Association of Therapeutic Effects on Psychological Status of Post-bariatric Patients One Year after Surgery

doi:10.12114/j.issn.1007-9572.2022.0463

Chinese General Practice ›› 2022, Vol. 25 ›› Issue (36): 4528-4536.DOI: 10.12114/j.issn.1007-9572.2022.0463

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Association of Therapeutic Effects on Psychological Status of Post-bariatric Patients One Year after Surgery

1.School of Nursing, Nanjing Medical University, Nanjing 211166, China
2.Department of Bariatric Surgery, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China

Received:2022-07-12 Revised:2022-08-16 Published:2022-12-20 Online:2022-08-25
Contact: XU Qin
About author:
ZHAO K, XU X Y, ZHU H F, et al. Association of therapeutic effects on psychological status of post-bariatric patients one year after surgery [J] . Chinese General Practice, 2022, 25 (36) : 4528-4536, 4545.

减重代谢手术后1年治疗效果对心理状况的影响研究

1.211166　江苏省南京市，南京医科大学护理学院
2.210029　江苏省南京市，南京医科大学第一附属医院普外科减重代谢病区

通讯作者: 许勤
作者简介:
赵康，徐欣怡，朱涵菲，等.减重代谢手术后1年治疗效果对心理状况的影响研究[J].中国全科医学，2022，25（36）：4528-4536，4545. [www.chinagp.net] 作者贡献：赵康、梁辉、许勤负责研究的构思与设计；赵康、梁辉、杨宁琍、林睿负责数据的收集与整理；赵康、徐欣怡负责数据分析；赵康、徐欣怡、朱涵菲、许勤负责稿件的撰写、修改与润色；赵康、许勤负责稿件的质量控制与校审。
基金资助:
江苏高校优势学科建设工程项目"护理学"(苏政办发〔2018〕87号); 2020年江苏省研究生培养创新工程研究生科研创新计划(KYCX20_1446); 2021年江苏省重点研发计划（社会发展）(BE2021722)

Abstract

Abstract:

Background

Bariatric surgery is the effective treatment for obesity, however, the effect of surgery on patients' psychological status is still unclear.

Objective

To investigate the treatment effects of bariatric surgery on patients' psychological status one year after the surgery.

Methods

This is a retrospective cross-sectional study. This study selected 172 patients who underwent bariatric surgery in the department of general surgery, First Affiliated Hospital of Nanjing Medical University during June 2019 to June 2020, and collected their clinical data. The indicators of the treatment effects of bariatric surgery include body composition indicators〔Weight, Body mass index (BMI) , Percentage of excess weight loss (EWL%) , Body muscle mass (BM) , Body fat mass (BF) , Visceral fat (VSF) , metabolism-related biochemical indexes〔Alanine aminotransferase (ALT) , Aspartate aminotransferase (AST) , Total protein (TP) , Albumin (ALB) 〕, preoperative comorbidities, relief of comorbidities after surgery, postoperative complications, postoperative complaints, surgery methods; Indicators of the postoperative psychological status include quality of life, perceived stress, general well-being and satisfaction degree of surgery. This study used the12-item Short Form Survey (SF-12) , Chinese version of the Perceived Stress Scale (CPSS) , General Well-being Schedule (GWS) , Questionnaire of Bariatric Surgery Patient' Satisfaction Survey to investigate the psychological status. This study used the Pearson correlation analysis and Spearman rank correlation analysis to explore the correlation between body composition indicators and metabolic-related biochemical indexes and postoperative psychological status, used the multivariate linear regression analysis to explore the factors that affect postoperative psychological status.

