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完整版: 为减肥把关 肠胃绕道手术不让复胖有机可乘
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【健康传媒 林雁茹/台北报导】2017.12.26
  隐藏的高热量成了减重杀手,加上身体活动量降低,一不小心体重可能就直线上升。虽然减重的方式五花八门,但肥胖者多半都因难以控制的口欲再度沦陷,即便透过减重手术改善,仍有极少数减重效果不如预期。对此,专业医师建议,可选择肠胃绕道手术作为第二线减重方式,来为减肥做把关。

   现今,可透过胃绕道、胃袖状切除、肠胃绕道等方式来达到减重的目的,各有优缺利弊。整形外科医师丁立文表示,胃绕道手术主要是以胃为开端的减重治疗法,胃绕道后食物不会经过十二指肠及近端小肠,术后除了热量吸收减少外,维生素的吸收也一并减少。至于肠胃绕道手术,则是创造另外一条新的消化路径,起点或终点不只局限于胃,可能由胃连结到肠或肠接到肠,单一绕道或双重绕道,胃不会被切除,十二指肠也能正常运作,患者术后普遍适应良好。反观胃绕道手术患者,术后食物不经过十二指肠及近端小肠,因此要长期补充身体所需的维生素、铁、钙等元素,否则易有贫血、骨质疏松的情形发生。

  值得注意的是,成功的减重手术若以超过理想体重的部分来计算(理想体重以BMI=22为标准),患者术后应在半年内瘦下超重部位的60%,而在第2至第3年时达到最低点并能维持,少数患者体重会有些许回升,但仍不至回复到原先体重。丁立文说明,一般胃袖状切术后,胃部被切除70%至80%,仅存不到三分之一,患者初期进食量少,随着食欲渐开越吃越多,一不小心胃的空腔越撑越大后,复胖机率就会增加。

  丁立文举例,曾收治一名身高168公分的38岁女性,她在进行胃袖状切除术前96公斤,两年后腹胖到98公斤,心情沮丧前来求助,采取肠胃绕道手术后,半年多来瘦了13公斤,目前体重85公斤,让她对自己重拾信心。肠胃绕道手术后前半个月应以流质食物为主、半个月后改为半流质,忌喝酸性饮料,以免分泌大量胃酸影响伤口愈合。1个月过后就能正常进食,每餐进食量以有饱意却不撑的六分饱,且不超过原先食量为原则,不须刻意挨饿,就能达到减重效果。

  对于少数无法控制食欲、术后体重变化幅度不大或减重速度过慢者,即适合利用肠胃绕道手术来对抗顽固肥胖或复胖机率大的减重患者,以减少吸收作用,顺利达到减重目的。肥胖问题不仅影响外型、也容易对健康和心理造成负面影响。丁立文指出,进行肠胃绕道减重手术时,可合并腹部抽脂和拉肚皮,术后肚围立即小一圈且不松垮;惟须注意的是,此手术难度较高,需经由经验丰富的专业医师评估及执刀,方能保障患者自身安全及术后成效。

引用来源 http://healthmedia.nownews.com/contents....0&id=22878

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