Raoof Mustafa, Näslund Ingmar, Rask Eva, Karlsson Jan, Sundbom Magnus, Edholm David, Karlsson F Anders, Svensson Felicity, Szabo Eva
Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden,
Obes Surg. 2015 Jul;25(7):1119-27. doi: 10.1007/s11695-014-1513-6.
It is evident that morbidly obese patients have a low health-related quality-of-life (HRQoL), and this low HRQoL has become a common reason for them to seek bariatric surgery. Several HRQoL studies demonstrate a dramatic postoperative improvement, but most of these have had a short follow-up period.
An observational, cross-sectional study for HRQoL was conducted to study 486 patients (average age of 50.7 ± 10.0 years, with 84 % of them being female) operated with gastric bypass (GBP) in the period 1993 to 2003 at the University Hospitals of Örebro and Uppsala. Mean follow-up after gastric bypass was 11.5 ± 2.7 years (range 7-17). Two HRQoL instruments were used, SF-36 and the Obesity-related Problems scale (OP). The study group was compared with two control groups, both matched for age and gender, one from the general population and one containing morbidly obese patients evaluated and awaiting bariatric surgery.
The study group scored better in the SF-36 domains (all four physical domains and the vitality subscore) and OP scale compared to obese controls, but their HRQoL scores were lower than those of the general population. HRQoL was better among younger patients and in the following subgroups: men, patients with satisfactory weight loss, satisfied with the procedure, free from co-morbidities and gastrointestinal symptoms, employment, good oral status and those not hospitalised or regularly followed up for non-bariatric reasons.
Long-term follow-up after GBP for morbid obesity showed better scores in most aspects of HRQoL compared to obese controls but did not achieve the levels of the general population. Patients with better medical outcome after gastric bypass operation had better HRQoL.
显然，病态肥胖患者的健康相关生活质量（HRQoL）较低，而这种低HRQoL已成为他们寻求减肥手术的常见原因。多项HRQoL研究表明术后有显著改善，但其中大多数随访期较短。
对1993年至2003年期间在厄勒布鲁大学医院和乌普萨拉大学医院接受胃旁路手术（GBP）的486例患者（平均年龄50.7±10.0岁，其中84%为女性）进行了一项关于HRQoL的观察性横断面研究。胃旁路手术后的平均随访时间为11.5±2.7年（范围7 - 17年）。使用了两种HRQoL工具，即SF - 36和肥胖相关问题量表（OP）。将研究组与两个年龄和性别匹配的对照组进行比较，一个来自普通人群，另一个包含经评估并等待减肥手术的病态肥胖患者。
与肥胖对照组相比，研究组在SF - 36领域（所有四个身体领域和活力子评分）和OP量表上得分更高，但他们的HRQoL得分低于普通人群。年轻患者以及以下亚组的HRQoL更好：男性、体重减轻满意的患者、对手术满意的患者、无合并症和胃肠道症状的患者、就业患者、口腔状况良好的患者以及未因非减肥原因住院或定期随访的患者。
对病态肥胖患者进行GBP后的长期随访显示，与肥胖对照组相比，HRQoL的大多数方面得分更高，但未达到普通人群的水平。胃旁路手术后医疗结果较好的患者HRQoL更好。