Results

One year after surgery, EWL% was (82.7±31.7) %, and BMI decreased by (10.3±4.3) kg/m². 96 patients (55.8%) had metabolic-related comorbidities such as type 2 diabetes mellitus, hypertension, fatty liver before surgery, 48 patients (27.9%) achieved complete remission, 30 patients (17.4%) achieved partial remission, and 18 patients (10.5%) had no remission after surgery. Patients'weight, BMI, BM, BF, VSF, ALT, AST were lower than those before surgery, the TP and ALB were higher than those before surgery (P<0.05) .The correlation analysis showed that patients' MCS scores were negatively correlated with ΔALT (r_s=-0.160, P=0.036) ; the CPSS scores were negatively correlated with EWL% (r=-0.181, P=0.017) and ΔBM% (r_s=-0.174, P=0.022) but positively correlated with ΔALT (r_s=-0.236, P=0.002) ; the GWS scores were negatively correlated with ΔALT (r_s=-0.228, P=0.003) and ΔAST (r_s=-0.216, P=0.004) ; the satisfaction of surgery were negatively correlated with ΔBMI (r=-0.171, P=0.025) , ΔBF% (r=-0.174, P=0.022) and ΔVSF (r=-0.154, P=0.043) but positively correlated with EWL% (r=0.284, P<0.001) . The multivariate linear regression analysis showed that postoperative stomachache (β=-0.239, P=0.002) and postoperative fatigue (β=-0.169, P=0.025) were factors that affect PCS scores; ΔALT (β=-0.181, P=0.017) and postoperative fatigue (β=0.171, P=0.024) were factors that affect MCS scores; EWL% (β=-0.188, P=0.010) , ΔBM% (β=-0.146, P=0.047) , ΔALT (β=0.219, P=0.003) and postoperative fatigue (β=0.169, P=0.022) were factors that affect CPSS scores; ΔALT (β=-0.254, P=0.001) and acid reflux (β=-0.251, P=0.001) were factors that affect GWS scores; ΔBMI (β=-0.245, P=0.010) , EWL% (β=0.247, P=0.003) and ΔBF% (β=-0.366, P<0.001) were factors that affect satisfaction of surgery. Among the 96 patients with preoperative comorbidities, multiple linear regression analysis showed that postoperative relief of comorbidities (β=0.411, P<0.001) and stomachache (β=-0.192, P=0.040) were factors that affect PCS scores; ΔALT (β=-0.273, P=0.006) and acid reflux (β=-0.263, P=0.008) were factors that affect MCS scores; postoperative relief of comorbidities (β=-0.220, P=0.024) , ΔALT (β=0.301, P=0.002) , stomachache (β=0.214, P=0.023) and ΔVSF (β=0.212, P=0.031) were factors that affect CPSS scores; postoperative relief of comorbidities (β=0.290, P=0.002) , ΔALT (β=-0.310, P=0.001) and stomachache (β=-0.271, P=0.004) were factors that affect GWS scores; postoperative relief of comorbidities (β=0.402, P<0.001) , ΔBF% (β=-0.452, P<0.001) and ΔBMI (β=-0.364, P<0.001) were factors that affect satisfaction of surgery.

Conclusion

Patients' BMI decreased significantly one year after bariatric surgery. The postoperative acid reflux, stomachache, fatigue and the increase of ΔBF% and ΔALT negatively affect patients'psychological status; the increase of EWL% and ΔBM% positively affect patients'psychological status. For patients with comorbidities, the higher the degree of postoperative comorbidity remission, the greater the positive impact on the patient's psychological status.

Key words: Obesity, Bariatric surgery, Treatment effects, Psychological status, Root cause analysis

摘要：

背景

减重代谢手术是目前治疗肥胖的有效措施，但手术效果对患者心理状况的影响仍不明确。

目的

探讨减重代谢手术后1年，治疗效果对患者心理状况的影响。

方法

采用回顾性横断面研究方法，选取2019年6月至2020年6月于南京医科大学第一附属医院普外科进行减重代谢手术的患者172例为研究对象，收集患者的临床资料。减重代谢手术治疗效果相关指标包括身体成分指标〔体质量、体质指数（BMI）、多余体质量减少率（EWL%）、体肌肉量（BM）、体脂肪量（BF）、内脏脂肪面积（VSF）〕、代谢相关生化指标〔丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总蛋白（TP）、白蛋白（ALB）〕、术前合并症、术后合并症缓解情况、术后并发症、术后相关主诉、手术术式；术后心理状况相关指标包括生活质量、压力感、幸福感和手术满意度，分别采用简明生命质量量表（SF-12）、中文版压力知觉量表（CPSS）、幸福感量表（GWS）、减重代谢手术患者满意度调查表进行调查。采用Pearson相关分析和Spearman秩相关分析探讨身体成分指标及代谢相关生化指标与患者术后心理状况指标的相关性，采用多元线性回归分析探讨术后心理状况的影响因素。

