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相關文獻
- Jejunoileal Bypass for Morbid Obesity among Chinese
- Surgical Treatment of Morbid Obesity with Vertical Banded Gastroplasty: A Comparison between TA90-4.8 and TA90-B
- Laparoscopic Vertical Banded Gastric Partition
- 病態肥胖症的麻醉評估
- Vertical Banded Gastroplasty: A Simple, Effective and Safe Surgery for Morbid Obesity
- 病態肥胖症的外科療法
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題名 | Jejunoileal Bypass for Morbid Obesity among Chinese=小腸短路手術治療中國人病態肥胖症之經驗 |
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作者 | 彭芳谷; |
期刊 | 中華民國外科醫學會雜誌 |
出版日期 | 19880700 |
卷期 | 21:4 1988.07[民77.07] |
頁次 | 頁397-406 |
分類號 | 415.599、415.599 |
語文 | eng |
關鍵詞 | 小腸短路手術治療; 病態肥胖症; |
中文摘要 | 雖然世界上已有超過一萬例以上有關以小腸短路手術治療病態肥胖症的報告,但目前尚無文獻報告此種手術在中國人的治療結果。榮民總醫院自民國六十三年至七十五年的十二年間以小腸短路手術治療了六十五位病態肥胖症的患者。這些病患之選擇必需是體重超過標準體重一倍以上,且會接受過其它治療失敗者方考慮手術。患者術前的平均體重為116.3公斤,術後第二年體重降至66.7公斤,多數患者在手術兩年後體重有部份回昇現象,然後即可維持一穩定狀態體重。患者術後除了體重得以減輕,同時其血糖,血脂肪,血壓,及個人衛生均獲得改善。 六十五位接受手術的患者,手術後仍有許多併發症,其中包括傷口感染佔20%,栓塞靜脈炎佔6.2%,嚴重腹瀉佔9.1%,膽結石佔9.1%,腎結石佔3.6%,肝功能異常佔1.8%,嚴重營養不良佔10.9%。六位患者由於併發症無法控制而需重新修改其小腸短路I術,經過這些修改手術後所有併發症均獲得痊癒。 以往許多文獻報告認為小腸短路手術之併發症甚高,尤其是造成肝硬化甚而死亡。但依本院所做之結果顯示雖然術後仍有併發症,但如早期治療都可以得到良好的療效。因此我們認為如果能術前仔細地選擇病人,術後長期定時追蹤檢查,早期治療併發症方可使小腸短路手術達到最佳的成效,小腸短路在治療病態肥胖症上仍然佔有其重要性。 |
英文摘要 | Sixty-five morbid obesity patients were treated by jejunoileal bypass at Veterans General Hospital during 1974-1986. All of our patients were selected with their body weight at least twice their ideal body weigth. Most operations left the functional small bowel less than 20 inches long. The mean initial weight of these 65 patients was 116.3±25kg, and after two years, the mean weight dropped to 66.7± kg. The benfits after this procedure were improved glucose tolerance, reduced cholesterol level, lowered blood pressure, improved personal hygiene and psychologicai benefits. The most frequent complications in the early postoperative period were wound infection 20%, thrombophlebitis 6.2%, severe diarrhea 9.1%, and the late complications were gall stones 9.1%, renal stones 3.6%, liver function impairment 1.8% and severe malnutrition 10.9%. Six of these sixty five patients needed their bypass revised due to uncontrollable malnutrition, electrolyte imbalance and liver function impairment. Although most complications happened frequently during the initial post-operative period, late complications also appeared in the later post-operative period. In our experiences we found that the jejunoileal bypass is a safe and most effective procedure for treatment of morbid obesity. However, careful selection of suitable candidates and close follow-up are key to achieving good results. Therefore, we think that jejuno-ileal bypass still plays an important role in the treatment of morbid obesity. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。