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肥胖及其对肝功能障碍的影响,肝切除后的发病率和死亡率
Stephanie Kampf1, Michael Sponder2, Fabian Fitschek1
1Division of Visceral Surgery, Department of General Surgery, Medical University of Vienna, Vienna, Austria.
Hepatobiliary surgery and nutrition
|October 27, 2023
概括
肥胖不会增加肝切除术后肝衰竭 (PHLF) 的风险. 与正常体重患者相比,接受LR的超重和肥胖患者经历了类似的PHLF率和术后并发症.
科学领域:
- 肝胆道手术是肝胆道的手术.
- 手术瘤学手术瘤学
- 代谢性疾病研究研究.
背景情况:
- 肥胖和非酒精性脂肪肝炎 (NASH) 是全球越来越多的健康问题.
- 在肝切除后,肥胖对肝切除后肝衰竭 (PHLF) 的影响仍然不完全理解.
- 了解这些关系对于优化手术结果至关重要.
研究的目的:
- 研究身体质量指数 (BMI) 和NASH对PHLF和LR后手术后发病率的影响.
- 为了确定增加的BMI或NASH的存在是否与更高的PHLF率相关.
- 评估不同体重类别患者的LR的安全性和结果.
主要方法:
- 一项回顾性研究分析了接受LR的患者.
- 根据BMI,患者被分为三组:正常体重 (18.5-24.9 kg/m2),超重 (25.0-29.9 kg/m2) 和肥胖 (≥30 kg/m2).
- 收集的数据包括BMI,NASH的存在,PHLF的发生率和其他术后并发症.
主要成果:
- 在888名患者中,40.7%的体重正常,40.5%的超重,18.8%的肥胖.
- 纳什的患病率与BMI显著增加 (正常体重的16.1%,肥胖患者的41.3%,P<0.001).
- 在不同体重组中,PHLF的发病率相似 (16.3%正常,15.3%超重,11.4%肥胖;P=0.32),NASH与PHLF无关. 主要LR是PHLF的唯一显著预测因素 (OR:2.7).
结论:
- 在接受LR的正常体重,超重和肥胖患者之间,术后并发症和PHLF的发生率是可比的.
- 肝切除可以安全地在BMI范围内的患者中使用现代手术技术进行.
- 患者的体重和NASH状态似乎不是PHLF的独立风险因素.
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