国人40364例腹外疝无张力修补荟萃分析_临床医学论文.docVIP

国人40364例腹外疝无张力修补荟萃分析_临床医学论文 国人40364例腹外疝无张力修补荟萃分析_临床医学论文 ［摘要］ 目的 总结腹外疝无张力修补术经验。方法 报道78例并搜索1997～2005年国内公开发表中文文献共40364例，所得资料荟萃分析。结果 （1）无张力疝修补术用于老年人占75.1%，少年儿童占0.0%，用于腹股沟疝占99.3%；（2）硬膜外麻醉占80.6%，局部麻醉占16.8%；Rutkow术占80.8%，Lichtenstein法占15.0%；（3）进口材料修补占96.5%，国产材料修补占2.9%；（4）术前并存症占17.9%，术后并发症发生率为18.0%；（5）24h内下床活动占93.8%，3周内恢复正常活动者占99.1%，7天以内住院日者占90.4%；（6）手术死亡率0.007%，随访死亡率0.05%，随访疝复发率0.60%。结论 无张力疝修补术具有手术时间短、术后下床活动早、恢复正常活动快、并发症少、复发率低等优点，主要用于老年人腹股沟疝，有并发症及复发性疝，不用于儿童疝，手术可在硬膜外麻醉或局麻下进行，最好选用进口材料修补，规范技术操作，预防切口感染，加强高龄Ⅳ型疝及老慢支病人处理，可进一步降低复发率。 ［关键词］ 腹外疝；无张力；修补术 Meta analysis of 40364 cases of tension-free hernioplasty of the abdominal external hernia in Chinese ［Abstract］ Objective To summarize experience of tension-free hernioplasty of the abdominal external hernia.Methods Reporting 78 cases and search the Chinese document of internal public publishes tension-free hernioplasty of external hernia on the Internet from 1997 to 2005,and meta analysing the information.Results (1)The tension-free hernoplasty apply old people occupied 75.1%,and apply early youth children occupied 0.0%,and apply inguinal femoral hernia occupied 99.3%;(2)The dura mater cavity external anaesthesia occupied 80.6%,local anaesthesia occupy 16.8%,Rutkow occupied 80.8%,and Lichtenstein occupied 15.0%;(3)The imported material preparation occupied 96.5%,and home material preparation occupied 2.9%;(4)The compatible disease of before operation occupied 17.9%,and complication after operation occupied 18.0%;(5)The get out of bed activities in the 24 hours occupied 93.8%,and return to normal activities in the 3 weeks occupied 99.1%,and average be in hospital in the 7 days occupied 90.4%;(6)The death rate of operation was 0.007%,and death rate of follow up was 0.05%,and relapse rate of follow up was 0.59%.Conclusion Tension-free herinolasty possess merit:operation times is short,get out of bed activities after operation is early,return to normal activities is fast,complication few,a relapse rate is low.It main adapt to inguino