结果

患者术后1年多余体质量减少率（EWL%）为（82.7±31.7）%，BMI下降（10.3±4.3）kg/m²。96例（55.8%）患者术前存在2型糖尿病、高血压、脂肪肝等代谢相关合并症，术后完全缓解48例（27.9%），部分缓解30例（17.4%），未缓解18例（10.5%）。患者术后1年体质量、BMI、BM、BF、VSF、ALT、AST低于术前，TP、ALB高于术前（P<0.05）。相关性分析结果显示，患者精神生活质量（MCS）得分与ΔALT呈负相关（r_s=-0.160，P=0.036）；CPSS得分与EWL%（r=-0.181，P=0.017）、Δ体肌肉率（BM%）（r_s=-0.174，P=0.022）呈负相关，与ΔALT（r_s=-0.236，P=0.002）呈正相关；GWS得分与ΔALT（r_s=-0.228，P=0.003）、ΔAST（r_s=-0.216，P=0.004）呈负相关；满意度与ΔBMI（r=-0.171，P=0.025）、Δ体脂肪率（BF%）（r=-0.174，P=0.022）、ΔVSF（r=-0.154，P=0.043）呈负相关，与EWL%（r=0.284，P<0.001）呈正相关。多元线性回归分析结果显示，术后胃痛（β=-0.239，P=0.002）、术后体虚乏力（β=-0.169，P=0.025）是PCS得分的影响因素；ΔALT（β=-0.181，P=0.017）、术后体虚乏力（β=0.171，P=0.024）是MCS得分的影响因素；EWL%（β=-0.188，P=0.010）、ΔBM%（β=-0.146，P=0.047）、ΔALT（β=0.219，P=0.003）、术后体虚乏力（β=0.169，P=0.022）是CPSS得分的影响因素；ΔALT（β=-0.254，P=0.001）、术后反酸胃灼热（β=-0.251，P=0.001）是GWS得分的影响因素；ΔBMI（β=-0.245，P=0.010）、EWL%（β=0.247，P=0.003）、ΔBF%（β=-0.366，P<0.001）是满意度得分的影响因素。96例有术前合并症的患者中，多元线性回归分析结果显示，术后合并症缓解（β=0.411，P<0.001）、术后胃痛（β=-0.192，P=0.040）是躯体生活质量（PCS）得分的影响因素；ΔALT（β=-0.273，P=0.006）、术后反酸胃灼热（β=-0.263，P=0.008）是MCS得分的影响因素；术后合并症缓解（β=-0.220，P=0.024）、ΔALT（β=0.301，P=0.002）、术后胃痛（β=0.214，P=0.023）、ΔVSF（β=0.212，P=0.031）是CPSS得分的影响因素；术后合并症缓解（β=0.290，P=0.002）、ΔALT（β=-0.310，P=0.001）、术后胃痛（β=-0.271，P=0.004）是GWS得分的影响因素；术后合并症缓解（β=0.402，P<0.001）、ΔBF%（β=-0.452，P<0.001）、ΔBMI（β=-0.364，P<0.001）是满意度得分的影响因素。

结论

减重代谢手术后1年，患者BMI显著降低，术后反酸胃灼热、胃痛、体虚乏力及ΔBF%、ΔALT升高对患者心理状况产生负面影响；EWL%、ΔBM%升高对患者心理状况产生正面影响。存在合并症的患者，术后合并症缓解程度越高对患者心理状况产生的积极影响越大。

关键词: 肥胖症, 减重代谢手术, 治疗效果, 心理状况, 影响因素分析

ZHAO Kang,XU Xinyi,ZHU Hanfei, et al. Association of Therapeutic Effects on Psychological Status of Post-bariatric Patients One Year after Surgery[J]. Chinese General Practice, 2022, 25(36): 4528-4536. DOI: 10.12114/j.issn.1007-9572.2022.0463.
赵康,徐欣怡,朱涵菲等. 减重代谢手术后1年治疗效果对心理状况的影响研究[J]. 中国全科医学, 2022, 25(36): 4528-4536. DOI: 10.12114/j.issn.1007-9572.2022.0463.

Figures/Tables 5

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指标		术前	术后1年	t_配对值	P值
身体成分指标（±s）
	体质量（kg）	104.7±22.7	75.2±15.4	29.028	<0.001
	BMI（kg/m²）	36.5±6.1	26.2±4.3	31.183	<0.001
	BM（kg）	33.2±7.4	30.3±6.3	11.392	<0.001
	BF（kg）	46.2±13.7	24.2±8.3	27.396	<0.001
	VSF（cm²）	202.6±45.6	113.1±37.0	32.497	<0.001
生化指标（±s）
	ALT（U/L）	56.1±45.9	21.0±12.2	9.722	<0.001
	AST（U/L）	42.0±33.4	22.1±7.6	7.694	<0.001
	TP（g/L）	70.5±6.2	74.6±4.6	8.354	<0.001
	ALB（g/L）	41.7±3.4	44.6±3.3	10.201	<0.001

