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[精准医学背景下减重手术的发展]

[Development of bariatric surgery in the context of precision medicine].

作者信息

Guo L N, Yang K Y, Wang Y

机构信息

Department of 4th General Surgery, the Fourth Affiliated Hospital of China Medical University, Shenyang 110032, China.

出版信息

Zhonghua Wei Chang Wai Ke Za Zhi. 2022 Oct 25;25(10):928-936. doi: 10.3760/cma.j.cn441530-20220630-00286.

Abstract

Precision medicine, which is based on individualized medicine, is a new medical model developed with the cross-application of genome sequencing technology, bioinformatics, and big data science. The establishment of precision medicine model is conducive to maximize the efficient utilization of medical resources and patient benefits. Bariatric surgery is an emerging branch of general surgery in the new century. Although the development of bariatric surgery still has a long way to go, precision medicine will add significant value to the rapid and positive development of the branch of bariatric surgery. In the context of precision medicine, bariatric metabolic surgery is now in its infancy. Currently, the successful implementation of precision control in bariatric surgery is initially focusing on the prediction of postoperative weight and the study of body weight differences in epigenetics. However, there are still gaps to be filled in the area of postoperative recovery, nutritional support treatment, and realization of individualized treatment based on big data. In the future, the integration of large-scale resource and data information can be realized by establishing the multi-center clinical sample library and perfecting the data collection of long-term follow-up and clinical information. Meanwhile, we can conduct deep biological data mining effectively with the big data platform, while using data reference to achieve accurate prediction and control of obesity treatment, so as to formulate detailed implementation plans and detailed procedure standard. Last but not least, we should pay attention to the patients' privacy and prevent personal health information leakage.

摘要

精准医学基于个体化医学,是随着基因组测序技术、生物信息学和大数据科学的交叉应用而发展起来的一种新的医学模式。精准医学模式的建立有利于最大限度地提高医疗资源的有效利用和患者受益。减重手术是新世纪普通外科领域新兴的一个分支。尽管减重手术的发展仍有很长的路要走,但精准医学将为减重手术这一分支的快速积极发展增添重要价值。在精准医学背景下,减重代谢手术目前尚处于起步阶段。目前,减重手术中精准控制的成功实施最初集中在术后体重预测以及表观遗传学中体重差异的研究上。然而,在术后恢复、营养支持治疗以及基于大数据实现个体化治疗等方面仍存在有待填补的空白。未来,通过建立多中心临床样本库并完善长期随访和临床信息的数据收集,可实现大规模资源和数据信息的整合。同时,利用大数据平台有效进行深度生物数据挖掘,借助数据参考实现肥胖治疗的精准预测和控制,从而制定详细的实施方案和详细的操作规范。最后但同样重要的是,要注意保护患者隐私,防止个人健康信息泄露。

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