JAMA:减肥术后大部分患者的身体疼痛和机体功能可得到改善

2016-04-08 MedSci MedSci原创

JAMA:减肥术后大部分患者的身体疼痛和机体功能可得到改善目前为止,关于Roux-en-Y胃旁路手术(RYGB)或腹腔镜可调节胃束带术(LAGB)后机体疼痛和身体功能的变异性和耐久性是否得到改善并没有很好地研究报道。本研究中来自匹兹堡大学公共卫生研究生院的研究人员报告了患者经RYGB或LAGB后的前3年的身体疼痛和身体功能的变化,并确定了与此相关的因素。减肥术纵向评估2是在美国10所医院进行的一项



目前为止,关于Roux-en-Y胃旁路手术(RYGB)或腹腔镜可调节胃束带术(LAGB)后机体疼痛和身体功能的变异性和耐久性是否得到改善并没有很好地研究报道。本研究中来自匹兹堡大学公共卫生研究生院的研究人员报告了患者经RYGB或LAGB后的前3年的身体疼痛和身体功能的变化,并确定了与此相关的因素。

减肥术纵向评估2是在美国10所医院进行的一项观察性队列研究。2005年2月至2009年2月期间招募了接受减肥手术的严重成人肥胖患者。手术及术后每年进行一次评估,随访截止至2012年10月。

主要研究结果是患者术后疼痛及身体功能较术前出现了有临床意义的改善,具体评估方法是使用简明健康测量量表(SF-36)的得分以及患者步行400米的时间。次要研究结果是使用西部安大略省麦克马斯特大学骨关节炎指数其结果具有临床意义。

结果2458参与者中2221名患者(1743名为女性,平均年龄为47岁,平均BMI为45.9;70.4%的患者接受了RYGB;25.0%的患者接受了LAGB)完成了基线以及随访期的评估。术后第1年,结果显示57.6%的患者在身体疼痛方面,76.5%的患者在身体功能方面以及59.5%的患者在400米步行时间上都得到了具有临床意义的改善。此外,部分研究对象在基线时期患有严重的膝关节疾病或残疾(633),或髋关节疼痛或残疾(500),约3/4的患者膝关节疼痛(77.1%)和髋关节功能(79.2%)得到了明显的改善。术后第1年至第3年,改善率显着患者身体疼痛的改善率下降到48.6%,身体功能下降到70.2%,但步行时间以及膝关节和髋关节疼痛的改善率得到了提高,但是膝关节和髋关节的功能的改善率并没有发生改变。年龄、男性、高收入、低BMI以及术前更少的抑郁症状;无糖尿病、术后无静脉性水肿溃疡;以及术后体重减轻和抑郁症状的减少都与术前到术后第1年,第2年及第3年的多重结局改善有关。

总而言之,本研究发现,该研究中接受减肥手术的严重肥胖成人患者,与基线时期相比,大部分患者在疼痛、身体功能以及步行时间上得到了改善,且效果可持续3年以上,但是术后第1年和第3年期间患者疼痛和身体功能的改善率有所下降。

原始出处:

Wendy C. King,; Jia-Yuh Chen, et al., Change in Pain and Physical Function Following Bariatric Surgery for Severe Obesity. JAMA. 2016;315(13):1362-1371. doi:10.1001/jama.2016.3010.

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1675628, encodeId=2a6316e562876, content=<a href='/topic/show?id=a678312e289' target=_blank style='color:#2F92EE;'>#减肥术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31272, encryptionId=a678312e289, topicName=减肥术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4ee227270207, createdName=kksonne, createdTime=Fri Apr 29 12:28:00 CST 2016, time=2016-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78248, encodeId=3c54e824854, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:49:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78249, encodeId=039fe824906, content=值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:49:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=77156, encodeId=0329e715658, content=真是一胖毁所有, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Sun Apr 10 18:21:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76516, encodeId=3b3ee65169f, content=减肥手术效果咋样, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJJAFMgSjibMicGVUgkmDBw4svXiccQxZicwjRHNxGPTghAmITxP12Rcmm0yFKfwGwUaiaUwpPUUUTOd2g/0, createdBy=fcd21609070, createdName=hekzn, createdTime=Sat Apr 09 00:50:00 CST 2016, time=2016-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76436, encodeId=9256e64361e, content=生活也好过, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Fri Apr 08 19:44:00 CST 2016, time=2016-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76352, encodeId=1de7e635219, content=几十斤肥肉整天背着,肌肉骨骼系统能受得了嘛,也加重心血管系统等的负担。卸掉它当然轻松。, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=225a1697989, createdName=1de7460am01(暂无匿称), createdTime=Fri Apr 08 09:06:00 CST 2016, time=2016-04-08, status=1, ipAttribution=)]
    2016-04-29 kksonne
  2. [GetPortalCommentsPageByObjectIdResponse(id=1675628, encodeId=2a6316e562876, content=<a href='/topic/show?id=a678312e289' target=_blank style='color:#2F92EE;'>#减肥术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31272, encryptionId=a678312e289, topicName=减肥术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=4ee227270207, createdName=kksonne, createdTime=Fri Apr 29 12:28:00 CST 2016, time=2016-04-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78248, encodeId=3c54e824854, content=文章不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:49:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=78249, encodeId=039fe824906, content=值得关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=240a1683959, createdName=李继凯, createdTime=Thu Apr 14 18:49:00 CST 2016, time=2016-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=77156, encodeId=0329e715658, content=真是一胖毁所有, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=90f31612316, createdName=xiaotaiyang1, createdTime=Sun Apr 10 18:21:00 CST 2016, time=2016-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76516, encodeId=3b3ee65169f, content=减肥手术效果咋样, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEJJAFMgSjibMicGVUgkmDBw4svXiccQxZicwjRHNxGPTghAmITxP12Rcmm0yFKfwGwUaiaUwpPUUUTOd2g/0, createdBy=fcd21609070, createdName=hekzn, createdTime=Sat Apr 09 00:50:00 CST 2016, time=2016-04-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76436, encodeId=9256e64361e, content=生活也好过, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTK29w9r0upRgxUXHNhe7bd3VxHnhBSpibMbKOjtX92zXr78SkuZfUNuADrjHiaw6uibZaEYjh9cJLzew/132, createdBy=261e1682638, createdName=1de3b290m83(暂无匿称), createdTime=Fri Apr 08 19:44:00 CST 2016, time=2016-04-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=76352, encodeId=1de7e635219, content=几十斤肥肉整天背着,肌肉骨骼系统能受得了嘛,也加重心血管系统等的负担。卸掉它当然轻松。, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=225a1697989, createdName=1de7460am01(暂无匿称), createdTime=Fri Apr 08 09:06:00 CST 2016, time=2016-04-08, status=1, ipAttribution=)]
    2016-04-14 李继凯

    文章不错

    0

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    2016-04-14 李继凯

    值得关注

    0

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    2016-04-10 xiaotaiyang1

    真是一胖毁所有

    0

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    2016-04-09 hekzn

    减肥手术效果咋样

    0

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    2016-04-08 1de3b290m83(暂无匿称)

    生活也好过

    0

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    2016-04-08 1de7460am01(暂无匿称)

    几十斤肥肉整天背着,肌肉骨骼系统能受得了嘛,也加重心血管系统等的负担。卸掉它当然轻松。

    0

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