Amaral J F, Thompson W R, Caldwell M D, Martin H F, Randall H T
Ann Surg. 1985 Feb;201(2):186-93. doi: 10.1097/00000658-198502000-00009.
To evaluate the long-term frequency and severity of anemia and selected vitamin and mineral deficiencies after gastric exclusion surgery for morbid obesity, the authors prospectively examined hematologic and nutritional parameters in 150 consecutive patients. These patients underwent a standardized gastric exclusion procedure during a six-year period (1976-1982) and were closely followed for up to seven years (mean, 33.2 months). Anemia developed in 36.8% of the population at a mean time from operation of 20 months. It was more frequent in women than in men (p less than 0.01), and it required transfusions in 3.5% of the population. A low serum iron concentration developed in 48.6%, iron deficiency in 47.2%, a low serum vitamin B12 concentration in 70.1%, vitamin B12 deficiency in 39.6%, and RBC folate deficiency in 18% of the population. Both iron and folate deficiencies responded to oral replacement. As a result of the high frequency and severity of anemia and nutritional deficiencies noted, all gastric exclusion patients should, as a minimum, be placed on oral multivitamin preparations containing iron, folate and vitamin B12. In addition, it is imperative that these patients be followed closely for the remainder of their lives with appropriate studies and replacement as necessary.
为评估病态肥胖患者胃旁路手术后贫血及特定维生素和矿物质缺乏的长期发生率和严重程度，作者前瞻性地检查了150例连续患者的血液学和营养参数。这些患者在六年期间（1976 - 1982年）接受了标准化的胃旁路手术，并被密切随访长达七年（平均33.2个月）。36.8%的患者出现贫血，平均发病时间为术后20个月。女性比男性更常见（p < 0.01），3.5%的患者需要输血。48.6%的患者血清铁浓度降低，47.2%的患者缺铁，70.1%的患者血清维生素B12浓度降低，39.6%的患者维生素B12缺乏，18%的患者红细胞叶酸缺乏。铁和叶酸缺乏均对口服补充剂有反应。鉴于所观察到的贫血和营养缺乏的高发生率和严重程度，所有胃旁路手术患者至少应服用含 铁、叶酸和维生素B12的口服多种维生素制剂。此外，必须在患者余生对其进行密切随访，并根据需要进行适当检查和补充。
