肥胖女性進行胃繞道與胃袖狀切除手術後飲食攝取、身體組成及血液生化值的變化

Comparisons of Changes in Dietary Intake, Body Composition, and Blood Parameters in Obese Women after Roux-En-Y Gastric Bypass and a Sleeve Gastrectomy

林琪凰(Chi-Huang Lin) ； 鄭佾琪(I-Chi Cheng) ； 王偉(Weu Wang) ； 汪曉琪(Hsiao-Chi Wang) ； 葉松鈴(Sung-Ling Yeh)

《臺灣營養學會雜誌》 41卷4期 (2016/12) Pp. 124-136

https://doi.org/10.6691/NSJ.201612_41(4).0003

摘要

本研究目的為探討肥胖女性進行胃繞道（Roux-en-Y gastric bypass, RYGB）或胃袖狀切除（sleeve gastrectomy, SG）手術後飲食攝取、身體組成與血液生化數值的變化。研究採病歷回溯法收集2012年1月～2014年12月於台北醫學大學附設醫院進行減重手術的個案資料，由34位RYGB個案中篩選出7位資料收集完整之女性，再於SG個案中挑選出性別、年齡、體位與RYGB個案相仿者共7位，比較兩種手術在術後3-6個月與7-12個月飲食攝取、身體組成及血液生化數值之差異。結果顯示，SG和RYGB兩種減重手術皆可有效減少熱量攝取、降低體重、腰圍與體脂肪重，緩解代謝性疾病的嚴重程度並維持肌肉瘦組織。減重手術個案在術後之三大營養素、維生素與礦物質攝取均低於營養素建議攝取量。在手術後3-6個月，RYGB組每日熱量攝取量顯著低於SG組，過多體重流失率（Excess body weight loss%）則高於SG組，但在術後7-12個月RYGB組熱量攝取漸增加，使兩組個案在熱量、營養素攝取量、身體組成與血液生化值兩組間無顯著差異。本研究顯示，兩種手術在術後7-12個月不論在營養攝取或減重結果上均無顯著差異。而減重手術個案在蛋白質、維生素、礦物質攝取不足的情形並未因不同減重手術而有所不同，故減重手術補充蛋白質及維生素、礦物質應為預防個案術後營養缺乏的必要措施。

關鍵字

胃繞道 ； 胃袖狀切除 ； 飲食攝取 ； 身體組成 ； 血液生化值

並列摘要

This retrospective study was designed to investigate the impacts of two different bariatric surgeries on dietary intake, body composition, and biochemical parameters in obese women. Patients who were scheduled for a Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) from January 2012 to December 2014 at Taipei Medical University Hospital were enrolled in this study. Among the 34 subjects who underwent the RYGB operation, only seven female subjects had complete information. Therefore, seven sex-, age-, and body mass index-matched subjects who underwent the SG operation were recruited. Results showed that both the RYGB and SG surgeries resulted in lower energy intake; decreased body weight, waist circumference, and fat mass; and alleviation of metabolic disorders, while maintaining a lean body mass. However, protein, vitamin, and mineral intake levels at 7～12 months postoperatively were significantly below recommendations of the Reference Dietary Intake. The RYGB group had lower caloric intake, whereas it had a higher excess body weight loss percentage than the SG group at 3～6 months after surgery. Caloric intake in the RYGB group rebounded to an amount comparable to the SG group at 7～12 months, and no significant differences in nutrient intake, body composition, or biochemical parameters were observed during this time period. These results suggest that nutrition intake and surgical outcomes were comparable between the RYGB and SG groups at 7～12 month after surgery. Since the intake of protein as well as vitamins and minerals did not meet suggested daily requirements, nutritional supplements should be recommended for all subjects after bariatric surgery.

並列關鍵字

Roux-en-Y gastric bypass ； sleeve gastrectomy ； dietary intake ； body composition ； biochemical parameters