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本指南的更新由AACE、TOS和ASMBS联合编写,遵循AACE2010年制定的临床实践指南的标准化协议的要求。每条建议均进行了二次评估,并均基于临床证据和协议中的主观要求。本指南更新中的延伸话题中的举例包括:袖状胃切除术和减肥手术对2型糖尿病的作用,减肥手术对轻微肥胖患者的作用,铜缺乏症,同意书以及行为问题。与2008年指南中的164条相比,本指南更新中包括74条建议(其中56条在以前的基础上修正,2条为新加入建议)。更新中共有引用403条,其中33条(8.2%)为EL1级,131条(32.5%)为EL2级,170(42.2%)条为EL3级,69条(17.1%)为EL4级。具有强烈证据(EL1级和2级)的研究占相对较大的比例(40.4%),而在2008年的AACE-TOS-ASMBS指南中这一比例仅有16.5%。指南的这些更新反映了最新的研究证据。减肥手术仍然是某些肥胖患者安全、有效的治疗干预措施。手术患者必须拥有一支着重处理营养和代谢问题的围手术期护理团队。
This guidebook update was prepared jointly by AACE, TOS and ASMBS and follows the guidelines of the AEC compliance guidelines set in AACE in 2010. Each recommendation was secondarily assessed and based on clinical evidence and the subjective requirements of the agreement. Examples of the extended topics in this guide update include the effects of sleeve gastrectomy and bariatric surgery on type 2 diabetes, the effects of bariatric surgery on slightly obese patients, copper deficiency, consent and behavioral problems. Compared with 164 of the 2008 Guidelines, this guide update includes 74 recommendations (56 of them are revised on a previous basis and 2 are new ones). There are 403 citations in the update, of which 33 (8.2%) are EL1, 131 (32.5%) are EL2, 170 (42.2%) are EL3 and 69 (17.1%) are EL4. Studies with strong evidence (Level EL1 and Level 2) accounted for a relatively large proportion (40.4%), compared with only 16.5% of the 2008 AACE-TOS-ASMBS guidelines. These updates to the guidelines reflect the latest research evidence. Bariatric surgery remains a safe and effective therapeutic intervention for some obese patients. Surgical patients must have a perioperative care team focused on nutrition and metabolic issues.