老年与非老年肥胖症患者行减重手术临床疗效的Meta分析

Clinical efficacy of bariatric surgery for elderly and nonelderly obese patients: a Meta analysis

  • 摘要: 目的:系统评价老年(年龄≥60岁)或非老年(年龄<60岁)肥胖症患者行减重手术的临床疗效。
    方法:以bariatric surgery、metabolic surgery、gastric bypass、gastric band、sleeve gastrectomy、biliopancreatic diversion、elderly、aged、over 60 years为检索词,检索PubMed、Embase、The Cochrane Library。检索时间为2006年1月至2016年6月。纳入比较老年与非老年肥胖症患者行减重手术临床疗效的队列研究,手术方式不限。患者年龄≥60岁设为老年组,<60岁设为非老年组。由两名研究者独立筛选文献和提取数据,并进行质量评价。计数资料采用比值比(OR)及95%可信区间(95%CI)表示。采用I2对异质性进行分析。
    结果:最终纳入符合标准的相关研究共11篇,均为回顾性研究,累计样本量9 913例,其中老年组792例,非老年组9 121例。Meta分析结果显示:老年组和非老年组肥胖症患者行减重手术后早期病死率、术后早期并发症发生率、术后糖尿病缓解率、术后高血压病缓解率、术后高脂血症缓解率、术后睡眠呼吸暂停综合征缓解率比较,差异均无统计学意义(OR=3.31,1.94,1.00,0.61,0.99,1.40,95%CI:0.86~12.77,1.01~3.74,0.66~1.50,0.34~1.10,0.42~2.29, 0.72~2.72,P>0.05)。
    结论:老年肥胖症患者行减重手术安全性和临床疗效与非老年患者相当。

     

    Abstract: Objective:To systematically evaluate the clinical efficacy of bariatric surgery for elderly (age ≥60 years) or nonelderly (age <60 years) obese patients.
    Methods:Literatures were researched using PubMed, Embase, Cochrane Library from January 2006 to June 2016 with the key words including “bariatric surgery, metabolic surgery, gastric bypass, gastric band, sleeve gastrectomy, biliopancreatic diversion, elderly, aged, over 60 years”. The cohort study about clinical efficacy of bariatric surgery for elderly or nonelderly obese patients were received and enrolled, and surgical procedures were unrestricted. Patients with age ≥60 years and with age <60 years were respectively allocated into the elderly group and nonelderly group. Two reviewers independently screened literatures, extracted data and assessed the risk of bias. Count data were described as odds ratio (OR) and 95% confidence interval (CI). The heterogeneity of the studies was analyzed using the I2 test.
    Results:Eleven retrospective studies were enrolled in the Meta analysis, and the total sample size was 9 913 patients, including 792 in the elderly group and 9121 in the nonelderly group. The results of Meta analysis showed that there were no statistically significant differences in the early mortality, incidence of postoperative early complication, remission rates of postoperative diabetes, postoperative hypertension, dyslipidemia and obstructive sleep apnea syndrome between elderly group and nonelderly group (OR=3.31, 1.94, 1.00, 0.61, 0.99, 1.40, 95%CI: 0.86-12.77, 1.01-3.74, 0.66-1.50, 0.34-1.10, 0.42-2.29, 0.72-2.72,P>0.05).
    Conclusion:The safety and clinical efficacy of bariatric surgery in the elderly obese patients are equivalent to that of nonelderly patients.

     

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