本文選題：體重指數(shù) + 減重手術(shù)�。� 參考：《南京醫(yī)科大學(xué)學(xué)報(bào)(自然科學(xué)版)》2016年01期

【摘要】：減重代謝手術(shù)成為臨床上最重要的創(chuàng)新之一,在2013年被Cleveland Clinic評(píng)選為當(dāng)年醫(yī)學(xué)十大創(chuàng)新之首。代謝手術(shù)治療肥胖型糖尿病的臨床效果遠(yuǎn)遠(yuǎn)優(yōu)于單純的內(nèi)科藥物治療,傳統(tǒng)的飲食控制和運(yùn)動(dòng)、生活方式改變等已被證明對(duì)于重度肥胖患者幾乎是無效的,代謝手術(shù)成為減重和治療代謝并發(fā)癥的有效手段。在中國由于2型糖尿病占糖尿病的95%左右,而且控糖達(dá)標(biāo)率較低,手術(shù)減重降糖已經(jīng)成為臨床的熱點(diǎn)。隨著減重代謝手術(shù)指南在中國的大力推廣,越來越多的問題也逐漸暴露出來;在臨床上也有許多醫(yī)生對(duì)于各種指南和共識(shí)中體重指數(shù)(body mass index,BMI)的限制表示不解。那么BMI和減重代謝手術(shù)到底是一種什么樣的關(guān)系?BMI是目前應(yīng)用最廣泛的判斷肥胖的指標(biāo),但是它并不能真實(shí)反映腹腔內(nèi)脂肪的含量,因此在以BMI為基礎(chǔ)的各種減重代謝外科指南中不同地區(qū)及國家分別給出了不同的標(biāo)準(zhǔn),在亞洲增加了腰圍的標(biāo)準(zhǔn)。在手術(shù)適應(yīng)證方面亞洲國家給出的BMI標(biāo)準(zhǔn)比西方低,而代謝手術(shù)的適應(yīng)證不同于減重手術(shù),從糖尿病并發(fā)癥的預(yù)防來說,美國臨床內(nèi)分泌醫(yī)師協(xié)會(huì)和美國內(nèi)分泌學(xué)會(huì)也發(fā)布了新的共識(shí)。
[Abstract]:Weight-loss metabolic surgery has become one of the most important innovations in clinical practice and was named the top ten innovations in medicine by the Cleveland Clinic in 2013. The clinical effect of metabolic surgery in the treatment of obese type diabetes is much better than that of medical medicine alone. Traditional diet control and exercise, lifestyle changes have been proved to be almost ineffective for severely obese patients. Metabolic surgery has become an effective means of weight loss and metabolic complications. In China, type 2 diabetes mellitus accounts for about 95% of diabetes mellitus, and the rate of glucose control is low. With the expansion of guidelines for weight-loss and metabolic surgery in China, more and more problems have emerged, and many doctors in the clinic have expressed confusion about the limitations of the guidelines and consensus on body mass index (BMI). So what is the relationship between BMI and metabolic surgery? BMI is the most widely used indicator of obesity, but it doesn't really reflect the amount of fat in the abdominal cavity. Therefore, different regions and countries give different standards in various BMI-based guidelines for weight-loss surgery, and increase waistline standards in Asia. In terms of surgical indications, Asian countries have given lower BMI standards than those in the West, while metabolic surgery is different from weight-loss surgery in terms of the prevention of diabetic complications. The American Association of Clinical Endocrinologists and the American Endocrine Society have also released a new consensus.
【作者單位】： 南京醫(yī)科大學(xué)第一附屬醫(yī)院普外科;
【分類號(hào)】：R656.6;R589.2
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本文編號(hào)：2040184