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肥胖症患者胃部缩小有助于降低心力衰竭风险

[Risk of heart failure diminished thanks to stomach reduction in obesity].

作者信息

Botter B, Koolen E, van Montfort G, Bracke F, Bouwman A, Buise M

机构信息

Maastricht UMC+, Afd. Anesthesiologie & Pijngeneeskunde, Maastricht.

出版信息

Ned Tijdschr Geneeskd. 2018;162:D1972.

Abstract

BACKGROUND

Obesity is a chronic disease and a risk factor for heart failure. In end-stage heart failure, heart transplantation may be the only available treatment option, but obesity is a contraindication for this treatment because of its unfavourable prognosis. Bariatric surgery and its subsequent weight loss may affect the indication for transplantation in patients with heart failure and morbid obesity.

CASE DESCRIPTION

A 46-year-old patient with morbid obesity and heart failure underwent gastric sleeve resection in preparation of a heart transplantation. Without it, he would not have been considered eligible for transplantation because of his obesity. The bariatric intervention was also intended to use weight loss as a way to reduce the symptoms of his heart failure and to make rehabilitation possible. One year after surgery, the condition of the patient had improved so much that heart transplantation was no longer necessary.

CONCLUSION

Bariatric surgery is safe for morbidly obese patients with severe heart failure and may sometimes even avoid heart transplantation.

摘要

背景

肥胖是一种慢性疾病,也是心力衰竭的危险因素。在终末期心力衰竭中,心脏移植可能是唯一可用的治疗选择,但肥胖因其不良预后而成为这种治疗的禁忌症。减肥手术及其随后的体重减轻可能会影响心力衰竭合并病态肥胖患者的移植指征。

病例描述

一名患有病态肥胖和心力衰竭的46岁患者接受了胃袖状切除术,为心脏移植做准备。如果不进行手术,由于他的肥胖,他将不被认为符合移植条件。减肥干预措施还旨在通过减轻体重来减轻他的心力衰竭症状,并使康复成为可能。术后一年,患者的病情有了很大改善,以至于不再需要进行心脏移植。

结论

减肥手术对患有严重心力衰竭的病态肥胖患者是安全的,有时甚至可以避免心脏移植。

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