减重代谢手术效果评价系统的应用  

Application of bariatric and metabolic analysis and reporting outcome system

作　　者：廉东波 刘晨 闫巍 杜德晓 宫轲 张能维 LIAN Dongbo;LIU Chen;YAN Wei;DU Dexiao;GONG Ke;ZHANG Nengwei(Department of General Surgery,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院普通外科,北京100038

出　　处：《外科理论与实践》2020年第5期402-407,共6页Journal of Surgery Concepts & Practice

基　　金：北京市科学技术委员会首都临床诊疗技术研究及示范应用(Z191100006619043)。

摘　　要：目的:应用减重代谢手术效果评价系统(bariatric analysis and reporting outcome system,BAROS)评价肥胖病人减重代谢手术的效果。方法:入组105例减重代谢术肥胖病人。按术后随访时间分为4组,分别为术后3~12个月(40例)、13~36个月(38例)、37~60个月(16例)和>61个月(11例)。采用中文版本BAROS,分析病人术后的多余体重下降率(percentage of excess weight loss,%EWL)、肥胖相关合并症改善、生活质量及术后并发症和再手术,评价病人手术效果。结果:所有病人均完成BAROS评价,随访(26.26±25.51)(3~114)个月。与术前相比,各组术后体质量指数均明显降低(P值均<0.001)。各组%EWL依次为57.3%±17.6%、83.5%±11.4%、84.9%±8.2%和88.2%±8.9%(P<0.001)。肥胖相关合并症在术后都得到较好改善,其中2型糖尿病缓解率69.77%,高脂血症缓解率98.15%。生活质量平均得分1.59±0.49。生活质量评定为“好”和“非常好”的病人为86.70%,无评价为“差”和“非常差”的病人,各组之间生活质量评价构成比差异无统计学意义(χ^2=7.506,P=0.277)。共18例出现并发症,1例再手术。BAROS评价结果显示手术效果评定为“极好”和“很好”为89.6%,无评价为“失败”的病人,各组间效果评价构成比差异无统计学意义(χ^2=6.682,P=0.670)。结论:BAROS可用于肥胖病人减重代谢手术的效果评价,术后短期与中、长期的病人均达到较好的评价效果。Objective To use the Bariatric Analysis and Reporting Outcome System(BAROS)questionnaire and to evaluate the effect of bariatric and metabolic surgery(BMS)on obese patients.Methods A total of 105 patients with BMS were enrolled and stratified into 4 groups according to postoperative duration:3-12 months(n=40),13-36 months(n=38),37-60 months(n=16)and>61 months(n=11).The Chinese version of BAROS was used to evaluate the results of operation including percentage of excess weight loss(%EWL),improvement of co-morbidities associated with obesity,quality of life(QOL),postoperative complications and reoperation.Results All patients completed BAROS questionnaire and were followed-up with duration of(26.26±25.51)(3-114)months.Postoperative body mass index decreased significantly compared with those preoperative in all groups(P<0.001).%EWL of patients in group 3-12 months was 57.3%±17.6%,and 83.5%±11.4%in group 13-36 months,84.9%±8.2%in group 37-60 months and 88.2%±8.9%in group>61 months(P<0.001).The co-morbidities with obese improved significantly and remission rate was 69.77%in cases with type 2 diabetes,98.15%in cases with hyperlipidemia.Mean score of QOL was(1.59±0.49).QOL was evaluated good and very good in 86.70%cases without any case evaluated as poor or very poor.Difference in QOL(%)among all groups was not statistically significant(χ^2=7.506,P=0.277).There were 18 cases with complications and one case had reoperation.Evaluation of operative results using BAROS score showed 89.6%cases as excellent and good and no case as failure of operation.There was no statistically significant difference among groups(χ^2=6.682,P=0.670).Conclusions BAROS can be used to analyze the effect of BMS and the results of short-term and middle/long term in this study were encouraged.

关 键 词：肥胖 减重代谢手术 手术效果评价 

分 类 号：R589.2[医药卫生—内分泌]