腹腔镜下胃袖状切除术后患者减重疗效的影响因素分析及护理启示OA

Objective:To observe the efficacy of obese patients after undergoing laparoscopic sleeve gastrectomy(LSG)one year later and to analyze its influencing factors,aiming to provide a basis for preoperative nursing risk assessment and the development of personalized postoperative intervention plans.Methods:A retrospective analysis was performed on baseline data of 780 obese patients who underwent laparoscopic sleeve gastrectomy(LSG)treatment,including general information,body composition,and laboratory parameters,etc.One year after the surgery,the patients were categorized into either the good weight loss group or the poor weight loss group based on whether their percentage of excess weight loss(EWL)was≥50%.The Wilcoxon signed-rank test was used to analyze the weight changes before and after the surgery.Univariate analysis,multicollinearity analysis,and logistic regression analysis were employed to investigate the influencing factors of the treatment efficacy.Results:One year after the operation,655 cases(83.97%)achieved good weight loss outcomes,with an excess body weight loss rate of(82.08±34.38)%.The differences in body weight and body mass index(BMI)before and after surgery were statistically significant(P<0.05).Logistic regression analysis revealed that the independent factors influencing the weight loss efficacy included hip circumference(OR=0.939,95%CI:0.922～0.956,P<0.001),baseline waist-to-hip ratio(OR=0.000,95%CI:0.000～0.060,P<0.001),activated partial thromboplastin time(OR=0.925,95%CI:0.872～0.981,P=0.010),prolactin(OR=1.032,95%CI:1.009～1.057,P=0.007),and fat-free mass(OR=1.027,95%CI:1.006～1.049,P=0.011).Conclusion:LSG is highly effective for patients with morbid obesity,but its outcomes vary individually.Nursing staff should pay close attention to key indicators such as body fat distribution patterns,glycolipid metabolism,and hormone levels during the perioperative period.Targeted personalized management plans involving nutrition,exercise,and health education should be implemented within continuous care to optimize long-term outcomes.