指标		术前	术后1年	t_配对值	P值
身体成分指标（±s）
	体质量（kg）	104.7±22.7	75.2±15.4	29.028	<0.001
	BMI（kg/m²）	36.5±6.1	26.2±4.3	31.183	<0.001
	BM（kg）	33.2±7.4	30.3±6.3	11.392	<0.001
	BF（kg）	46.2±13.7	24.2±8.3	27.396	<0.001
	VSF（cm²）	202.6±45.6	113.1±37.0	32.497	<0.001
生化指标（±s）
	ALT（U/L）	56.1±45.9	21.0±12.2	9.722	<0.001
	AST（U/L）	42.0±33.4	22.1±7.6	7.694	<0.001
	TP（g/L）	70.5±6.2	74.6±4.6	8.354	<0.001
	ALB（g/L）	41.7±3.4	44.6±3.3	10.201	<0.001

指标		变化比值（%）	PCS得分		MCS得分		CPSS得分		GWS得分		满意度得分
指标		变化比值（%）	r（r_s）值	P值	r（r_s）值	P值	r（r_s）值	P值	r（r_s）值	P值	r（r_s）值	P值
身体成分指标
	ΔBMI（±s）	-27.5±8.9	-0.132	0.085	-0.003	0.971	0.118	0.125	-0.112	0.143	-0.171	0.025
	EWL%（±s）	82.7±31.7	0.049	0.519	0.014	0.851	-0.181	0.017	0.126	0.100	0.284	<0.001
	ΔBM%〔M（P₂₅，P₇₅）〕	-9.7（-15.2，-2.0）	0.013^a	0.862	0.150^a	0.052	-0.174^a	0.022	0.057^a	0.454	0.024^a	0.758
	ΔBF%（±s）	-11.7±5.9	-0.111	0.147	-0.062	0.417	0.110	0.150	-0.101	0.185	-0.174	0.022
	ΔVSF（±s）	-43.8±14.6	-0.107	0.163	-0.059	0.443	0.134	0.081	-0.042	0.585	-0.154	0.043
生化指标
	ΔALT〔M（P₂₅，P₇₅）〕	-52.7（-75.7，-17.8）	-0.031^a	0.687	-0.160^a	0.036	0.236^a	0.002	-0.228^a	0.003	-0.008^a	0.922
	ΔAST〔M（P₂₅，P₇₅）〕	-31.1（-62.7，2.6）	-0.020^a	0.791	-0.109^a	0.156	0.143^a	0.064	-0.216^a	0.004	-0.047^a	0.541
	ΔTP〔M（P₂₅，P₇₅）〕	5.7（0.6，11.3）	0.033^a	0.667	0.035^a	0.644	-0.095^a	0.213	0.045^a	0.555	0.023^a	0.764
	ΔALB（±s）	7.5±9.5	0.121	0.114	0.053	0.488	-0.135	0.077	0.048	0.531	0.073	0.343

指标		变化比值（%）	PCS得分		MCS得分		CPSS得分		GWS得分		满意度得分
指标		变化比值（%）	r（r_s）值	P值	r（r_s）值	P值	r（r_s）值	P值	r（r_s）值	P值	r（r_s）值	P值
身体成分指标
	ΔBMI（±s）	-27.5±8.9	-0.132	0.085	-0.003	0.971	0.118	0.125	-0.112	0.143	-0.171	0.025
	EWL%（±s）	82.7±31.7	0.049	0.519	0.014	0.851	-0.181	0.017	0.126	0.100	0.284	<0.001
	ΔBM%〔M（P₂₅，P₇₅）〕	-9.7（-15.2，-2.0）	0.013^a	0.862	0.150^a	0.052	-0.174^a	0.022	0.057^a	0.454	0.024^a	0.758
	ΔBF%（±s）	-11.7±5.9	-0.111	0.147	-0.062	0.417	0.110	0.150	-0.101	0.185	-0.174	0.022
	ΔVSF（±s）	-43.8±14.6	-0.107	0.163	-0.059	0.443	0.134	0.081	-0.042	0.585	-0.154	0.043
生化指标
	ΔALT〔M（P₂₅，P₇₅）〕	-52.7（-75.7，-17.8）	-0.031^a	0.687	-0.160^a	0.036	0.236^a	0.002	-0.228^a	0.003	-0.008^a	0.922
	ΔAST〔M（P₂₅，P₇₅）〕	-31.1（-62.7，2.6）	-0.020^a	0.791	-0.109^a	0.156	0.143^a	0.064	-0.216^a	0.004	-0.047^a	0.541
	ΔTP〔M（P₂₅，P₇₅）〕	5.7（0.6，11.3）	0.033^a	0.667	0.035^a	0.644	-0.095^a	0.213	0.045^a	0.555	0.023^a	0.764
	ΔALB（±s）	7.5±9.5	0.121	0.114	0.053	0.488	-0.135	0.077	0.048	0.531	0.073	0.343

