减重手术后并发症、营养及心理状况。
Post bariatric surgery complications, nutritional and psychological status.
机构信息
Dietetics Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
Dietetics Programme, School of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia. Email:
出版信息
Asia Pac J Clin Nutr. 2024 Jun;33(2):162-175. doi: 10.6133/apjcn.202406_33(2).0003.
BACKGROUND AND OBJECTIVES
Bariatric surgery becomes the final option for managing severe obesity. This study aims to identify the complications, changes in anthropometry, adherence to dietary recommendations, and psychological well-being of post-bariatric surgery patients.
METHODS AND STUDY DESIGN
An observational study was conducted on 63 post-bariatric surgery patients who had undergone bariatric surgery between two weeks and five years after surgery. The participants were assessed for the complications experienced, current comorbidities, anthropometric changes, dietary intake, and psychological well-being. A three-day, 24-hour diet recall was done to assess the dietary intake of the patients. The mean macronutrient and micronutrient intakes were compared to several available recommendations. The DASS-21 questionnaire was administered to determine the psychological well-being of the participants.
RESULTS
The most common complications experienced by patients after bariatric surgery were hair loss (50.8%), gastroesophageal reflux disease (GERD) (49.2%), and vomiting (41.3%). There were significant differences in mean weight before (129.5 (33.0) kg/m2) and after (85.0 (32.0) kg/m2) bariatric surgery (p<0.001). The prevalence of clinically severe obesity declined by 55%. Overall, patients had insufficient intake of some nutrients such as protein, fat, calcium, and iron. Majority of the patients experienced a normal level of stress, anxiety, and depression, but some had mild (3.2%), moderate (4.8%), and severe anxiety (1.6%).
CONCLUSIONS
There were drastic improvements in patients' weight following bariatric surgery. However, there were several complications including nutrient deficiencies. Due to the anatomical changes in the gastrointestinal tract, patients must comply with the dietary and lifestyle changes and follow up with the healthcare professional. A nutrition module will be helpful for patients to prepare for and adapt to the changes after bariatric surgery.
背景与目的
减重手术成为治疗重度肥胖症的最终选择。本研究旨在确定减重手术后患者的并发症、人体测量学变化、饮食建议的依从性和心理健康状况。
方法和研究设计
对 63 名接受减重手术的患者进行了一项观察性研究，这些患者在手术后两周至五年内接受了减重手术。对患者的并发症、当前合并症、人体测量学变化、饮食摄入和心理健康进行了评估。进行了三天 24 小时饮食回忆，以评估患者的饮食摄入。将患者的平均宏量营养素和微量营养素摄入量与几种可用的推荐值进行了比较。采用 DASS-21 问卷评估参与者的心理健康状况。
结果
患者在接受减重手术后最常见的并发症是脱发（50.8%）、胃食管反流病（GERD）（49.2%）和呕吐（41.3%）。减重手术前后的平均体重有显著差异（术前 129.5（33.0）kg/m2，术后 85.0（32.0）kg/m2，p<0.001）。临床重度肥胖的患病率下降了 55%。总体而言，患者的一些营养素摄入不足，如蛋白质、脂肪、钙和铁。大多数患者的压力、焦虑和抑郁水平正常，但有一些患者存在轻度（3.2%）、中度（4.8%）和重度焦虑（1.6%）。
结论
减重手术后患者的体重有明显改善。然而，存在多种并发症，包括营养不足。由于胃肠道解剖结构的改变，患者必须遵守饮食和生活方式的改变，并向医疗保健专业人员随访。营养模块将有助于患者为减重手术后的变化做好准备和适应。
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