腹腔镜胃袖状切除术对肥胖症患者营养状况的影响  

Influence of laparoscopic sleeve gastrectomy on nutritional status in patients with obesity

作　　者：郑莉[1] 马颖璋[3] 陆佳军 唐霖[3] 杨飖[3] 朱江帆[3] 励丽[2] 

机构地区：[1]宁波市第一医院麻醉科,315010 [2]宁波市第一医院内分泌科,315010 [3]同济大学附属东方医院减重与代谢病外科,上海200120

出　　处：《中华临床营养杂志》2017年第4期221-225,共5页Chinese Journal of Clinical Nutrition

基　　金：宁波市科技计划项目（2016A610169）

摘　　要：目的观察腹腔镜胃袖状切除术（LSG）对肥胖症患者营养状况的影响。方法2014年8月至2015年7月24例肥胖症患者在同济大学附属东方医院接受LSG。观察患者术前、术后3、6、12个月体质量和营养状况变化。结果24例肥胖症患者LSG术后3、6、12个月体质量分别为（81.94±21.39）kg、（78.83±24.49）kg、（62.67±10.79）kg，与术前体质量[（99.02±23.92）kg]相比显著下降，差异有统计学意义（P＝0.004）。LSG术后白蛋白、血红蛋白水平及微量元素（钙、铁、锌、镁、铜）变化差异均无统计学意义（P〉0.05）。血浆维生素D（25羟维生素D）术前为（13.1±4.1）μg/L，术后12个月显著上升[（19.8±5.3）μg/L，P＝0.031]；叶酸术前为（6.2±3.9）μg/L，LSG术后3个月上升到（14.2±9.2）μg/L，差异有统计学意义（P＝0.009）；术后6、12个月叶酸水平又逐渐下降，但均高于术前。结论肥胖症患者术前有维生素D的缺乏。在手术后的1年随访中，患者血浆蛋白和微量元素无改变，但维生素D和叶酸显著升高。ObjectiveTo assess the influence of laparoscopic sleeve gastrectomy （LSG） on the nutritional status in patients with obesity.MethodsFrom August 2014 to July 2015, 24 obese patients underwent LSG in Dongfang Hospital Affiliated to Tongji University. Weight and nutritional status of these patients were measured pre-operatively and 3, 6, and 12 months after surgery.ResultsThe mean body weight of the 24 obesity patients was （81.94±21.39） kg, （78.83±24.49） kg, （62.67±10.79） kg 3, 6, and 12 months after surgery, respectively, which were significantly lower than the preoperative body weight [（99.02±23.92）kg] （P=0.004）. The serum levels of albumin, hemoglobin, and trace elements （including calcium, iron, zinc, magnesium, and copper） showed no significant change after surgery （all P〉0.05）. Plasma vitamin D[25（OH）D] increased significantly from （13.1±4.1）μg/L preoperatively to （19.8±5.3）μg/L 12 months after surgery （P=0.031）. Folic acid was （6.2±3.9）μg/L before LSG and significantly increased to （14.2±9.2） μg/L 3 months later surgery （P=0.009）; the folic acid level gradually decreased 6 and 12 months after LSG but was still higher than the preoperative level.ConclusionVitamin D deficiency is present in obese patients before LSG. After surgery, while the serum albumin and trace elements have no obvious change, the vitamin D and folic acid levels remarkably increase.

关 键 词：肥胖症 腹腔镜胃袖状切除术 营养缺乏 

分 类 号：R589.2[医药卫生—内分泌]