指标		例数	PCS			MCS			CPSS			GWS			满意度
指标		例数	得分	t（F）值	P值	得分	t（F）值	P值	S得分	t（F）值	P值	得分	t（F）值	P值	得分	t（F）值	P值
术前合并症				0.748	0.456		0.851	0.396		1.394	0.165		1.840	0.067		0.455	0.649
	有	96	48.2±7.5			47.5±8.1			22.6±7.1			82.5±13.1			91.3±7.0
	无	76	47.2±9.3			46.4±9.8			24.1±6.9			78.9±12.8			90.9±6.2
术后合并症缓解				16.351^a	<0.001		2.387^a	0.098		4.143^a	0.019		16.470^a	<0.001		7.011^a	0.001
	完全缓解	48	50.9±7.1			47.8±10.6			21.3±7.5			83.4±11.8			93.6±5.7
	部分缓解	30	49.7±6.1			48.5±8.3			22.2±7.0			89.0±12.2			90.4±6.8
	未缓解	18	38.3±11.3			42.9±6.3			26.8±4.9			69.6±8.5			86.9±8.4
术后并发症				0.199	0.842		0.147	0.883		0.703	0.483		1.027	0.306		0.925	0.356
	有	9	47.2±9.9			46.6±8.0			24.9±5.6			76.6±12.7			89.1±5.6
	无	163	47.7±8.3			47.1±8.9			23.2±7.1			81.2±13.1			91.2±6.7
术后反酸胃灼热				2.013	0.046		1.824	0.070		2.126	0.035		3.336	0.001		0.790	0.430
	有	66	46.1±9.0			45.5±9.2			24.7±7.1			76.8±13.1			90.6±7.2
	无	106	48.7±7.7			48.0±8.5			22.4±6.9			83.5±12.5			91.4±6.3
术后呕吐				3.047	0.003		1.913	0.057		1.328	0.186		2.499	0.013		0.203	0.840
	有	76	45.6±9.5			45.6±10.0			24.1±7.7			78.2±12.9			91.0±7.1
	无	96	49.4±6.9			48.2±7.7			22.7±6.4			83.1±12.9			91.2±6.4
术后胃痛				3.808	<0.001		0.627	0.531		1.933	0.055		2.560	0.011		0.487	0.215
	有	33	42.9±9.5			46.2±8.3			25.4±5.8			75.8±11.3			90.6±8.2
	无	139	48.8±7.6			47.2±9.0			22.8±7.2			82.1±13.2			91.2±6.3
术后体虚乏力				3.048	0.003		2.561	0.011		2.577	0.011		2.593	0.010		0.687	0.493
	有	77	45.6±8.8			45.1±10.3			24.8±7.2			78.1±13.5			90.7±7.3
	无	95	49.4±7.5			48.6±7.2			22.1±6.7			83.2±12.4			91.4±6.2
术后脱发				1.386	0.168		1.661	0.099		1.033	0.303		1.986	0.049		1.231	0.220
	有	106	47.0±8.8			46.1±9.1			23.7±6.8			79.4±12.7			90.6±7.0
	无	66	48.8±7.5			48.4±8.3			22.6±7.4			83.4±13.4			91.9±6.1
术后排气恶臭				1.750	0.082		0.940	0.349		1.883	0.061		0.877	0.382		1.685	0.094
	有	76	46.5±8.4			46.3±9.1			24.4±6.6			79.9±12.3			90.2±7.4
	无	96	48.7±8.1			47.6±8.6			22.4±7.3			81.7±13.7			91.9±6.0
手术方式				1.198^a	0.312		1.010^a	0.390		0.224^a	0.879		1.185^a	0.317		0.377^a	0.770
	SG	99	47.8±8.2			48.0±9.4			23.0±7.2			81.8±12.9			91.6±6.9
	RYGB	7	46.2±7.6			45.5±7.7			23.0±7.0			74.6±10.9			91.3±5.0
	SG+JJB	50	48.7±7.9			45.5±7.6			24.0±7.0			79.3±13.3			90.5±6.5
	其他	16	44.4±9.5			46.2±9.6			22.8±6.5			83.7±13.9			90.2±6.5

