肥胖的篩查和預(yù)防
肥胖人群的大量增加,肥胖的嚴(yán)重度與糖尿病、心血管等疾病的風(fēng)險(xiǎn)等呈正相關(guān),因此早預(yù)防、早發(fā)現(xiàn)、早干預(yù)是肥胖工作的重心之一。
預(yù)防工作應(yīng)該從兒童出生時(shí)就開(kāi)始。從小應(yīng)形成良好的生活習(xí)慣,避免超重。對(duì)于有肥胖家族史或母親患妊娠糖尿病的兒童,其發(fā)生肥胖的風(fēng)險(xiǎn)要高于常人,更需重視預(yù)防。一旦發(fā)現(xiàn)超重但未發(fā)生其他并發(fā)癥,應(yīng)時(shí)常監(jiān)測(cè)體重,并及時(shí)調(diào)整飲食,增加鍛煉,避免體重進(jìn)一步增加而成為肥胖人群。家庭、學(xué)校和社區(qū)在其中都扮演重要角色,并應(yīng)隨著兒童的年齡增長(zhǎng)而有所調(diào)整?;鶎优R床工作者則需對(duì)整個(gè)過(guò)程進(jìn)行宣教、引導(dǎo)和鼓勵(lì),如帶領(lǐng)他們制訂減重計(jì)劃、定期隨訪、及時(shí)評(píng)估并幫助解決遇到的問(wèn)題等。
BMI測(cè)量由于其簡(jiǎn)便易行被認(rèn)為是理想的篩查方式。相關(guān)指南推薦對(duì)6歲及以上的兒童、青少年及成人進(jìn)行肥胖篩查。若篩查陽(yáng)性,應(yīng)對(duì)患者的各系統(tǒng)進(jìn)行評(píng)估,尤其注意肥胖各種可能的合并癥,及時(shí)診斷清楚肥胖的原因,幫助治療。同時(shí)需評(píng)估飲食、運(yùn)動(dòng)和行為情況,并及早進(jìn)行合適的干預(yù)。
目前我國(guó)肥胖人數(shù)正在迅猛增加,青少年的肥胖問(wèn)題更是不容忽視。借鑒歐美主流指南,用慢病管理模式管理肥胖癥患者,綜合個(gè)人、家庭、學(xué)校、工作區(qū)、社區(qū)和醫(yī)院的力量,積極預(yù)防及控制,將是我國(guó)近一段時(shí)間內(nèi)防治肥胖癥及其并發(fā)癥的主要舉措。
(韓亭亭)
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