Crowley L V, Seay J, Mullin G
Am J Gastroenterol. 1984 Nov;79(11):850-60.
We studied 41 patients who had gastric bypass for obesity from 1974-1979. The procedure was well received by patients and most achieved adequate weight loss, but most subjects consumed inadequate diets and many developed iron and/or vitamin B12 deficiencies. Ten were anemic and 13 had been treated previously for postbypass anemia. Severely vitamin B12-deficient subjects did not respond to 50 micrograms oral vitamin B12 tablets, but those with milder deficiencies usually did. Schilling tests were usually abnormal and corrected when intrinsic factor was given. Many subjects developed manifestations compatible with osteoporosis due to inadequate calcium intake and absorption, and some also developed abnormal laboratory tests suggesting coexisting osteomalacia. Hematopoietic complications of gastric bypass can usually be prevented and are relatively easy to treat, but musculoskeletal complications may be more difficult to prevent and treat.
我们研究了1974年至1979年间接受胃旁路手术治疗肥胖症的41例患者。该手术受到患者的广泛认可，大多数患者体重减轻效果良好，但大多数受试者饮食摄入不足，许多人出现了铁和/或维生素B12缺乏症。10例患者贫血，13例曾因胃旁路术后贫血接受过治疗。严重维生素B12缺乏的受试者对50微克口服维生素B12片剂无反应，但缺乏程度较轻的受试者通常有反应。希林试验通常异常，给予内因子后可得到纠正。由于钙摄入和吸收不足，许多受试者出现了与骨质疏松症相符的症状，一些人还出现了提示同时存在骨软化症的异常实验室检查结果。胃旁路手术的造血并发症通常可以预防，且相对易于治疗，但肌肉骨骼并发症可能更难预防和治疗。
