手术与常规疗法减肥治疗阻塞性睡眠呼吸暂停:一个随机对照试验
John B Dixon1, Linda M Schachter, Paul E O'Brien
1Obesity Research Unit, Department of General Practice, Monash University, Melbourne, Victoria, Australia. john.dixon@bakeridi.edu.au
JAMA
|September 20, 2012
概括
减肥手术导致肥胖患者有阻塞性睡眠呼吸暂停 (OSA) 的显著体重减轻. 然而,与传统的减肥疗法相比,它没有显著改善呼吸暂停-低呼吸暂停指数 (AHI).
科学领域:
- 睡眠医学 睡眠医学
- 腹部外科 腹部外科
- 肥胖管理 肥胖管理
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 与肥胖密切相关.
- 减肥是管理肥胖个体OSA的一个关键建议.
研究的目的:
- 为了比较手术诱导的减肥疗法与OSA管理的常规减肥疗法的有效性.
- 评估减肥手术对OSA严重程度和相关健康结果的影响.
主要方法:
- 这是一项随机对照试验,涉及60名肥胖患者,他们最近被诊断患有OSA和高呼吸暂停-呼吸暂停指数 (AHI).
- 参与者被随机分配到传统的减肥计划 (饮食师/医生咨询,非常低热量饮食) 或减肥手术 (腹腔镜可调节的胃带).
- 主要结局是AHI在2年后的变化,通过多睡眠学评估.
主要成果:
- 与常规组 (5.1公斤) 相比,腹部外科手术患者的体重减轻显著增加 (27.8公斤).
- 呼吸暂停-呼吸暂停指数 (AHI) 在两组都下降,但减肥手术和常规治疗之间的差异在统计学上并不显著 (-11.5事件/小时;P = .18).
- 持续正气道压力 (CPAP) 的坚持在两组之间没有差异,而减肥手术组报告了功能状态的改善.
结论:
- 尽管体重减轻显著,但减肥手术并没有导致与OSA肥胖患者的常规减肥疗法相比,AHI在统计学上显著减少.
- 腹腔外科手术可以为患有OSA的肥胖患者提供功能状态改善的好处.
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