肥胖人群减重代谢术后运动康复方案的构建研究

doi:10.12114/j.issn.1007-9572.2019.00.240

摘要/Abstract

摘要： 背景　减重代谢手术是目前国际上有效的治疗病态肥胖的方法，但代谢术后并非所有患者均取得最佳的减重疗效，运动康复作为减重代谢术后康复和生活方式管理的重要组成部分，对于改善患者术后减重结局意义重大，但目前我国尚缺乏科学规范的代谢术后患者运动康复相关指南或共识来指导临床实践。目的　构建适合我国肥胖人群减重代谢术后的运动康复方案。方法　系统检索国内外减重代谢术后运动康复相关文献，检索时间为建库至2017-12-28，对筛选后的文献进行质量评价并提炼内容，制定减重代谢术后运动康复方案的初稿。于2018年1—2月采用德尔菲法，通过16名专家进行２轮专家函询，修订并最终确定肥胖人群减重代谢术后运动康复方案。结果　２轮专家函询的问卷回收率分别为88.9%（16/18）和100.0%（16/16），专家权威系数为0.90。肯德尔协调系数（Kendall's W）分别为0.343和0.453（P<0.01），最终形成的运动康复方案包括筛查与评估、运动处方制定、随访与教育3项一级指标，二级指标10项，三级指标48项。结论　基于文献研究和德尔菲法构建的运动康复方案具有一定的科学性和实用性，可用于指导肥胖人群减重代谢术后的运动康复。

关键词: 肥胖症, 减重代谢手术, 运动康复, 德尔菲技术, 运动疗法

Abstract: Background　For severe obese people，bariatric surgery is the most effective choice，but not all patients can achieve satisfied weight loss after the surgery.As an important component of postoperative rehabilitation and lifestyle management，exercise rehabilitation is of great significance in improving postoperative weight loss related outcomes.However，in China，there is lack of a scientific and standardized exercise rehabilitation guideline or consensus to guide clinical practice.Objective　To construct a scientific and practical exercise rehabilitation program suitable for Chinese obese population after bariatric surgery.Methods　We systematically searched the articles about exercise rehabilitation after bariatric surgery from the establishment of the database to 28 December，2017，and extracted useful contents from the eligible ones after a quality assessment，then formulated an initial version of the exercise rehabilitation program for Chinese obese people after bariatric surgery.After this，we conducted two rounds of Delphi consultation among 16 experts from January to Febnary 2018，and according to the results，we revised the initial version，and developed the final version.Results　The response rates for the first，and second consultations were 88.9%（16/18）and 100.0%（16/16），respectively，and the authority coefficient of experts was 0.90.Kendall's coefficients of concordance in the first，and second consultations were 0.343 and 0.453 respectively（P<0.01）． The final program includes 3 primary indicators （screening and assessment，exercise prescription formulation，follow-up and education），10 secondary indicators and 48 tertiary indicators.Conclusion　Our exercise rehabilitation program conducted on the basis of literature review and Delphi consultation is scientific and practical，which may be useful in guiding the exercise rehabilitation of patients after bariatric surgery.

Key words: Obesity, Bariatric surgery, Exercise rehabilitation, Delphi technique, Exercise therapy

任子淇,张天资,杨宁琍,等. 肥胖人群减重代谢术后运动康复方案的构建研究[J]. 中国全科医学, 2019, 22(19): 2332-2339. DOI: 10.12114/j.issn.1007-9572.2019.00.240.
REN Ziqi,ZHANG Tianzi,YANG Ningli, et al. Construction of an Exercise Rehabilitation Program for Obese People after Bariatric Surgery　[J]. Chinese General Practice, 2019, 22(19): 2332-2339. DOI: 10.12114/j.issn.1007-9572.2019.00.240.

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