重度肥胖患者胃肠分流术后低氧血症机制的分析

Hypoxaemia following gastric bypass surgery in morbidly obese patients

目的 研究重度肥胖对胃肠分流术后动脉血氧分压的影响。方法 对 6 1例进行胃肠分流术的重度肥胖患者及 5 5例择期腹部手术的正常体重患者进行术前肺功能、术前及术后 1～ 5d的血气分析检测。结果 肥胖组术后1～ 5d、对照组术后 1～ 2d的动脉血氧分压较术前显著下降 (P <0 .0 5 ) ;肥胖组术后 1～ 2d动脉血氧分压与其最大分钟通气量及腰臀比显著相关 (P <0 .0 0 0 1)。结论 重度肥胖者较正常体重患者在腹部手术后发生低氧血症的程度较严重且持续时间长。

Objective To investigate the influence of morbidly obesity on arterial oxygen partial pressure (PaO 2) following gastric bypass surgery. Methods\ Preoperative lung function and blood gas analysis before and 1 to 5 days after abdominal surgery were performed on 61 morbidly obese patients and 55 patients with normal body weight. Results\ PaO 2 first five days in obese group post-operatively and first 2 days after the surgery in control group were significantly lower than preoperative values( P <0.05). PaO 2 first two days after surgery in obese group was significantly correlated with maximal voluntary ventilation and waist-hip ratio ( P <0 000 1). Conclusion\ Postoperative hypoxaemia in morbidly obese patients following gastric bypass surgery is more severe and lasted longer than that in patients with normal body weight after selective abdominal surgery.