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肥胖在心脏外科手术中的影响:转诊模式、病理生理学、并发症、预后。

Implications of obesity in cardiac surgery: pattern of referral, physiopathology, complications, prognosis.

作者信息

De Santo Luca Salvatore, Moscariello Caesar, Zebele Carlo

机构信息

Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.

Division of Cardiac Surgery, Casa di Cura Montevergine, GVM Care & Research, Mercogliano, AV, Italy.

出版信息

J Thorac Dis. 2018 Jul;10(7):4532-4539. doi: 10.21037/jtd.2018.06.104.

Abstract

A U-shaped relationship between body mass index (BMI) and outcomes emerged after cardiac surgery. This review analyses the physio pathologic basis of obesity related complications and evaluates prognostic implications. Both leaner and morbid obese should be considered pre-operatively rather than reactively and, when referred for elective surgery, should undergo a focused metabolic status management, and a thorough evaluation of health status. Adherence to sound surgical principles, and tailored patient blood management and perioperative care are mandatory.

摘要

心脏手术后,体重指数(BMI)与预后之间呈现出一种U型关系。本综述分析了肥胖相关并发症的生理病理基础,并评估了其对预后的影响。术前应主动考虑偏瘦和病态肥胖患者,而非被动应对,对于择期手术患者,应进行针对性的代谢状态管理,并全面评估其健康状况。必须坚持合理的手术原则,进行个性化的患者血液管理和围手术期护理。

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