减肥栓塞术现状及展望

Current status and prospect of bariatric artery embolization

过去50年间,全球肥胖发病率大幅增加,严重威胁人类健康。常规减重手段,如饮食、运动疗法等难以获得稳定、快速的减肥效果,而目前多数具有减重作用药物的主要适应证为糖尿病,不宜用于单纯肥胖人群。传统外科减肥手术普及率低、手术费用及并发症风险高。因此,减肥栓塞术(bariatricarteryembolization,BAE)作为新兴的减肥疗法应运而生,快速发展。BAE不仅能实现长期有效的体重控制,还可能给糖尿病前驱期患者带来额外的血糖获益,且相比于传统减重手术,BAE创伤小、恢复快、术后并发症风险低。但目前对于术中栓塞材料及栓塞位点的选择尚无统一标准,术后胃功能的变化情况以及机体代谢改善的具体机制也有待进一步探讨。本文对BAE的研究背景、技术原理、国内外最新研究进展及存在的问题进行介绍。

Over the past 50 years,the global incidence of obesity has dramatically increased,posing a serious threat to human health.Conventional weight loss methods,such as dieting and exercise therapy,are difficult to obtain a stable and rapid weight-loss effect.Besides,most weight-loss drugs available nowadays are not specifically designed for the pure obese population,they are mainly used for diabetes.The prevalence of traditional bariatric surgery is low,and it carries high surgical costs and high risk of developing complications.Therefore,bariatric artery embolization(BAE),regarded as a new weight-loss therapy,has emerged and it has developed rapidly.BAE can not only achieve long-term weight control,but also provide glycemic benefit to patients with pre-diabetes.Compared with traditional bariatric surgery,BAE has the advantages of less trauma,quick recovery and low risk of postoperative complications.However,there is no unified standard for the selection of intraoperative embolization materials and embolization sites so far,and the postoperative changes of gastric function and the specific mechanism of body metabolism improvement need to be further explored.This paper aims to make a detailed review about BAE,focusing on the research background,the technical principles,the latest research progress,and the existing problems.