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中华疝和腹壁外科杂志(电子版)

中华疝和腹壁外科杂志(电子版) ›› 2018, Vol. 12 ›› Issue (03) : 217 -222. doi: 10.3877/cma.j.issn.1674-392X.2018.03.015

所属专题： 文献；

循证医学

轻型补片与传统补片在腹股沟疝修补术中有效性和安全性的荟萃分析
张振名1, 张著杰1, 李坡1,†()   
  1. 1. 734000　甘肃张掖，河西学院附属张掖人民医院普外科
  • 收稿日期:2017-10-11 出版日期:2018-06-18
  • 通信作者: 李坡

Comparison of lightweight mesh and heavyweight mesh in inguinal hernia repair: A Meta-analysis

Zhenming Zhang1, Zhujie Zhang1, Po Li1,†()   

  1. 1. Department of General Surgery, Zhangye People's Hospital of He Xi College, Zhangye 734000, China
  • Received:2017-10-11 Published:2018-06-18
  • Corresponding author: Po Li
  • About author:
    Corresponding author: Li Po, Email:
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张振名, 张著杰, 李坡. 轻型补片与传统补片在腹股沟疝修补术中有效性和安全性的荟萃分析[J]. 中华疝和腹壁外科杂志(电子版), 2018, 12(03): 217-222.

Zhenming Zhang, Zhujie Zhang, Po Li. Comparison of lightweight mesh and heavyweight mesh in inguinal hernia repair: A Meta-analysis[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2018, 12(03): 217-222.

目的

系统评价轻量型补片与传统补片在腹股沟疝修补术中的有效性和安全性。

方法

计算机检索PubMed、Embase、Cochrane Library、中国生物医学文献数据库、中国科技期刊全文数据库、中国期刊全文数据库。全面收集比较轻量型补片与传统补片在腹股沟疝修有效性和安全性的随机对照试验（randomized controlled trials，RCTs），2名评价者独立评价纳入文献的方法学质量，用RevMan 5.3软件进行统计分析。

结果

共纳入19篇RCTs，Meta分析结果显示，轻量型补片组与传统传统补片组患者在复发率方面比较，差异无统计学意义[RR=0.82，95% CI（0.56～1.19），P=0.30]；在慢性疼痛[RR=0.68，95% CI（0.57～0.81），P<0.000 1]、异物感[RR=0.67，95% CI（0.56～0.81），P<0.000 1]及其并发症[RR=0.63，95% CI（0.51～0.77），P<0.000 1]方面比较，差异均有统计学意义。

结论

轻量型补片与传统传统补片在无张力疝修补术中的复发率方面相似，而轻量型补片减轻慢性疼痛、异物感及并发症发生方面优于传统补片。

关键词: 疝，腹股沟, 疝修补术, 轻型补片, 传统补片, Meta分析
Objective

To systematic review the efficacy and safety of use of lightweight versus heavyweight mesh in inguinal hernia repair.

Methods

We searched PubMed, Embase, Cochrane Library, Chinese biomedicine literature database, Chinese Journal full-text database and Chinese Scientific Journals full-text database for randomized controlled trials comparing lightweight mesh with heavyweight mesh in inguinal hernia repair. Two reviewers independently assessed the quality of included studies. We analyzed the statistic data using Review Manager (version 5.3).

Results

19 randomized controlled trials were included. Meta analysis showed that there was no significant difference between lightweight mesh and heavyweight mesh in recurrence rate [RR=0.82, 95% CI (0.56, 1.19), P=0.30], but significant differences were existed in chronic groin pain [RR=0.68, 95% CI (0.57,0.81), P<0.000 1], foreign body sensation [RR=0.67, 95% CI (0.56, 0.81), P<0.000 1] and complication incidence [RR=0.63, 95% CI (0.51, 0.77), P<0.000 1].

Conclusion

Compared with heavyweight mesh, the application of lightweight mesh for inguinal hernia repair was similar in hernia recurrence rate. Lightweight mesh reduced the incidence of chronic groin pain and the risk of foreign body sensation as well as complication incidence.

Key words: Hernia, inguinal, Herniorrhaphy, Lightweight mesh, Heavyweight mesh, Meta analysis
表1 纳入文献基本特征表
作者（年） 国家 样本量 中位年龄 术式 随访时间 补片类型（H/L）
Bringman 2004[5] 瑞士和芬兰 260/251 55岁 Lich 2个月 Prolene/VyproII
Post 2004[6] 德国 60/48 60岁 Lich 6个月 Surgipro/Vypro
Bringman 2005[7] 瑞士和芬兰 263/263 55岁 Lich 6个月 Prolene/VyproII
O'Dwyer 2005[3] 英国和德国 162/159 55.7 Lich 12个月 Atrium/VyproII
Bringman 2006[8] 瑞士和芬兰 251/243 55岁 Lich 36个月 Prolene/VyproII
Heikkinen 2006[9] 芬兰 69/68 56岁 TEP 2个月 Prolene/VyproII
Paajanen 2007[10] 芬兰 155/78 56岁 Lich 24个月 Premilene/VyproII
Champault 2007[11] 法国 53/179 54岁 TEP 24个月 Prolene/Ultrapro
Koch 2008[12] 瑞士 156/161 56岁 Lich 12个月 Prolene/TiMesh
Smietanski 2008[13] 波兰 177/218 56岁 Lich 12个月 Prolene/Ultrapro
Agarwal 2009[14] 印度 25/25 54岁 TEP 25个月 Prolene/Prolene
Nikkolo 2010[15] 爱沙尼亚 66/69 55岁 Lich 6个月 Premilene/Optilene
Chowbey 2010[16] 印度 211/191 56岁 TEP 12个月 Prolene/Ultrapro
Chui 2010[17] 中国 50/50 56岁 TEP 12个月 Surgipro/Dynamesh
Smietanski 2011[18] 波兰 92/90 56岁 Lich 60个月 Prolene/Ultrapro
Peeters 2014[19] 比利时 12/15 未描述 TEP 36个月 Marlex/VyproII
Burgmans 2016[4] 荷兰 478/471 55 TEP 24个月 Prolene/Ultrapro
Groene 2016[1] 美国 99/188 59 Lich 20个月 Prolene/Ultrapro
图1 纳入文献方法学质量评价图
图2 轻型与传统补片在腹股沟疝修补术中复发率的Meta分析
图3 轻型与传统补片在腹股沟疝修补术中慢性疼痛的Meta分析
图4 轻型与传统补片在腹股沟疝修补术中异物感的Meta分析
图5 轻型与传统补片在腹股沟疝修补术中其他症状的Meta分析
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