Department of Medicine Based Discipline (Medicine/Endocrinology), Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
Department of Surgical Based Discipline (ORL-HNS), Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia.
BMJ Case Rep. 2020 Dec 28;13(12):e236197. doi: 10.1136/bcr-2020-236197.
A 31-year-old woman, with a body mass index of 70.31 kg/m, presented with progressive worsening of dyspnoea for 3 days. She had multiple comorbidities, including obesity hypoventilation syndrome. The patient developed type II respiratory failure with respiratory acidosis along with multiorgan failure. She was intubated and put on a mechanical ventilator and treated with intravenous diuretics, subcutaneous low-molecular-weight heparin and other supportive measures. Later, she was on noninvasive, continuous positive airway pressure ventilation overnight. She was prescribed a very-low-calorie diet along with physiotherapy and exercise. The patient underwent bariatric surgery 2 months after resolution of acute illness. Ten months after surgery, her body weight reduced from 180 kg to 121 kg, and her general condition improved. Successful management before and after surgical intervention depends on multidisciplinary teamwork, which includes the dietician, physiotherapist, endocrinologist, pulmonologist, nursing care and other supportive care.
一位 31 岁的女性，体重指数为 70.31kg/m²，因呼吸困难逐渐加重 3 天就诊。她患有多种合并症，包括肥胖低通气综合征。患者发生 II 型呼吸衰竭伴呼吸性酸中毒和多器官功能衰竭，予以气管插管、机械通气，并给予静脉利尿剂、皮下低分子肝素等支持治疗。之后，她接受了一整晚的无创持续气道正压通气。患者同时接受了极低热量饮食、物理治疗和运动治疗。急性疾病缓解后 2 个月，患者接受了减重手术。术后 10 个月，体重从 180kg 降至 121kg，一般情况改善。手术前后的成功管理取决于多学科团队合作，包括营养师、物理治疗师、内分泌学家、肺科医生、护理和其他支持性护理。
