人工合成材料在腹壁切口疝修补中应用的临床系统评价

Clinical evaluation of artificial synthetic material for repairing incisional hernia of abdominal wall

目的:评价人工合成材料在腹壁切口疝修补中的应用特点及安全性。方法:以计算机检索方法在中国期刊全文数据库中(CNKI:2001/2009)检索关于应用疝修补材料对腹壁切口疝进行修补的随机照实验,检索词为"疝修补材料、聚丙烯补片、腹壁切口疝"。检索后对每项研究的资料结果进行提取、分析。结果:共有24项实验1393例腹壁切口疝、腹壁缺损及腹股沟疝患者符合纳入标准.分析结果显示用聚丙烯补片和聚四氟乙烯补片修补腹壁大切口疝及巨大切口疝,重建了腹壁的完整性,创伤小,操作简化,恢复快,复发率低,具有广阔的应用前景。但由于进口补片的价格较贵,有研究对国产涤纶疝修补材料与进口聚丙烯补片进行了比较,结果显示国产涤纶疝修补材料植入后异物感轻,局部解剖顺应性好,其安全性及副反应发生情况与进口补片无显著性差异。结论:人工合成材料补片有极好的组织相容性、很强的抗张力强度,可耐受弯曲和折屈的外力,并可随意裁剪,适用于不同大小的腹壁缺损,植入后无明显不适、恢复快、复发率低及并发症少,是一值得推广的疝修补材料。

OBJECTIVE： To evaluate characteristics and security of artificial synthetic material for repairing incisional hernia of abdominal wall. METHODS： Articles about randomized controlled studies which were focus on repairing incisional hernia of abdominal wall were collected from CNKI from 2001 to 2009 with the retrieval words of repairing materials for hernia,polypropylene patch, and incisional hernia ofabdominal wall. And then, those articles were summed up and analyzed. RESULTS： Among 24 tests, a total of 1 393 patients who had incisional hernia of abdominal wall, abdominal-wall defect, and inguinal hernia were included in the final analysis. Polypropylene patch and polytetrafluoroethylene patch could reconstruct integrity of abdominal wall during repairing large and huge incisional hernia, characterizing by less trauma, simple operation, rapid recovery, and low relapse rate. However, import patches were expensive. Home-made dacron materials for repairing hernia has been compared with import polyprepylene patch, and the results indicated that dacron materials had light foreign body sensation and good complaisance after implantation; additionally, there was no significant difference in security and adverse reaction between dacron materials and import patches. CONCLUSION： Artificial synthetic materials characterize by great biocompatibility, strong anti-tensile strength, excellent tolerance to inflexion, optional cutting, beneficial for abdominal-wall defect at differential sizes, no comfortlessness, rapid recovery, low relapse rate, and less complication. Thus, artificial synthetic materials are extensive prospect.