首頁資訊術(shù)前減重在減重代謝手術(shù)中的作用：一項系統(tǒng)評價及Meta分析

術(shù)前減重在減重代謝手術(shù)中的作用：一項系統(tǒng)評價及Meta分析

來源：泰然健康網(wǎng) 時間：2024年12月25日 00:47

目的

系統(tǒng)評價術(shù)前減重是否可以改善減重代謝手術(shù)患者的臨床療效。

方法

通過檢索PubMed、Emabase、Cochrane數(shù)據(jù)庫搜集關(guān)于術(shù)前減重對接受減重代謝手術(shù)治療患者臨床療效的研究，檢索時限均從建庫至2020年10月。采用Review Manager 5.3軟件進(jìn)行Meta分析，主要評估術(shù)前合并癥改善、術(shù)中腔鏡中轉(zhuǎn)、手術(shù)時間、住院時間、非計劃二次手術(shù)、術(shù)后傷口感染、術(shù)后出血、術(shù)后早期并發(fā)癥、術(shù)后合并癥改善、術(shù)后體重減輕指標(biāo)。

結(jié)果

共納入包括6 000名患者在內(nèi)的10項研究。Meta分析顯示，與常規(guī)對照組相比，術(shù)前減重組在術(shù)前合并癥改善、術(shù)中腔鏡中轉(zhuǎn)、手術(shù)時間、術(shù)后早期并發(fā)癥、術(shù)后出血、術(shù)后傷口感染、非計劃二次手術(shù)、住院時間、術(shù)后合并癥改善、術(shù)后6個月減輕指標(biāo)、術(shù)后12個月均無明顯獲益，兩組間差異均無統(tǒng)計學(xué)意義。而術(shù)前減重組在術(shù)后短期3個月內(nèi)體重減輕更明顯。

結(jié)論

實施減重代謝手術(shù)前進(jìn)行術(shù)前減重可能使患者在術(shù)后短期內(nèi)體重減輕更明顯，但在圍手術(shù)期風(fēng)險、合并癥改善、住院時間、遠(yuǎn)期體重減輕等方面獲益并不明顯，其臨床療效仍需更多高級別循證研究證據(jù)的幫助與支持。

Objective

To evaluate systematically whether Preoperative weight loss can improve the clinical efficacy of patients undergoing bariatric surgery.

Methods

The study was collected by searching the database of PubMed, Emabase and Cochrane. The retrieval time was from inception of the database to October 2020. Meta-analysis was performed with Review Manager 5.3. The improvement of preoperative complications, conversion to endoscopy, operation time, hospital stay, unplanned secondary operation, postoperative wound infection, postoperative bleeding, early postoperative complications, improvement of postoperative complications and postoperative weight loss were evaluated.

Results

A total of 10 studies were finally included involving 6000 patients. Meta-analysis showed that, compared with the routine control group, reduced weight before operation group had no benefit in preoperative complications improvement, intraoperative endoscopic conversion, operation time, early postoperative complications, and postoperative bleeding, postoperative wound infection, unplanned second operation, hospital stay, postoperative complications improvement, weight loss index after 6 months, weight loss index after 12 months. There was no significant difference between the two groups. But, the weight loss before operation was more obvious within 3 months after operation.

Conclusions

Preoperative weight loss before bariatric surgery may make patients lose weight more obviously in the short term after operation, but they cannot benefit from perioperative risk, improvement of complications, hospital stay, and long-term weight loss and so on. Its clinical effect still needs the help and support of more high-level evidence-based research evidence.

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