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胃旁路手术后患者的长期营养状况。

Long-term nutritional status in patients following Roux-en-Y gastric bypass surgery.

机构信息

Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.

Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.

出版信息

Clin Nutr. 2018 Apr;37(2):612-617. doi: 10.1016/j.clnu.2017.01.022. Epub 2017 Feb 3.

Abstract

BACKGROUND & AIMS: Roux-en-Y gastric bypass (RYGB) is an effective treatment for obesity. However, it also leads to multiple nutritional deficiencies. Much is known about the short term prevalence, but hardly any long term data is available on deficiencies. The aim of this study was to assess the long term outcome of nutritional status after RYGB.

METHODS

We performed a retrospective analysis of prospectively collected data obtained from 51 morbidly obese patients who underwent a primary laparoscopic RYGB. Primary outcomes were iron, vitamin B12 and vitamin D deficiencies. Secondary outcomes were deficiencies of other vitamins and minerals and compliance of the patients to multivitamin use.

RESULTS

The mean follow-up was 81 ± 27 months. A total of 35%, 16% and 55% of the patients had deficiencies for iron, vitamin B12 and vitamin D respectively. Sixty-nine percent of patients used a (nonspecific) multivitamin supplement on a daily basis. Patients with multivitamin usage had a lower rate of iron deficiency (26% vs. 56%, p = 0.034), vitamin B12 (11% vs. 25%, p = 0.46) and vitamin D (46% vs. 75%, p = 0.07), compared to non-compliant patients.

CONCLUSIONS

Nutritional deficiencies are common after a RYGB operation. Therefore, strict follow-up by a bariatric surgeon, endocrinologist or general practitioner is required, both short and long term.

摘要

背景与目的

Roux-en-Y 胃旁路术(RYGB)是肥胖症的有效治疗方法。然而,它也会导致多种营养缺乏。人们对短期患病率了解较多,但长期缺乏相关数据。本研究旨在评估 RYGB 后营养状况的长期结果。

方法

我们对 51 例接受腹腔镜 RYGB 初次手术的病态肥胖患者前瞻性收集的数据进行了回顾性分析。主要结局为铁、维生素 B12 和维生素 D 缺乏。次要结局为其他维生素和矿物质缺乏以及患者对多种维生素使用的依从性。

结果

平均随访时间为 81±27 个月。分别有 35%、16%和 55%的患者出现铁、维生素 B12 和维生素 D 缺乏。69%的患者每天使用(非特异性)多种维生素补充剂。使用多种维生素的患者铁缺乏(26% vs. 56%,p=0.034)、维生素 B12(11% vs. 25%,p=0.46)和维生素 D(46% vs. 75%,p=0.07)的发生率低于不依从的患者。

结论

RYGB 手术后营养缺乏很常见。因此,需要由减重外科医生、内分泌学家或全科医生进行短期和长期的严格随访。

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