中国微创外科杂志
中國微創外科雜誌
중국미창외과잡지
CHINESE JOURNAL OF MINIMALLY INVASIVE SURGERY
2014年
12期
1128-1134
,共7页
盆腔器官脱垂%合成网片%阴道修补术%meta分析
盆腔器官脫垂%閤成網片%陰道脩補術%meta分析
분강기관탈수%합성망편%음도수보술%meta분석
Pelvic organ prolapse%Synthetic mesh%Colporrhaphy%Meta-analysis
目的:系统评价合成网片用于盆腔器官脱垂修补手术和阴道修补术的有效性和安全性。方法检索PubMed(1980~2013年)、Cochrane图书馆(1995~2013年)、Google Scholar(1980~2013年)、中国期刊网全文数据库(1980~2013年)、中国生物医学文献数据库(1980~2013年),纳入合成网片修补术和传统阴道修补术2种治疗方法的随机对照研究,并应用RevMan5.0软件进行统计分析。结果纳入10项随机对照试验,meta分析结果显示:合成网片组手术时间明显长于传统阴道修补组(WMD:16.57 min,95%CI:14.06~19.08 min,P<0.00001),术中出血量明显多于传统阴道修补组(WMD:24.98 ml,95%CI:7.13~42.84 ml,P=0.006),客观治愈率明显高于传统阴道修补组(OR:4.16,95%CI:3.10~5.58, P<0.00001),主观治愈率明显高于传统阴道修补组(OR:2.13,95%CI:1.55~2.91,P<0.00001),性交困难发生率明显低于传统阴道修补组(P=0.04),术后再发尿失禁、术后再次手术率无统计学差异(P=0.13,P=0.06)。结论与传统阴道修补术相比,合成网片提高主、客观治愈率,提示合成网片应用于治疗盆腔器官脱垂有效,但仍需高质量前瞻性研究进一步证实。
目的:繫統評價閤成網片用于盆腔器官脫垂脩補手術和陰道脩補術的有效性和安全性。方法檢索PubMed(1980~2013年)、Cochrane圖書館(1995~2013年)、Google Scholar(1980~2013年)、中國期刊網全文數據庫(1980~2013年)、中國生物醫學文獻數據庫(1980~2013年),納入閤成網片脩補術和傳統陰道脩補術2種治療方法的隨機對照研究,併應用RevMan5.0軟件進行統計分析。結果納入10項隨機對照試驗,meta分析結果顯示:閤成網片組手術時間明顯長于傳統陰道脩補組(WMD:16.57 min,95%CI:14.06~19.08 min,P<0.00001),術中齣血量明顯多于傳統陰道脩補組(WMD:24.98 ml,95%CI:7.13~42.84 ml,P=0.006),客觀治愈率明顯高于傳統陰道脩補組(OR:4.16,95%CI:3.10~5.58, P<0.00001),主觀治愈率明顯高于傳統陰道脩補組(OR:2.13,95%CI:1.55~2.91,P<0.00001),性交睏難髮生率明顯低于傳統陰道脩補組(P=0.04),術後再髮尿失禁、術後再次手術率無統計學差異(P=0.13,P=0.06)。結論與傳統陰道脩補術相比,閤成網片提高主、客觀治愈率,提示閤成網片應用于治療盆腔器官脫垂有效,但仍需高質量前瞻性研究進一步證實。
목적:계통평개합성망편용우분강기관탈수수보수술화음도수보술적유효성화안전성。방법검색PubMed(1980~2013년)、Cochrane도서관(1995~2013년)、Google Scholar(1980~2013년)、중국기간망전문수거고(1980~2013년)、중국생물의학문헌수거고(1980~2013년),납입합성망편수보술화전통음도수보술2충치료방법적수궤대조연구,병응용RevMan5.0연건진행통계분석。결과납입10항수궤대조시험,meta분석결과현시:합성망편조수술시간명현장우전통음도수보조(WMD:16.57 min,95%CI:14.06~19.08 min,P<0.00001),술중출혈량명현다우전통음도수보조(WMD:24.98 ml,95%CI:7.13~42.84 ml,P=0.006),객관치유솔명현고우전통음도수보조(OR:4.16,95%CI:3.10~5.58, P<0.00001),주관치유솔명현고우전통음도수보조(OR:2.13,95%CI:1.55~2.91,P<0.00001),성교곤난발생솔명현저우전통음도수보조(P=0.04),술후재발뇨실금、술후재차수술솔무통계학차이(P=0.13,P=0.06)。결론여전통음도수보술상비,합성망편제고주、객관치유솔,제시합성망편응용우치료분강기관탈수유효,단잉수고질량전첨성연구진일보증실。
Objective To review systemically the effectiveness and safety of mesh versus traditional colporrhaphy for pelvic organ prolapse . Methods The literature were retrieved from the PubMed ( 1980 -2013 ) , Cochrane ( 1995 -2013 ) , Google Scholar (1980-2013), CNKI (1980-2013), and SinoMed (1980-2013).The randomized controlled trials (RCT) were collected and compared, and the data were analyzed by using the RevMan 5.0 software. Results There were totally 10 randomized controlled trials collected .Meta-analysis showed that:the operation time was significantly longer in the mesh group than that in the colporrhaphy group [WMD:16.57 min, 95%CI:14.06-19.08 min, P<0.00001]; the intraoperative blood loss was significantly more in the mesh group than that in the colporrhaphy group [ WMD: 24.98 ml, 95%CI:7.13 -42.84 ml, P=0.006]; the mesh group was superior to colporrhaphy group in the increase of objective cure rate [OR:4.16, 95%CI:3.10-5.58,P<0.00001] and subjective cure rate [OR:2.13, 95%CI:1.55-2.91, P<0.00001]; as compared with all various relating operations , the incidence rate of dyspareunia was statistically significant (P=0.04), whereas there were no statistical differences in postoperative recurrence of urinary incontinence and re-operation (P=0.13, P=0.06). Conclusion Apllication of mesh for pelvic organ prolapse can improve the objective and subjective cure rates .Mesh may be usefully applied to the treatment of pelvic organ prolapse , and further high-quality prospective studies are needed .