中国实用外科杂志

中国实用外科杂志

• 专题笔谈 • 上一篇    下一篇

减重代谢手术围手术期管理的几个关键问题

梁    辉   

  1. 南京医科大学第一附属医院普外科，江苏南京 210029
  • 出版日期:2019-04-01 发布日期:2019-04-04

  • Online:2019-04-01 Published:2019-04-04

摘要：

近年来，减重代谢手术广泛开展，由于肥胖及糖尿病病人自身的特殊性，围手术期的管理也有其特殊性。关键问题包括：术前的诊断和鉴别诊断、术前合并症的处理、术前和术后干预等。术前减重可以降低手术难度，减少并发症发生，而围手术期的睡眠呼吸暂停综合征的处理相对复杂。另外，在深静脉血栓的预防方面，东西方国家可能有所差异。

关键词: 减重代谢外科, 围手术期, 睡眠呼吸暂停综合征, 深静脉血栓, 并发症

Abstract:

Key issues of perioperative management in bariatric and metabolic surgery        LIANG Hui. Department of General Surgery，the First Affiliated Hospital with Nan Jing Medical University，Nanjing 210029，China
Abstract    Bariatric and metabolic surgery has gained its rapid development recently. However，their perioperative management remains special due to the complex nature of obesity and type 2 diabetes mellitus. Special attention regarding the perioperative management of bariatric and metabolic surgery includes preoperative diagnosis and differential diagnosis, management of obesity related preoperative comorbidities, preoperative and postoperative management. Preoperative weight loss could decrease the surgical difficulty and surgical related compilations. Perioperative management of obstructive sleep apnea syndrome is relatively complicated. Meanwhile，measures regarding the deep venous thromboembolism prophylaxis are different in eastern and western countries.

Key words: bariatric and metabolic surgery, perioperative period, obstructive sleep apnea syndrome, deep venous thromboembolism, complication