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[减肥手术后的体重增加]

[Weight gain after bariatric surgery].

作者信息

Romeijn M M, Uittenbogaart M, Janssen L, van Dielen F M H, Leclercq W K G

机构信息

Máxima Medisch Centrum, afd. Chirurgie, Eindhoven/Veldhoven.

Contact: M.M. Romeijn (

出版信息

Ned Tijdschr Geneeskd. 2020 Oct 29;164:D5339.

Abstract

Despite the frequent success of bariatric surgery, 20-30% of patients do not respond well. These patients may experience insufficient weight loss, defined as primary non-response, or may regain an excessive amount of weight after sufficient weight loss, defined as secondary non-response. The aetiology and subsequent treatment of these two types of non-response may differ. This is illustrated by three cases: a patient with primary non-response after gastric bypass (total weight loss 18%) treated conservatively; a patient with secondary non-response after gastric bypass (total weight loss 27%) treated conservatively and lost 7kg as a result of this therapy; a patient with secondary non-response after gastric bypass (total weight loss 27%) treated surgically though experienced malabsorptive complaints as result of distalisation. These cases can be used to demonstrate the challenges that are faced by professionals in the current treatment of post-bariatric surgery patients.

摘要

尽管减肥手术常常取得成功,但仍有20%至30%的患者反应不佳。这些患者可能体重减轻不足,即原发性无反应,或者在体重充分减轻后又重新增加了过多体重,即继发性无反应。这两种无反应的病因及后续治疗可能有所不同。以下三个病例说明了这一点:一名接受胃旁路手术后出现原发性无反应的患者(总体重减轻18%)接受了保守治疗;一名接受胃旁路手术后出现继发性无反应的患者(总体重减轻27%)接受了保守治疗,并因此疗法减重7千克;一名接受胃旁路手术后出现继发性无反应的患者(总体重减轻27%)接受了手术治疗,但因消化道改道术出现了吸收不良症状。这些病例可用于证明专业人员在当前减肥手术后患者治疗中所面临的挑战。

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