Association of Therapeutic Effects on Psychological Status of Post-bariatric Patients One Year after Surgery

减重代谢手术后1年治疗效果对心理状况的影响研究

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因变量	自变量	B（95%CI）	SE	β	t值	P值	调整R²	F值
PCS得分	常量	49.934（48.307，51.561）	0.830	—	60.196	<0.001	0.106	9.970^a
	术后胃痛	-5.039（-8.140，-1.938）	1.582	-0.239	3.186	0.002
	术后体虚乏力	-2.825（-5.279，-0.371）	1.252	-0.169	2.256	0.025
MCS得分	常量	47.195（45.145，49.245）	1.046	—	45.102	<0.001	0.069	6.287^a
	ΔALT	-0.031（-0.056，-0.006）	0.013	-0.181	2.415	0.017
	术后体虚乏力	-3.031（-5.632，-0.430）	1.327	-0.171	2.284	0.024
CPSS得分	常量	25.886（22.715，29.057）	1.618	—	15.995	<0.001	0.138	6.667^a
	EWL%	-0.042（-0.073，-0.011）	0.016	-0.188	2.591	0.010
	ΔBM%	-0.111（-0.219，-0.003）	0.055	-0.146	2.005	0.047
	ΔALT	0.030（0.010，0.050）	0.010	0.219	3.008	0.003
	术后体虚乏力	2.388（0.367，4.409）	1.031	0.169	2.316	0.022
GWS得分	常量	81.032（78.325，83.739）	1.381	—	58.690	<0.001	0.126	12.185^a
	ΔALT	-0.064（-0.099，-0.029）	0.018	-0.254	3.534	0.001
	术后反酸胃灼热	-6.749（-10.532，-2.966）	1.930	-0.251	3.496	0.001
满意度得分	常量	86.633（83.438，89.828）	1.630	—	53.141	<0.001	0.175	11.906^a
	ΔBMI	-0.183（-0.320，-0.046）	0.070	-0.245	2.593	0.010
	EWL%	0.052（0.019，0.085）	0.017	0.247	3.028	0.003
	ΔBF%	-0.414（-0.600，-0.228）	0.095	-0.366	4.372	<0.001

因变量	自变量	B（95%CI）	SE	β	t值	P值	调整R²	F值
PCS得分	常量	42.325（39.009，45.641）	1.692	—	25.021	<0.001	0.216	12.830^a
	术后合并症缓解	4.761（2.674，6.848）	1.065	0.411	4.469	<0.001
	胃痛	-4.280（-8.304，-0.256）	2.053	-0.192	2.084	0.040
MCS得分	常量	46.709（44.065，49.353）	1.349	—	34.618	<0.001	0.137	7.364^a
	ΔALT	-0.055（-0.092，-0.018）	0.019	-0.273	2.827	0.006
	术后反酸胃灼热	-5.150（-8.848，-1.452）	1.887	-0.263	2.729	0.008
CPSS得分	常量	30.873（26.165，35.581）	2.402	—	12.853	<0.001	0.219	6.365^a
	术后合并症缓解	-2.034（-3.773，-0.295）	0.887	-0.220	2.292	0.024
	ΔALT	0.046（0.019，0.073）	0.014	0.301	3.194	0.002
	术后胃痛	3.825（0.573，7.077）	1.659	0.214	2.306	0.023
	ΔVSF	0.104（0.012，0.196）	0.047	0.212	2.185	0.031
GWS得分	常量	74.316（68.971，79.661）	2.727	—	27.252	<0.001	0.242	9.809^a
	术后合并症缓解	4.936（1.892，7.980）	1.553	0.290	3.177	0.002
	ΔALT	-0.087（-0.138，-0.036）	0.026	-0.310	3.397	0.001
	术后胃痛	-8.893（-14.746，-3.040）	2.986	-0.271	2.978	0.004
满意度得分	常量	85.602（81.625，89.579）	2.029	—	42.182	<0.001	0.323	14.616^a
	术后合并症缓解	3.655（2.099，5.211）	0.794	0.402	4.605	<0.001
	Δ体脂肪量	-0.547（-0.774，-0.320）	0.116	-0.452	4.695	<0.001
	ΔBMI	-0.263（-0.398，-0.128）	0.069	-0.364	3.810	<0.001

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