Halverson J D
Am Surg. 1986 Nov;52(11):594-8.
Gastric stapling for morbid obesity has been popularized, in part, because of an apparent lack of metabolic sequelae. Of our series of prospectively studied gastric bypass patients, 74 patients have been followed for more than 1 year. Anemia developed in more than one-third of the patients. Nearly two-thirds of the patients developed decreased levels of vitamin B12, and other abnormalities were commonly seen (folate, 38%; iron, 49%; potassium, 56%). While prompt recognition and treatment has prevented development of a clinical deficiency syndrome in most patients, 12 per cent became anemic most likely because of micronutrient deficiency related to the bypass. More than 10,000 gastric restriction operations are carried out for morbid obesity each year in this country. Previous reports of thiamine deficiency-related neurologic sequelae, immune paralysis, and marrow suppression, together with the micronutrient deficiencies and anemia herein reported make long-term frequent metabolic assessment of these patients essential.
胃吻合术治疗病态肥胖症已得到推广，部分原因是其明显缺乏代谢后遗症。在我们前瞻性研究的一系列胃旁路手术患者中，74例患者已随访1年以上。超过三分之一的患者出现贫血。近三分之二的患者维生素B12水平下降，其他异常情况也很常见（叶酸，38%；铁，49%；钾，56%）。虽然及时识别和治疗已防止大多数患者出现临床缺乏综合征，但12%的患者贫血很可能是由于与旁路手术相关的微量营养素缺乏所致。该国每年有超过10000例针对病态肥胖症的胃限制手术。先前关于硫胺素缺乏相关神经后遗症、免疫麻痹和骨髓抑制的报告，以及本文报道的微量营养素缺乏和贫血，使得对这些患者进行长期频繁的代谢评估至关重要。
