA）的患者进行比较。行为医学工作人员在术前和术后全程跟踪患者。
在205例减肥手术患者中，有74例（36.1%）有药物滥用史。术前平均体重指数（BMI）为46.2±8.1kg/m²，Roux-en-Y胃旁路术、腹腔镜袖状胃切除术和腹腔镜胃束带术在12个月时的超重减轻百分比分别为71.8%、58.0%和33.5%，与无药物滥用史组无显著差异（P=0.15、0.75、0.96）。有药物滥用史和无药物滥用史患者术后的药物滥用率分别为8.1%和1.5%（P=0.234）。
有药物滥用史在接受减肥手术的退伍军人中很常见；体重减轻结果与一般退伍军人减肥队列相当。术后药物滥用率较低，但无药物滥用史患者的药物滥用率更高。术后全程密切的多学科随访可能是患者成功的关键。
