腹腔镜胃减容术治疗单纯病态肥胖症的围手术期处理

Nursing of the morbidly obese patients treated with laparoscopic vertical banded gastroplasty

目的 :探讨经腹腔镜胃减容术治疗单纯病态肥胖症患者术前、术后的护理。 方法 :对 6例单纯病态肥胖症患者在术前进行肥胖程度、并发症和心理状态评估。术后进行呼吸道监护 ,手术相关并发症的观察和饮食指导。结果 :术前 6例中有 5例为 度肥胖 ,1例为 度肥胖。 4例有高血压及棘皮病 ,1例有关节炎 ,所有患者均有呼吸睡眠综合征。都曾试过各种减肥方法 ,对胃减容术能否成功有一定的思想顾虑。 6例患者的手术均获成功。术后 1个月食量和体质量均明显减少。术后呼吸道的监护包括监测 Sp O2 和呼吸的变化等。少量渗血 (1例 ) ,肩、背酸痛 (1例 )和恶心、呕吐 (5例 )是常见的手术相关并发症。饮食原则是高蛋白、低热量、先流质后固体。 结论 :观察和预防呼吸暂停综合征、腹腔内出血、消化道症状是重点 ,指导患者正确的饮食习惯是达到手术减肥效果的关键。

Objective: To study the nursing of patients with morbid obesity treated with laparoscopic vertical banded gastroplasty (LVBG). Methods: Before operation, obese degree, obesity related conditions and mental states were examined routinely. Monitoring of respiratory tract, observing operative complications and instructing of diets were done after operation. Results: Among 6 patients, 5 were at the third degree of obese, one was at second. In obesity related conditions, 4 patients had hypertension and acantha derma, 1 had arthritis, and all had respiratory sleeping syndrome. The operations were all successful. The food amount food and body weight both decreased significantly 1 month after operation. The common operative complications were mild bleeding (1 case), shoulder back pain (1 case), nausea and vomiting (5 cases). Diet principle was high protein, low energy, liquid food was the first choice. Conclusion: Observing and preventing respiratory sleeping syndrome are the main points of postoperative cares. Instructing patients to establish correct diet habit is the key to reach the best efficacy of LVBG.