CAJ | 학술논문

背景：目前对于自固定补片及普通缝合补片用于腹股沟疝修补谁更具优势存在争议。目的：采用Meta分析方法比较自固定补片与普通缝合补片用于开放式腹股沟疝修补术的疗效。方法：计算机检索Cochrane library、PubMed、Medline、EMBASE、Ovid、维普、万方、知网、中国生物医学文献数据库、康健等数据库从建库至2014年12月的文献，并追查已纳入研究的参考文献，收集比较自固定补片与普通缝合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RevMan5.3软件进行Meta分析。结果与结论：纳入9个随机对照试验，共2100例腹股沟疝患者，其中自固定补片组1033例，普通缝合补片组1067例。Meta分析结果显示：与普通缝合补片组相比，自固定补片组腹股沟疝修补手术时间短(P<0.05)；两组在术后复发、血清肿、血肿、切口感染、疼痛、异物感方面无明显差异(P >0.05)。现有证据表明，自固定补片用于腹股沟疝修补能达到与普通缝合补片相似的临床疗效，但因纳入的文献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：목전대우자고정보편급보통봉합보편용우복고구산수보수경구우세존재쟁의。목적：채용Meta분석방법비교자고정보편여보통봉합보편용우개방식복고구산수보술적료효。방법：계산궤검색Cochrane library、PubMed、Medline、EMBASE、Ovid、유보、만방、지망、중국생물의학문헌수거고、강건등수거고종건고지2014년12월적문헌，병추사이납입연구적삼고문헌，수집비교자고정보편여보통봉합보편응용우개방식복고구산수보적전첨성수궤대조시험，안예설표준진행사선，대납입연구진행질량평개，제취수거후용RevMan5.3연건진행Meta분석。결과여결론：납입9개수궤대조시험，공2100례복고구산환자，기중자고정보편조1033례，보통봉합보편조1067례。Meta분석결과현시：여보통봉합보편조상비，자고정보편조복고구산수보수술시간단(P<0.05)；량조재술후복발、혈청종、혈종、절구감염、동통、이물감방면무명현차이(P >0.05)。현유증거표명，자고정보편용우복고구산수보능체도여보통봉합보편상사적림상료효，단인납입적문헌질량불고급양본량유한，상술결론수요대양본급고질량적림상수궤대조시험래제공경호적순증증거。
BACKGROUND:It remains controversial in term of therapeutic efficacy of self-fixating mesh and sutured mesh in inguinal hernia repair. OBJECTIVE:To compare the therapeutic effects of self-fixating mesh and sutured mesh in open inguinal hernia repair with Meta-analysis. METHODS:Comprehensive electronic search strategies were developed using the folowing electronic databases: Cochrane library, PubMed, EMBASE, Medline, Ovid, CNKI, Wanfang and FMJS. The Literature published before December 2014 was searched. Perspective randomized controled trials about comparing self-fixating mesh and sutured mesh in open inguinal hernia repair were included. A data-extraction sheet was developed based on the preset standards. The data from eligible studies were pooled through Meta-analysis. RESULTS AND CONCLUSION:Nine trials with a total of 2 100 inguinal hernia patients met the inclusion criteria, including 1 033 cases of self-fixing mesh and 1 067 cases of sutured mesh. The Meta-analysis showed that no significant differences were found between the two groups in the recurrence rate, seroma, hematoma, wound infection, pain, foreign body sensations (P > 0.05), but the duration of operation was less in the self-fixing mesh group than the sutured mesh group (P < 0.05). According to limited evidence, there are some findings as folows: self-fixating mesh is equivalent to sutured mesh in the therapeutic effects on open inguinal hernia repair. Because of the limits of samples and literature quality, more large-sample and high-quality trials are required to make a definite clinical evidence to use self-fixating mesh for groin hernia repair.