肥胖人口仍然在不断扩增,肥胖不仅影响人们的身心健康,其导致的相关的代谢疾病亦造成了严重的社会经济负担。世界超重及肥胖人口不断增加,预计到2030年,将有超过29亿的成年人的体质指数超过正常范围,而其中11亿成年人将确诊肥胖症,预计到2030年,我国的超重人口将达到5亿。随着肥胖症的全球流行,减重代谢手术已成为治疗严重肥胖及其相关代谢性疾病的最有效手段。然而,手术改变了患者的消化道解剖结构和生理功能,在改善了患者的代谢相关疾病的同时,也给患者的营养状况带来重大挑战。本文旨在梳理减重代谢手术围手术期营养支持的最新研究进展,从术前评估与准备到术后早期恢复与长期随访进行全面分析。研究表明,基于“加速康复外科”理念的个性化营养治疗方案能够有效改善患者术后结局,减少并发症,提高手术成功率。有效的围手术期营养支持不仅是手术成功的重要保障,也是患者长期健康的基础。
Abstract
The global obese population continues to grow. Obesity not only impacts People's physical and mental health but also creates a significant socioeconomic burden through its associated metabolic diseases.According to the latest article collecting global obesity data, the number of overweight and obese people worldwide continues to rise. It is estimated that by 2030, more than 2.9 billion adults will have a body mass index (BMI) above the normal range, with 1.1 billion adults diagnosed with obesity. It is estimated that by 2030, the overweight population in China will reach as high as 500 million.As obesity becomes a global epidemic, metabolic and bariatric surgery has emerged as the most effective method for treating severe obesity and its related metabolic diseases. However, these procedures alter the gastrointestinal anatomy and physiological functions of patients, while improving patients' metabolic diseases, it also poses significant challenges to their nutritional status. This article reviews recent advances in perioperative nutritional support for metabolic and bariatric surgery, providing a comprehensive analysis spanning preoperative assessment and preparation, and early postoperative recovery and long-term follow-up. Studies demonstrate that personalized nutritional management plans, based on the enhanced recovery after surgery (ERAS) protocol, can effectively improve postoperative outcomes, reduce complications, and enhance surgical success rates. Effective perioperative nutritional management is not only crucial for surgical success but also fundamental to patients' long-term health.
关键词
减重代谢手术 /
代谢性疾病 /
围手术期 /
营养治疗 /
肥胖 /
营养不良 /
加速康复外科 /
并发症
Key words
metabolic and bariatric surgery /
Metabolic diseases /
Perioperative period /
Nutritional treatment /
Obesity /
Malnutrition /
Enhanced recovery after surgery /
Complication
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