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减肥手术的隐性代价:韦尼克脑病与多发性神经病

The Hidden Cost of Bariatric Surgery: Wernicke's Encephalopathy and Polyneuropathy.

作者信息

Mishu Lailus Sabikunnahar, Abuelgassem Hagahmed Mohamed Esraa, Odogwu Tochukwu Samuel, Toor Muhammad Aftab, Jibon NoimUddin

机构信息

Respiratory Medicine, Mid and South Essex NHS Foundation Trust, Southend-On-Sea, GBR.

Internal Medicine, Mid and South Essex NHS Foundation Trust, Southend-On-Sea, GBR.

出版信息

Cureus. 2025 Mar 28;17(3):e81337. doi: 10.7759/cureus.81337. eCollection 2025 Mar.

Abstract

Bariatric surgery is a recognised intervention for severe obesity, a global epidemic associated with numerous comorbidities like diabetes, hypertension, and cardiovascular diseases. Procedures such as Roux-en-Y gastric bypass facilitate significant weight loss, improving metabolic health and quality of life. However, these surgeries carry hidden costs, particularly concerning nutritional deficiencies that are often overlooked in preoperative assessments. This case report presents a 27-year-old patient who, after undergoing gastric sleeve surgery, developed neurological symptoms due to thiamine deficiency. Thiamine, essential for energy metabolism, is crucial for neurological function, and its deficiency can lead to serious conditions like Wernicke's encephalopathy and polyneuropathy. Despite the initial success of the surgery, the patient faced significant morbidity due to this oversight. The report emphasises the need for rigorous nutritional monitoring and proactive supplementation post-surgery. It advocates for comprehensive preoperative counselling that addresses potential deficiencies and their long-term implications. By recognising these hidden costs, healthcare providers can better prepare patients for effective long-term management, enhancing post-operative outcomes and improving the overall quality of life for those battling severe obesity.

摘要

减肥手术是一种公认的针对重度肥胖的干预措施,重度肥胖是一种全球性流行病,与糖尿病、高血压和心血管疾病等众多合并症相关。诸如胃旁路手术等术式能显著减轻体重,改善代谢健康和生活质量。然而,这些手术存在隐性成本,尤其是术前评估中常常被忽视的营养缺乏问题。本病例报告介绍了一名27岁的患者,该患者在接受袖状胃切除术后,因硫胺素缺乏出现了神经症状。硫胺素对能量代谢至关重要,对神经功能也至关重要,其缺乏会导致如韦尼克脑病和多发性神经病等严重疾病。尽管手术初期取得了成功,但由于这一疏忽,患者面临了严重的发病情况。该报告强调术后需要进行严格的营养监测和积极的补充。它提倡进行全面的术前咨询,解决潜在的营养缺乏问题及其长期影响。通过认识到这些隐性成本,医疗服务提供者可以更好地让患者为有效的长期管理做好准备,提高术后效果,改善那些与重度肥胖作斗争的患者的整体生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4697/12034089/0c5e5680075b/cureus-0017-00000081337-i01.jpg

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