CAJ | 학술논문

背景：目前对于轻型网片及重型网片修补腹股沟疝谁更具优势存在争议。 　　目的：采用Meta分析的方法比较重型与轻型补片开放式修补腹股沟疝的疗效。 　　方法：计算机检索PubMed、Cochrane library、EMBASE、Medline、Ovid、万方、知网、维普、中国生物医学文献数据库、康健等数据库,并追查已纳入研究的参考文献，检索时间从建库至2013年2月。收集比较重型与轻型补片应用于开放式腹股沟疝修补的前瞻性随机对照试验，按预设标准进行筛选，对纳入研究进行质量评价，提取数据后用RevMan5.1软件进行Meta分析。 　　结果与结论：纳入18个随机对照试验，共4450例腹股沟疝。Meta分析结果显示，与重型网片相比，轻型网片修补腹股沟疝后短期内疼痛及异物感较少[OR=0.57，95%可信区间(0.43,0.74)，P<0.05]、[OR=0.49，95%可信区间(0.35,0.69)，P<0.05]；两组修补手术后复发、血清肿、血肿、切口感染、睾丸萎缩、尿潴留、中长期疼痛方面差异无显著性意义(P>0.05)。现有证据表明，轻型网片修补腹股沟疝是安全可行的，能达到与重型网片相似的临床疗效，但因纳入文献的质量不高及样本量有限，上述结论需要大样本及高质量的临床随机对照试验来提供更好的循证证据。
배경：목전대우경형망편급중형망편수보복고구산수경구우세존재쟁의。 　　목적：채용Meta분석적방법비교중형여경형보편개방식수보복고구산적료효。 　　방법：계산궤검색PubMed、Cochrane library、EMBASE、Medline、Ovid、만방、지망、유보、중국생물의학문헌수거고、강건등수거고,병추사이납입연구적삼고문헌，검색시간종건고지2013년2월。수집비교중형여경형보편응용우개방식복고구산수보적전첨성수궤대조시험，안예설표준진행사선，대납입연구진행질량평개，제취수거후용RevMan5.1연건진행Meta분석。 　　결과여결론：납입18개수궤대조시험，공4450례복고구산。Meta분석결과현시，여중형망편상비，경형망편수보복고구산후단기내동통급이물감교소[OR=0.57，95%가신구간(0.43,0.74)，P<0.05]、[OR=0.49，95%가신구간(0.35,0.69)，P<0.05]；량조수보수술후복발、혈청종、혈종、절구감염、고환위축、뇨저류、중장기동통방면차이무현저성의의(P>0.05)。현유증거표명，경형망편수보복고구산시안전가행적，능체도여중형망편상사적림상료효，단인납입문헌적질량불고급양본량유한，상술결론수요대양본급고질량적림상수궤대조시험래제공경호적순증증거。
BACKGROUND:It remains controversial in term of efficacy for the lightweight mesh and heavyweight mesh in inguinal hernia repair. OBJECTIVE:To compare the clinical therapeutic effects of lightweight mesh and heavyweight mesh in open methods of inguinal hernia repair with Meta-analysis. METHODS:Comprehensive electronic search strategies were developed using the fol owing electronic databases:PubMed, Cochrane Library, EMBASE, Medline, Ovid, CNKI, VIP, Wanfang and FMJS. The Literature published before February 2013 was searched. The randomized control ed trials about comparing lightweight mesh and heavyweight mesh in open methods of inguinal hernia repair were included. A data-extraction sheet was developed based on the preset standards. The data from eligible studies were pooled using RevMan5.1 software through Meta-analysis. RESULTS AND CONCLUSION:Eighteen trials with a total of 4 450 hernias met the inclusion criteria. The meta-analysis showed that there was a statistical difference between lightweight mesh group and the heavyweight mesh group on short-term pain [odd ratio (OR)=0.57, 95%confidence interval (CI) (0.43, 0.74), P<0.05] and a reduced risk of developing foreign body sensations [OR=0.49, 95%CI (0.35, 0.69), P<0.05]. No significant differences were found between the two groups in recurrence rate, testicular atrophy, seroma, hematoma, wound infection, urine retention (P>0.5). According to limited evidence, there are some findings as fol ows:the lightweight mesh is of feasibility, safety and effectiveness for inguinal hernia repair. Because of the limits of sample and quality, more large-sample and high-quality trials are required to make a definite clinical evidence to use lightweight mesh for inguinal hernia repair.