背景减重代谢术后不良饮食行为是导致术后复胖的重要原因,但其概念尚未统一,且用词混乱,较大程度地限制了该领域的深入研究及研究结论的可靠程度。目的界定减重代谢术后不良饮食行为的概念。方法于2022年5月,系统检索中国知网、万方数...背景减重代谢术后不良饮食行为是导致术后复胖的重要原因,但其概念尚未统一,且用词混乱,较大程度地限制了该领域的深入研究及研究结论的可靠程度。目的界定减重代谢术后不良饮食行为的概念。方法于2022年5月,系统检索中国知网、万方数据知识服务平台、中国生物医学文献数据库、PubMed、Web of Science、CINAHL数据库,获取以“减重代谢术后不良饮食行为”为主要研究内容且涉及相关概念、定义属性、先决条件、结局指标的文献,检索时限为建库至2022-05-10,语种限定为中、英文。根据纳入的文献,按照Rodgers演化概念分析的步骤,从概念演化、属性特征、先决条件、后果、相关概念、典型案例、为概念的进一步发展提出假设和启示7个方面对减重代谢术后不良饮食行为的相关内容进行分析与整合。结果共纳入符合要求的文献36篇,包括英文文献33篇、中文文献3篇。Rodgers演化概念分析结果显示:减重代谢术后不良饮食行为包括失控性进食、放牧饮食、情绪性进食、食物渴求、食物成瘾、补偿行为6个属性特征;先决条件包括主观和客观因素,主观因素包括自我效能、饮食态度、心理状况、工作压力等,客观因素包括年龄、性别、文化程度、肥胖病史等;后果包括进食障碍和精神心理疾病、减重效果、营养状况、生活质量。结论减重代谢术后不良饮食行为的概念尚未统一,未来还需结合我国国情深入剖析减重代谢术后不良饮食行为的内涵,在此基础上对相关理论、评估工具、影响因素和干预措施等内容进行深入研究,从而维持患者术后减重效果,提高患者生活质量。展开更多
目的对减重代谢术后患者随访现状进行整合性综述,明确目前的随访策略及相关影响因素,为临床实践和未来研究提供参考。方法采用整合性综述方法,系统检索PubMed、Web of Science、Cochrane Library、CINAHL、中国知网、万方数据库、维普...目的对减重代谢术后患者随访现状进行整合性综述,明确目前的随访策略及相关影响因素,为临床实践和未来研究提供参考。方法采用整合性综述方法,系统检索PubMed、Web of Science、Cochrane Library、CINAHL、中国知网、万方数据库、维普网中有关减重代谢术后随访的相关研究,检索时限为建库至2024年12月1日。由2名研究者对纳入文献进行数据提取及汇总分析。结果共纳入30篇文献,包括12篇定量非随机对照研究、11篇定量描述性研究、3篇定量随机对照研究、3篇定性研究、1篇混合研究。15篇研究提及了减重术后患者的失访原因及影响因素,主要涉及主观原因及心理因素、客观障碍、人口学特征、医疗相关因素4个方面。12篇研究对文中描述的随访策略进行了效果评价,发现结合互联网或物联网技术的远程随访模式能提升患者依从性,降低并发症发生风险。多学科协作模式在提高随访率、降低术后并发症发生率及增加多余体重减少率等方面优于传统管理模式。经济激励措施的短期效果显著,定量研究表明其可维持术后6个月内随访率,但未能促进长期减重;定性研究则指出,患者虽认可经济激励的辅助作用,却认为其对随访动机影响有限。此外,常规监测、专人主导的连续性护理及团队高效沟通等被视为有效的随访策略。结论影响减重代谢术后患者随访的因素较多,基于信息技术的远程随访和个性化支持优势较为凸显,可以提高患者随访率,未来应进一步促进减重代谢术后随访的规范化。展开更多
Background:Obesity is commonly observed in patients with cirrhosis,especially with the increasing prevalence of nonalcoholic steatohepatitis(NASH).Bariatric surgery has been avoided in these patients given concerns ab...Background:Obesity is commonly observed in patients with cirrhosis,especially with the increasing prevalence of nonalcoholic steatohepatitis(NASH).Bariatric surgery has been avoided in these patients given concerns about increased perioperative risk;therefore,data are lacking regarding long-term outcomes.In this study,we aimed to evaluate the long-term outcomes of patients with cirrhosis who underwent bariatric surgery.Methods:We reviewed the charts of adult patients with compensated cirrhosis who underwent bariatric surgery after they were prospectively enrolled between February 23,2009 and November 9,2011,and followed in a pilot study for evaluation of bariatric surgery outcomes.Only patients with more than 4 years of follow-up were included in the analysis.Data regarding their liver disease,metabolic status,and survival were collected.A descriptive analysis was performed.Results:The cohort consisted of 10 patients,of whom 7 were females.The median post-surgical follow-up was 8.7 years(61.4 years).All patients had biopsy-proven NASH;two patients had concurrent,untreated hepatitis C infection.During the observation period,there was a mean weight loss of 24 kg(19.2%of total body weight pre surgery,P<0.001)and only one patient regained weight to the baseline pre-surgical measurement.One patient who was not eligible for transplant developed hepatic encephalopathy 3 years after surgery and later died.The remainder of the patients did not have any hepatic decompensation,cardiovascular event,or mortality.Except for one patient with Gilbert syndrome,bilirubin was normal in all patients at last follow-up.Conclusions:Bariatric surgery in patients with compensated cirrhosis can lead to sustained weight loss and stable hepatic function on long-termfollow-up.展开更多
