无张力疝修补术治疗腹股沟嵌顿疝安全性的系统评价

目的评价无张力疝修补术治疗腹股沟嵌顿疝的安全性。方法检索PubMed、EMBASE、CochraneLibrary、中国生物医学文献数据库、万方数字化期刊群，并手工检索相关领域其他杂志。纳入比较无张力疝修补术与传统疝修补术治疗腹股沟嵌顿疝的前瞻性随机对照研究或设计良好的非随机对照研究。评价纳入研究的质量，采用RevMan5．0软件进行Meta分析。结果纳入11个研究，共计716例。Meta分析结果显示：与传统疝修补术相比，无张力疝修补术平均手术时间缩短加权均数差=-15．16，95％可信区间（-22．11，-8．20），P〈0．05]，手术后住院天数缩短加权均数差=-1．59，95％可信区间（-2．83，-0．34），P〈0．05]。手术后伤口感染发生没有明显差异加权均数差=O．84，95％可信区间（O．44，1．59），P〉0．05]。阴囊血肿比值比=0．77，95％可信区间（0．39，1．51），P〉0．05]、腹股沟区血清肿比值比=3．80，95％可信区间（0．91，15．91），P〉0．05]及尿潴留发生比值比=0．62，95％可信区间（0．32，1．22），P〉0．05]没有明显差别，术后远期复发率较传统疝修补术低f比值tE=0．14，95％可信区间（0．06，0．33），P〈0．05]。结论无张力疝修补术治疗无肠管坏死物切除的腹股沟嵌顿疝是可行的。

Tension-Free Repair Versus Traditional Herniorrhaphy in Strangulated Inguinal Hernia: A Meta-Analysis

Objective To evaluate the efficacy and safety of tension-free repair versus traditional herniorrhaphy in strangulated inguinal hernia. Method We searched the related studies included randomized controlled trials and between-study heterogeneity. PubMed, EMBASE, Cochrane Library, CBM and Wanfang were searched and related journals were hand-searched. Evaluated the quality of the studies. Meta analysis was performed by Revman 5.0 software. Result Eleven studies involving 716 patients were included. In comparison with the traditional herniorrhaphy, fewer time of surgeryWMD=-lS.16,95%CI （-22.11,-8.20）, P〈0.05]; fewer day of postoperative hospital stay WMD=- 1.59,95%CI （-2.83,-0.34）,P〈0.05]; postoperative edema of scrotum, groin bruises and urinary retention did not differ significantly between the two groupsOR=0.77, 95%CI （0.39, 1.51）, P〉0.05; OR=3.80, 95%CI （0.91, 15.91）, P〉0.05; OR=0.62, 95%CI （0.32, 1.22）, P〉0.05]. Postoperative recurrence rate did not differ significantly between the two groups OR=0.14,95v/6CI （0.06,0.33） ,P〈0.05]. Conclusion The use of tension-free repair in emergency treatment of strangulated inguinal hernia is safe.