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Prevalence of Overweight and Obesity among Rural Elderly Women in Liaoning Province and Its Risk Factors
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摘要:目的 分析辽宁省农村地区老年女性超重和肥胖的患病率及其相关危险因素。方法 2004年6月至2005年6月, 采用分层整群随机抽样方法, 对辽宁省农村地区3232名年龄在60岁以上的老年女性人群进行横断面研究。全部研究对象进行体格检查及生活方式等其他相关因素调查。超重及肥胖分别按WHO及中国标准定义。结果 按WHO标准, 超重及肥胖的患病率分别为17.7%和2.2%;而按中国标准, 分别为23.7%和5.8%。通过多元Logistic回归分析:蒙古族、饮酒是超重与肥胖的危险因素; 而年龄及吸烟则为保护性因素。结论 辽宁省农村老年女性肥胖的患病率尽管较低, 但其超重患病率仍处于较高水平。不健康的生活方式、年龄、民族与超重和肥胖相关。Abstract:Objective To investigate the prevalence of overweight and obesity among rural elderly women and its risk factors.Methods A cross-sectional cluster survey was conducted during 2004-2005 in Liaoning province, China. A total of 3232 elderly women age ≥ 60 years were enrolled. Their baseline lifestyle and other factors were obtained. Overweight and obesity were separately defined according to both the World Health Organization (WHO) criteria and Chinese criteria.Results When the WHO criteria were applied, the prevalence of overweight and obesity was 17.7% and 2.2%, respectively. When the Chinese criteria were applied, the corresponding figures were 23.7% and 5.8%, respectively. Multivariate logistic regression analysis showed that Mongolian nationality and current drinking were the risk factors for overweight or obesity. Aging and current smoking status were negatively correlated with overweight and obesity.Conclusions Although the prevalence of obesity was low, the prevalence of overweight was relatively high among rural elderly women. Unhealthy lifestyle, aging, and ethnicity are risk factors of overweight and obesity in this population.
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Keywords:
- overweight /
- obesity /
- rural areas
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2012年4月，北京协和医院肝脏外科联合胸外科、麻醉科、ICU及输血科等，成功完成1例巨大肝脏血管瘤切除手术。肿瘤长径达48 cm，总重量约11. 9 kg，手术中洗出血液8400 ml。目前患者已康复出院。
这位来自安徽农村的中年女性患者，早在1990年就诊断出肝血管瘤，并在当地医院接受了胸腹部联合切口的肿瘤切除术，但手术未获成功。20余年来，瘤体不断增大，患者腹部明显膨隆，生活陷入极度痛苦中。今年3月，患者怀着最后一线希望来到北京协和医院求治。
协和肝脏外科对此病例进行了认真研究。检查显示，患者右肝巨大血管瘤占据整个腹腔、右侧胸腔和部分盆腔，左肝外侧叶和脾脏已经被推挤至盆腔，心脏被明显推向左侧。用该科独创的术前肝脏功能评估系统“钟氏系统”对患者肝功能进行评估，发现患者左肝外侧叶的功能可以基本满足术后生存，为手术治疗提供依据。
患者重度贫血(血红蛋白不足70 g/L)和严重营养不良，给手术造成更大困难。在医务处组织下，肝脏外科、胸外科、麻醉科、手术室、输血科和ICU等相关科室对该病例进行了联合讨论，决定采取胸腹部联合切口进行手术。
4月10日，肝脏外科卢欣教授和胸外科李力医师等组成的手术组克服了重重难关: 20多年前的第1次手术留下的粘连疤痕，使薄薄的血管瘤壁极易破损; 巨大的瘤体将肝脏相关血管推压变异，使分离缺乏解剖依据; 一大块瘤体位于右侧胸腔，膈肌薄如纸片，须深入胸腔分理出心耳，才能找到下腔静脉。手术小组经过11个小时的努力，最终将肿瘤成功切除。
(北京协和医院肝脏外科 徐意瑶 党委综合办 段文利)
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