收稿日期: 2023-03-26
录用日期: 2023-09-15
网络出版日期: 2023-10-28
Advances in preoperative medical management of metabolic surgery
Received date: 2023-03-26
Accepted date: 2023-09-15
Online published: 2023-10-28
肥胖是一种慢性代谢性疾病，其人数日益增多，已成为包括中国在内的许多国家的重要公共卫生问题和流行病。肥胖及其合并症如2型糖尿病（type 2 diabetes mellitus，T2DM）、非酒精性脂肪肝、高血压和心血管疾病等严重危害生命健康。随着代谢手术的不断发展和完善，其作为一种安全、有效的治疗肥胖及其合并症的方法，已被广泛应用于肥胖患者的临床治疗中。代谢手术可以帮助患者显著减轻体质量，改善代谢指标，降低糖尿病、高血压等慢性病的风险，改善患者的生活质量，为患者带来全面的健康益处。然而，目前临床上缺乏规范的代谢手术术前内科管理，可能导致患者出现代谢紊乱、营养缺乏等并发症，从而增加手术风险和术后并发症发生率，影响减重的效果，对患者的预后造成不良影响。该文回顾了代谢手术术前减重、血糖控制、血压和血脂控制、微量营养素补充、心理和行为调节等方面的相关文献，对代谢手术术前内科管理进行综述，旨在为有效提高代谢手术的安全性和治疗效果，以及改善患者的预后提供参考。
单颖仪 , 于浩泳 . 代谢手术术前内科管理进展[J]. 上海交通大学学报（医学版）, 2023 , 43(10) : 1332 -1338 . DOI: 10.3969/j.issn.1674-8115.2023.10.016
Obesity is a chronic metabolic disease that is increasing in prevalence and has become a major public health problem and epidemic in many countries, including China. Obesity and its associated complications, such as type 2 diabetes (T2DM), non-alcoholic fatty liver disease, hypertension, and cardiovascular disease, seriously damage health. With the continuous development of metabolic surgery, it has become a widely used, safe and effective method for treating obesity and its associated complications. Metabolic surgery can significantly lose weight, improve metabolic indicators, reduce the risk of chronic diseases such as diabetes and hypertension, improve the quality of life of patients, and bring comprehensive health benefits to patients. However, there is currently a lack of standardized preoperative medical management for metabolic surgery, which may lead to metabolic disorders, nutrient deficiencies, and other complications, increasing the risk of surgery and postoperative complications, and affecting the efficacy of weight loss and the prognosis of patients. Through the systematic review of literature related to preoperative weight loss, glycemic control, blood pressure and lipid control, micronutrient supplementation, and psychological and behavioral modifications, this paper reviews preoperative medical management of metabolic surgery with the aim of providing reference for effectively improving the safety and efficacy of metabolic surgery and improving the prognosis of patients.
Key words： metabolic surgery; obesity; diabetes; medical management
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