减重手术后的营养管理与复胖:现状与思考

Nutritional management and weight regain after bariatric surgery:current situation and thoughts

肥胖已成为全球性的公共卫生问题,减重手术目前是治疗肥胖最长期有效的方法。患者的术后营养管理也非常重要,术后蛋白质营养不良是最常见的宏量营养素缺乏症,且术前微量营养素缺乏症也会在术后持续存在甚至加剧。与其他减重手术相比,Roux-en-Y胃旁路术(RYGB)术后微量营养素缺乏最严重。复胖是术后面临的一项长期挑战,患者术后不遵循饮食建议和饮食控制、放牧行为是重要因素。本文对减重手术术后营养缺乏现状、复胖现状及危险因素进行了综述,提供了术后营养管理建议,以及长期随访策略。未来,需要更多深入研究临床实践以达成术后营养管理及预防复胖的共识,提高减重手术的长期疗效,改善患者生活质量。

Obesity has become a global public health problem,and bariatric surgery is currently the most enduring treatment for obesity.Postoperative nutritional management is crucial,with postoperative protein malnutrition being the most common micronutrient deficiency,and preoperative micronutrient deficiencies persisting and potentially worsening postoperatively.Among various bariatric surgeries,Roux-en-Y gastric bypass(RYGB)is associated with the most severe postoperative micronutrient deficiencies.Long-term weight regain presents a significant challenge postoperatively,with non-adherence to dietary recommendations and behavior contributing as important factors.This article reviews the current status of postoperative nutritional deficiencies,the state of weight regain,and associated risk factors,offering postoperative nutritional management recommendations,as well as long-term follow-up strategies.Future research is needed to establish consensus in clinical practice to improve postoperative nutritional management and prevent weight regain,ultimately enhancing the long-term effectiveness of weight loss surgery and the quality of life for patients.