Perfil clínico de pacientes dismetabólicos candidatos a bypass gástrico del Hospital de Especialidades y Docencia Dr. Abel Gilbert Pontón período 2013-2014-2015.
Fecha
2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
Síndrome Dismetabolico se denomina así a un grupo de factores de riesgo que aumentan las probabilidades de sufrir enfermedades del corazón, diabetes, ataques cerebrales y otros problemas de salud. Se puede diagnosticar cuando están presentes tres de los siguientes cinco factores de riesgo: Glucosa en sangre elevada , Niveles bajos de colesterol HDL en la sangre , Niveles altos de triglicéridos en la sangre , Circunferencia de la cintura grande o cuerpo en “forma de manzana” (IMC>35), Presión arterial alta.
Desde de la 1ª Cirugía Cumbre de Diabetes (DSS-I), un cuerpo sustancial de evidencia adicional se ha acumulado, incluso de numerosos ensayos clínicos aleatorios (ECA), lo que demuestra que la cirugía bariátrica / metabólica logra un control glucémico superior y reducción de los factores de riesgo cardiovascular en pacientes obesos con diabetes tipo 2 en comparación con diversas especialidades médicas / intervenciones de estilo de vida.
Dentro de los años de estudio de este trabajo nos indica que no hay muchos pacientes solicitando el servicio del departamento de Cirugía/Endocrinología para realizarse cirugía bariátrica en el Hospital Abel Gilbert Pontón del periodo 2013-2015, dándonos un total de 120 pacientes desde el periodo de enero del 2013 a diciembre del 2015 de los cuales solo 100 pacientes cumplen con los parámetros para realizarse bypass gástrico.
Según el estudio realizado de los100 paciente dismetabólicos aptos para realizarse cirugía bariátrica, los resultados indican que no hay en cuanto a la distribución sexual de los pacientes ya que el 50% de los pacientes que solicitan el servicio eres de sexo masculino y el otro 50% de sexo femenino.
El estudio realizado podemos entender que de acuerdo al grupo etario hemos dividido en dos grupos de estudio de 25-35 y 36-50 años. Los pacientes dismetabólicos aptos para realizarse un bypass gástrico es de 36-50 años dándonos un 65% de los 100 pacientes aptos para este tipo de cirugía quedándonos el grupo de 25-35 años con un 35%.
Con respecto a las complicaciones posquirúrgicas fue mínimo el porcentaje, dándonos solo el 2% de complicaciones en los 100 pacientes intervenidos quirúrgicamente. Dentro de las complicaciones tenemos 1 (1%) paciente con fistula y 1 (1%) paciente con mortalidad.
El tiempo de hospitalización de los pacientes sometidos a bypass gástrico fue de 2 días con nada por vía oral, se registró un solo reingreso por un fistula. Y un registro de mortalidad como complicación postquirúrgica.
Todos los pacientes deben cumplir con dieta estricta por 3 meses. Para evitar complicaciones postquirúrgicas.
Todos los pacientes llevan seguimiento tanto por el departamento de Cirugía, Psicología y de Nutrición
Dysketabolic Syndrome is thus called a group of risk factors that increase the chances of suffering from heart disease, diabetes, stroke and other health problems. Three of the following five risk factors can be diagnosed: High blood glucose, Low HDL cholesterol levels in the blood, High triglyceride levels in the blood, Large waist circumference or "apple-shaped" body, (BMI> 35), High blood pressure. Since the 1st Surgery Diabetes Summit (DSS-I), a substantial body of additional evidence has been accumulated, including numerous randomized clinical trials (RCTs), demonstrating that bariatric / metabolic surgery achieves superior glycemic control and reduction Of cardiovascular risk factors in obese patients with type 2 diabetes compared to various medical specialties / lifestyle interventions. During the years of study of this work indicates that there are not many patients requesting the service of the Department of Surgery / Endocrinology to perform bariatric surgery at the Abel Gilbert Pontón Hospital from the period 2013-2015, giving us a total of 120 patients from the period From January 2013 to December 2015, of which only 100 patients meet the parameters for gastric bypass. According to the study of the 100 dismetabolic patients able to undergo bariatric surgery, the results indicate that there is no sexual distribution of patients since 50% of the patients requesting the service are male and the other 50% Female. The study we can understand that according to the age group we have divided into two study groups of 25-35 and 36-50 years. Dismetabolic patients able to undergo a gastric bypass is 36-50 years giving us 65% of the 100 patients suitable for this type of surgery leaving us the group of 25-35 years with 35%. Regarding postoperative complications, the percentage was minimal, giving us only 2% of complications in the 100 patients who underwent surgery. Within the complications we have 1 (1%) patient with fistula and 1 (1%) patient with mortality. The hospitalization time of the patients undergoing gastric bypass was 2 days with nothing orally, a single reentry was recorded for a fistula. And a mortality register as a post-surgical complication. All patients must comply with strict diet for 3 months. To avoid post-surgical complications. All patients are followed up both by the Department of Surgery, Psychology and Nutrition.
Dysketabolic Syndrome is thus called a group of risk factors that increase the chances of suffering from heart disease, diabetes, stroke and other health problems. Three of the following five risk factors can be diagnosed: High blood glucose, Low HDL cholesterol levels in the blood, High triglyceride levels in the blood, Large waist circumference or "apple-shaped" body, (BMI> 35), High blood pressure. Since the 1st Surgery Diabetes Summit (DSS-I), a substantial body of additional evidence has been accumulated, including numerous randomized clinical trials (RCTs), demonstrating that bariatric / metabolic surgery achieves superior glycemic control and reduction Of cardiovascular risk factors in obese patients with type 2 diabetes compared to various medical specialties / lifestyle interventions. During the years of study of this work indicates that there are not many patients requesting the service of the Department of Surgery / Endocrinology to perform bariatric surgery at the Abel Gilbert Pontón Hospital from the period 2013-2015, giving us a total of 120 patients from the period From January 2013 to December 2015, of which only 100 patients meet the parameters for gastric bypass. According to the study of the 100 dismetabolic patients able to undergo bariatric surgery, the results indicate that there is no sexual distribution of patients since 50% of the patients requesting the service are male and the other 50% Female. The study we can understand that according to the age group we have divided into two study groups of 25-35 and 36-50 years. Dismetabolic patients able to undergo a gastric bypass is 36-50 years giving us 65% of the 100 patients suitable for this type of surgery leaving us the group of 25-35 years with 35%. Regarding postoperative complications, the percentage was minimal, giving us only 2% of complications in the 100 patients who underwent surgery. Within the complications we have 1 (1%) patient with fistula and 1 (1%) patient with mortality. The hospitalization time of the patients undergoing gastric bypass was 2 days with nothing orally, a single reentry was recorded for a fistula. And a mortality register as a post-surgical complication. All patients must comply with strict diet for 3 months. To avoid post-surgical complications. All patients are followed up both by the Department of Surgery, Psychology and Nutrition.
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Síndrome dismetabólico por Síndrome metabólico, Derivación gástrica, Perfil clínico, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador