网片对比传统阴道修补术治疗盆腔脏器脱垂的系统评价

目的本研究旨在系统评价网片（Mesh）治疗盆腔脏器脱垂与传统阴道修补术的有效性和安全性。方法计算机检索Cochrane Library、PubMed、EMBASE、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库,检索时间截至2011年10月。检索词为pelvic organ prolapsed、POP、Mesh、盆腔脏器脱垂、网片等。纳入传统手术和网片对比治疗盆腔脏器脱垂的随机对照试验,由两名研究员分别独立提取数据和进行文献质量评价,并进行meta分析。结果共纳入5篇RCTs,meta分析结果显示：网片治疗妇女盆腔脏器脱垂并未增加手术成功率[RR=1.09,95%CI（0.58,2.02）,P=0.79]、降低术后POP-Q分度[MD=0.11,95%CI（-0.15,0.36）,P=0.41],同时术后性交困难[OR=1.25,95%CI（0.54,2.87）,P=0.60]和复发率[RR=0.76,95%CI（0.10,5.28）,P=0.78]等并未降低。结论当前证据表明：与传统手术相比,网片并不能增加手术的客观成功率,亦不能降低术后POP-Q分度以及术后感染等,尚需经济学评价及适用性研究以指导临床实践。

The systematic review on using Mesh versus traditional colporrhaphy for the treatment of pelvic organ prolapse

Objective To compare the effectiveness and safty of traditional colporrhaphy and pelvic floor reconstruction surgery with Mesh in treating pelvic organ prolapse （POP）. Methods We searched the following databases from their inception to October 2011：The Cochrane Library, PubMed, EMBASE,CBMdisc, CNKI and CQVIP. The index words included：pelvic organ prolapse, POP, vaginal prolapse and Mesh. Include criteria was：Randomized Controlled Trials（RCTs） that compared traditional colporrhaphy with using Mesh surgery in treating POP. Two researchers extracted the data and evaluate the literature quality independently.Results Meta-analysis showed that：using Mesh to treat POP didn＇t improve the successful rate of surgery ,also it didn＇t decrease the POP-Q stages ,sexual dysfunction and recurrence rate . Conclusion Comparing with traditional colporrhaphy, Mesh can＇t increase the objective successful rate, it also can＇t decrease POP-Q stage and infection rate.