Journal of Surgery Concepts & Practice ›› 2020, Vol. 25 ›› Issue (05): 402-407.doi: 10.16139/j.1007-9610.2020.05.010
• Original article • Previous Articles Next Articles
LIAN Dongbo, LIU Chen, YAN Wei, DU Dexiao, GONG Ke, ZHANG Nengwei()
Received:
2020-07-27
Online:
2020-09-25
Published:
2022-07-27
CLC Number:
LIAN Dongbo, LIU Chen, YAN Wei, DU Dexiao, GONG Ke, ZHANG Nengwei. Application of bariatric and metabolic analysis and reporting outcome system[J]. Journal of Surgery Concepts & Practice, 2020, 25(05): 402-407.
减重效果(得分) | 合并症(得分) | Moorehead-Ardelt生活质量问卷(得分)a) |
---|---|---|
体重增加(-1) %EWL | 加重(-1) | 1. 通常我觉得:自己糟透了 自己棒极了 2. 我对身体活动的享受程度:一点不喜欢 非常喜欢 3. 我参加令人满意的社交活动:没有 非常多 4. 我能完成工作:不能完成任何工作 非常多工作 5. 我从性生活得到满足感:完全没有 极大满足 6. 我对吃的看法是:为吃而生活 为生活而吃 |
0-24(0) | 无变化(0) | |
25-49(1) | 改善(1) | |
50-74(2) | 1个主要合并症缓解,其余改善(2) | |
75-100(3) | 所有主要合并症缓解(3) | |
小计(得分) | 小计(得分) | 小计(得分) |
术后并发症和再手术(扣分) 轻度并发症:扣0.2分 严重并发症:扣1.0分 再手术: 扣1分 | 效果评价标准b) | |
效果 有肥胖相关合并症 无肥胖相关合并症 失败 得分≤1 得分=0 一般 1<得分≤3 0<得分≤1.5 良好 3<得分≤5 1.5<得分≤3.0 很好 5<得分≤7 3.0<得分≤4.5 极好 7<得分≤9 4.5<得分≤6.0 |
疾病 | 诊断标准 | 缓解标准 | 改善标准 |
---|---|---|---|
高血压 | 收缩压>130 mmHg,舒张压>80 mmHg | 仅饮食/利尿药可保持血压正常 | 服用药物可控制血压 |
心血管疾病 | 有冠心病、周围血管疾病或充血心力衰竭证据 | 不需服用药物即可控制 | 需服用药物控制 |
血脂异常 | 总胆固醇>6.0 mmol/L,或其他脂类代谢异常 | 不需服用药物即可控制 | 服用药物可正常 |
2型糖尿病 | 有症状+餐后血糖>11.1 mmol/L,或空腹血糖>7.0 mmol/L,或糖耐量实验2 h血糖>11 mmol/L | 仅饮食控制/锻炼可保持正常 | 口服降糖药可正常(不需 胰岛素) |
睡眠呼吸暂停综合征 | 睡眠监测诊断,二氧化碳分压>45 mmHg,血红蛋白>150 g/L | 正常(呼吸暂停<5次/h) | 呼吸暂停5~15次/h |
骨关节炎 | 影像学检查评估 | 不需服用药物即可控制 | 服用药物可控制 |
不育症(多囊卵巢) | 不育/性激素异常 | 怀孕 | 月经正常 |
外科并发症 | 内科并发症 | ||||
---|---|---|---|---|---|
严重 | 轻度 | 严重 | 轻度 | ||
早期 | 胃肠道漏伴腹膜炎或腹腔脓肿 | 血清肿 | 肺炎,严重肺不张 | 肺不张,尿路感染 | |
严重切口感染,切口裂开 | 轻微切口感染 | 呼吸功能不全,肺水肿 | 深静脉血栓形成 | ||
腹腔出血,胃肠道出血需输血 脾损伤需脾切除术 | 皮下气肿 | 肺栓塞,急性呼吸功能障碍 综合征 | 电解质失衡,呕吐 | ||
其他严重器官损伤,严重肠梗阻 | 心肌梗死,充血性心力衰竭 | 食管炎 | |||
肠扭转/闭襻肠梗阻 | 脑血管意外 | ||||
急性肾功能衰竭 | |||||
严重术后抑郁 | |||||
其他精神异常 | |||||
晚期 | 复杂消化性溃疡病 | 吻合口狭窄,电解质失衡 | 肝衰竭,肝硬化 | 贫血 | |
胆石病,切口疝 | 持续恶心或呕吐 | 神经性厌食症,暴食症 | 代谢缺陷(维生素/ | ||
胃漏 | 食管炎,Barrett食管 | 严重抑郁 | 矿物质/蛋白质缺乏) | ||
严重蛋白质缺乏或其他营养问题 需住院治疗 | 吻合口溃疡,消化性溃疡 | 脱发 |
分组 | 自尊 | 身体活动 | 社会交往 | 工作 | 性活动 | 对吃的看法 | 总分 |
---|---|---|---|---|---|---|---|
1 | 0.29±0.20 | 0.25±0.20a) | 0.22±0.15 | 0.26±0.14 | 0.15±0.26 | 0.26±0.19 | 1.42±0.54a) |
2 | 0.35±0.18 | 0.33±0.13 | 0.22±0.2 | 30.33±0.17 | 0.16±0.28 | 0.23±0.21 | 1.61±0.48 |
3 | 0.34±0.07 | 0.34±0.08 | 0.33±0.11 | 0.33±0.11 | 0.23±0.22 | 0.29±0.14 | 1.85±0.31 |
4 | 0.32±0.30 | 0.38±0.14 | 0.28±0.16 | 0.32±0.13 | 0.12±0.34 | 0.28±0.15 | 1.70±0.42 |
全部病人 | 0.32±0.19 | 0.31±0.16 | 0.24±0.18 | 0.30±0.15 | 0.16±0.27 | 0.26±0.19 | 1.59±0.49 |
F值 | 0.626 | 3.251 | 1.700 | 1.869 | 0.437 | 0.391 | 3.430 |
P值 | 0.600 | 0.025 | 0.172 | 0.140 | 0.727 | 0.760 | 0.020 |
合并症 | 术前[n(%)] | 术后[n(%)] | |||
---|---|---|---|---|---|
加重 | 无变化 | 改善 | 缓解 | ||
高血压 | 22(20.95)a) | -- | 1(4.55)b) | 7(31.82)b) | 14(63.64)b) |
心血管疾病 | 4(3.81)a) | -- | -- | 4(100.00)b) | -- |
高脂血症 | 54(51.43)a) | -- | -- | 1(1.85)b) | 53(98.15)b) |
2型糖尿病 | 43(40.95)a) | -- | -- | 13(30.23)b) | 30(69.77)b) |
睡眠呼吸暂停综合征 | 41(39.05)a) | -- | -- | 9(21.95)b) | 32(78.05)b) |
不育症(多囊卵巢综合征) | 7(6.67)a) | -- | -- | 4(57.14)b) | 3(42.86)b) |
胃食管反流病 | 2(1.90)a) | 2(100.00)b) |
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