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肥胖症的多学科综合治疗模式
于健春中国医学科学院北京协和医院基本外科
摘要肥胖症在我国及世界多国迅速增长威胁到人类健康引起了代谢性疾病的增长和疾病谱改变其伴发疾病死亡率及引发相关的社会经济问题亟待世界性关注近年来对于肥胖的治疗也从单纯饮食运动和药物治疗转向了多学科综合治疗模式对于保守治疗效果欠佳的重度肥胖患者体重指数 40kgm2或体重指数介于35~40kgm2且合并肥胖相关合并症如严重糖尿病肥胖相关心肌病变严重睡眠呼吸暂停不育影响日常生活的骨关节炎等疾病患者选择微创腹腔镜减肥手术治疗如可调节胃束带术等可获得长期稳定的减重治疗效果特别是对合并症的明显治愈或预防改善作用并最终降低死亡率多学科综合治疗模式已在恶性肿瘤及肥胖症等多种疾病的治疗中被大多数国家和医院所采用现代多学科优势对于提高疾病诊疗效果和医疗服务水平共同探讨解决边缘学科难题促进相关学科学术水平提高将发挥越来越重要的作用
关键词肥胖症多学科综合治疗模式
中图分类号R4593R656 文献标志码A 文章编号1000-503X201001-0001-03DOI103881jissn1000-503X201001001
Integrated Multidisciplinary Treatment Modalities for ObesityYU Jian-chunDepartment of General Surgery PUMC Hospital CAMS and PUMC Beijing 100730 ChinaTelFax010-65296038E-mailyu-ABSTRACTThe rapid increase of obesity nationwide and worldwide has threatened human health and caused the increase of metabolic diseases and the changes of disease spectrum Its co-morbidities mortality and relevant socio-economic issues have became global concerns Integrated multidisciplinary treatme
nt modalities have emerged in recent years For severely obese patients 〔body mass index BMI 40 kgm2〕 or obese patients BMI 35 - 40 kgm2 with co-morbidities such as severe diabetes obesity-associated cardiac lesions severe sleep apnea infertility and osteoarthritis that affect the daily life minimally invasive laparoscopic bariatric surgery such as Lap Banding can achieve satisfactory results by reducing body weight in long term treating or preventing the co-morbidities and ultimately decreasing mortality Multidisciplinary treatment modalities for tumors obesity and other diseases have been widely adopted This strategy may play increasingly important roles in improving the treatment effectiveness upgrading healthcare services and addressing interdisciplinary problemsKey wordsobesitymultidisplinary team integrated treatment modalitiesActa Acad Med Sin20103211-3
基金项目卫生部内分泌重点实验室资助课题Supported by the Endocrine Major Laboratory Financial Assistance Subject of Minstry of Health
肥胖症是由基因环境及行为等诸多因素所致随