减重代谢手术是治疗肥胖及代谢性疾病的重要方法,术后往往伴随着一系列并发症的发生。 贫血是术后常见的并 发症,其发生率受到不同国家、不同手术方式以及随访时间长短的影响,其发生主要与术后营养物质摄入减少,以及吸收障碍 相关,包括铁、维生素 B12 、叶酸及铜的缺乏。 此外,消化道溃疡或月经失血也是重要诱因。 难治性缺铁性贫血、地中海贫血及 幽门螺杆菌感染可能进一步加剧患者术后贫血。 减重代谢手术后贫血的治疗应采取阶梯化管理,首先通过饮食调整增加相 关营养素食物的摄入;若效果不佳,则采用口服补充剂;对于存在吸收障碍或严重贫血者,静脉补充可快速改善相关营养素储 备。 临床需结合患者手术方式、营养状态及并发症制订个体化方案,同时关注特殊病因的筛查与干预,以降低术后贫血发生 率并优化治疗效果。

Bariatric and metabolic surgery BMS is an important method for treating obesity and metabolic diseases yet it is frequently associated with postoperative complications. Anemia is a common complication with its incidence influenced by factors such as country surgical technique and follow-up duration. The primary cause is impaired nutrient absorption post-surgery leading to deficiencies in iron vitamin B12 folic acid and copper. Additionally peptic ulcers and menstrual blood loss are significant contributing factors. Conditions such as refractory iron deficiency anemia thalassemia and Helicobacter pylori infection may further elevate the risk of postoperative anemia. The treatment of iron deficiency anemia after BMS should adopt a stepwise management approach. First dietary modification to increase nutrient-rich food intake is recommended. If ineffective oral supplementation should be initiated. For patients with malabsorption or severe anemia intravenous supplementation can rapidly replenish nutrient reserves. Clinically individualized plans should be formulated in combination with the patient's surgical method nutritional status and comorbidities. Concurrently screening and addressing specific underlying causes are crucial to reduce the incidence of postoperative anemia and optimize treatment outcomes.