文摘背景减重代谢术后不良饮食行为是导致术后复胖的重要原因,但其概念尚未统一,且用词混乱,较大程度地限制了该领域的深入研究及研究结论的可靠程度。目的界定减重代谢术后不良饮食行为的概念。方法于2022年5月,系统检索中国知网、万方数据知识服务平台、中国生物医学文献数据库、PubMed、Web of Science、CINAHL数据库,获取以“减重代谢术后不良饮食行为”为主要研究内容且涉及相关概念、定义属性、先决条件、结局指标的文献,检索时限为建库至2022-05-10,语种限定为中、英文。根据纳入的文献,按照Rodgers演化概念分析的步骤,从概念演化、属性特征、先决条件、后果、相关概念、典型案例、为概念的进一步发展提出假设和启示7个方面对减重代谢术后不良饮食行为的相关内容进行分析与整合。结果共纳入符合要求的文献36篇,包括英文文献33篇、中文文献3篇。Rodgers演化概念分析结果显示:减重代谢术后不良饮食行为包括失控性进食、放牧饮食、情绪性进食、食物渴求、食物成瘾、补偿行为6个属性特征;先决条件包括主观和客观因素,主观因素包括自我效能、饮食态度、心理状况、工作压力等,客观因素包括年龄、性别、文化程度、肥胖病史等;后果包括进食障碍和精神心理疾病、减重效果、营养状况、生活质量。结论减重代谢术后不良饮食行为的概念尚未统一,未来还需结合我国国情深入剖析减重代谢术后不良饮食行为的内涵,在此基础上对相关理论、评估工具、影响因素和干预措施等内容进行深入研究,从而维持患者术后减重效果,提高患者生活质量。
文摘目的对减重代谢术后患者随访现状进行整合性综述,明确目前的随访策略及相关影响因素,为临床实践和未来研究提供参考。方法采用整合性综述方法,系统检索PubMed、Web of Science、Cochrane Library、CINAHL、中国知网、万方数据库、维普网中有关减重代谢术后随访的相关研究,检索时限为建库至2024年12月1日。由2名研究者对纳入文献进行数据提取及汇总分析。结果共纳入30篇文献,包括12篇定量非随机对照研究、11篇定量描述性研究、3篇定量随机对照研究、3篇定性研究、1篇混合研究。15篇研究提及了减重术后患者的失访原因及影响因素,主要涉及主观原因及心理因素、客观障碍、人口学特征、医疗相关因素4个方面。12篇研究对文中描述的随访策略进行了效果评价,发现结合互联网或物联网技术的远程随访模式能提升患者依从性,降低并发症发生风险。多学科协作模式在提高随访率、降低术后并发症发生率及增加多余体重减少率等方面优于传统管理模式。经济激励措施的短期效果显著,定量研究表明其可维持术后6个月内随访率,但未能促进长期减重;定性研究则指出,患者虽认可经济激励的辅助作用,却认为其对随访动机影响有限。此外,常规监测、专人主导的连续性护理及团队高效沟通等被视为有效的随访策略。结论影响减重代谢术后患者随访的因素较多,基于信息技术的远程随访和个性化支持优势较为凸显,可以提高患者随访率,未来应进一步促进减重代谢术后随访的规范化。
文摘Background:Obesity is commonly observed in patients with cirrhosis,especially with the increasing prevalence of nonalcoholic steatohepatitis(NASH).Bariatric surgery has been avoided in these patients given concerns about increased perioperative risk;therefore,data are lacking regarding long-term outcomes.In this study,we aimed to evaluate the long-term outcomes of patients with cirrhosis who underwent bariatric surgery.Methods:We reviewed the charts of adult patients with compensated cirrhosis who underwent bariatric surgery after they were prospectively enrolled between February 23,2009 and November 9,2011,and followed in a pilot study for evaluation of bariatric surgery outcomes.Only patients with more than 4 years of follow-up were included in the analysis.Data regarding their liver disease,metabolic status,and survival were collected.A descriptive analysis was performed.Results:The cohort consisted of 10 patients,of whom 7 were females.The median post-surgical follow-up was 8.7 years(61.4 years).All patients had biopsy-proven NASH;two patients had concurrent,untreated hepatitis C infection.During the observation period,there was a mean weight loss of 24 kg(19.2%of total body weight pre surgery,P<0.001)and only one patient regained weight to the baseline pre-surgical measurement.One patient who was not eligible for transplant developed hepatic encephalopathy 3 years after surgery and later died.The remainder of the patients did not have any hepatic decompensation,cardiovascular event,or mortality.Except for one patient with Gilbert syndrome,bilirubin was normal in all patients at last follow-up.Conclusions:Bariatric surgery in patients with compensated cirrhosis can lead to sustained weight loss and stable hepatic function on long-termfollow-up.
