【摘要】 目的通过按二次折叠公式改良LAGBP与传统LAGBP术后1年的减重效果及安全性比较,探讨二次折叠公式的可行性与安全性。方法 2015年7月至2016年12月在解放军总医院接受改良LAGBP有24例,再从2011年9月至2015年7月传统LAGBP的患者中挑选24例进行术前指标匹配,匹配指标有性别、年龄、术前体质量指数(BMI),对比两组手术的手术时间、术中出血、住院时间、术后并发症及术后1年的多余体重减少百分比(%EWL)。结果两组在术前指标除年龄外其他指标具有可比性。改良组与传统组手术时间分别为(98±20)min和(87±17)min,两组差异有统计学意义(P<0.05)。改良组与传统组术中出血分别为(18.3±7.5)ml和(23.5±11.7)ml,两组差异无统计学意义(P>0.05)。改良组与传统组住院时间分别为(4.5±0.7)d和(4.3±0.9)d,两组差异无统计学意义(P>0.05)。改良组与传统组在术后12个月%EWL分别为(63.77±11.26)%、(57.36±9.72)%,差异有统计学意义(P<0.05)。两组%EWL在1年之内均有上升趋势,改良组在术后1~6月上升幅度高于传统组。改良组与传统组术后并发症分别为8.33%(2/24)、12.5%(3/24),两组差异无统计学意义(P>0.05)。结论传统LAGBP经折叠公式改良后减重效果显著增加,但并发症无显著差异。基于36 Fr气囊胃管的折叠公式"(1.5+x)/2"有助于实现LAGBP的标准化,为LAGBP的多中心研究提供一定的参考,也为类似需要气囊胃管及其他校正探条的手术提供一种思路。更多还原

【Abstract】 Objective The feasibility and safety of the two-folding-formula were discussed by comparing the weight reduction effect and safety of the modified LAGBP group and the traditional LAGBP group for 1 year after operation. Methods 24 patients were underwent the modified LAGBP procedure from July 2015 to December 2016 at General Hospital of PLA. From September 2011 to July 2015, 24 patients who underwent traditional LAGBP procedure were selected for preoperative indexes matching with modified LAGBP procedure. The matching indexes included gender, age, preoperative BMI. The operative time, intraoperative bleeding, hospital stay, postoperative complications and the percentage of excess weight loss(%EWL) at 1 year after operation were compared between the two groups. Results Preoperative indicatorsof both groups were comparable except for age. The operation time of the modified group and the traditional group were(98±20) min and(87±17) min, respectively, with significant difference between the two groups(P<0.05). The bleeding volume in the modified group and the traditional group were(18.3±7.5) ml and(23.5± 11.7) ml, respectively, with no significant difference between the two groups(P>0.05). The hospitalization time was(4.5±0.7) days and(4.3±0.9) days in the modified group and the traditional group, respectively, with no significant difference between the two groups(P>0.05). The % EWL of the modified group and the traditional group at 12 months after operation were(63.77±11.26) % and(57.36±9.72) %, respectively, the difference was statistically significant(P<0.05). The two groups of %EWL had an upward trend in 1 years, and the increase of %EWL in the modified group was higher than that of the traditional group at 1-6 months after the operation. The postoperative complications of the modified group and the traditional group were 8.33%(2/24) and 12.5%(3/24), respectively, with no significant difference between the two groups(P>0.05). Conclusion LAGBP improved by the folding formula, the effect of weight loss was significantly increased, but there was no significant difference in postoperative complications. The folding formula "(1.5+x)/2" based on 36 Fr bougie helps to standardize the LAGBP, provides a reference for the LAGBP multicenter study, and provides an idea for surgeries that require bougies.更多还原