Abstract: Objective: To observe the efficacy of obese patients after undergoing laparoscopic sleeve gastrectomy (LSG) one year later and to analyze its influencing factors, aiming to provide a basis for preoperative nursing risk assessment and the development of personalized postoperative intervention plans. Methods: A retrospective analysis was performed on baseline data of 780 obese patients who underwent laparoscopic sleeve gastrectomy (LSG) treatment, including general information, body composition, and laboratory parameters, etc. One year after the surgery, the patients were categorized into either the good weight loss group or the poor weight loss group based on whether their percentage of excess weight loss (EWL) was ≥50%. The Wilcoxon signed-rank test was used to analyze the weight changes before and after the surgery. Univariate analysis, multicollinearity analysis, and logistic regression analysis were employed to investigate the influencing factors of the treatment efficacy. Results: One year after the operation, 655 cases (83.97%) achieved good weight loss outcomes, with an excess body weight loss rate of (82.08±34.38)%. The differences in body weight and body mass index (BMI) before and after surgery were statistically significant (P<0.05). Logistic regression analysis revealed that the independent factors influencing the weight loss efficacy included hip circumference (OR=0.939, 95%CI: 0.922~0.956, P<0.001), baseline waist-to-hip ratio(OR=0.000, 95%CI: 0.000~0.060, P<0.001), activated partial thromboplastin time (OR=0.925, 95%CI: 0.872~0.981, P=0.010), prolactin (OR=1.032, 95%CI: 1.009~1.057, P=0.007), and fat-free mass (OR=1.027, 95%CI: 1.006~1.049, P=0.011). Conclusion: LSG is highly effective for patients with morbid obesity, but its outcomes vary individually. Nursing staff should pay close attention to key indicators such as body fat distribution patterns, glycolipid metabolism, and hormone levels during the perioperative period. Targeted personalized management plans involving nutrition, exercise, and health education should be implemented within continuous care to optimize long-term outcomes.

Key words: Sleeve gastrectomy, Obesity, Efficacy analysis, Nursing intervention, Influencing factors

摘要： 目的：观察肥胖症患者接受腹腔镜下胃袖状切除术（Laparoscopic Sleeve Gastrectomy，LSG）术后 1 年的疗效，并分析其影响因素，旨在为术前护理风险评估及术后个性化干预方案的制定提供依据。方法：回顾性分析 780 例接受 LSG 治疗的肥胖症患者的基线资料，包括一般资料、身体成分、实验室指标等，术后 1 年根据超额体质量减轻率是否≥50% 划分为减重良好与减重不佳组，采用Wilcoxon 符号秩和检验分析术前术后体质量变化，采用单因素分析、多重共线性分析、logistic 回归分析疗效的影响因素。结果：术后 1 年达到良好减重效果的有 655 例（83.97%），超额体质量减轻率为（82.08±34.38）%，术前术后的体质量、身体质量指数比较差异有统计学意义（P<0.05）。logistic 回归分析显示，影响减重疗效的独立因素包括臀围（OR=0.939，95%CI：0.922~0.956，P<0.001）、基线腰臀比（OR=0.000，95%CI：0.000~0.060，P<0.001）、活化部分凝血活酶时间（OR=0.925，95%CI：0.872~0.981，P=0.010）、催乳素（OR=1.032，95%CI：1.009~1.057，P=0.007）以及去脂体质量（OR=1.027，95%CI：1.006~1.049，P=0.011）。结论：LSG 对病态肥胖患者疗效确切，但存在个体差异，护理人员应在围手术期重点关注患者的脂肪分布模式、糖脂代谢及激素水平等关键指标，并在延续性护理中实施针对性的营养、运动和健康教育个性化管理方案，以优化远期手术疗效。

关键词: 胃袖状切除术, 肥胖症, 疗效分析, 护理干预, 影响因素