腹壁切口疝与横、纵切口选择的关系--Meta分析

摘要

目的 比较腹部横切口与纵切口两种不同方式与切口疝发生率之间的关系.方法 通过检索PubMed、EMBASE数据库中与之相关的随机对照试验(randomized controlled trials,RCTs)和队列研究(cohort study),并辅以手工检索和文献追溯法收集1990年1月1日至今公开发表的关于腹部切口发生切口疝的相关文献,对最终纳入的文献采用Stata(12.0版)软件进行Meta分析.结果 通过数据库检索出文献502篇,根据入选标准和排除标准,通过阅读全文最终纳入22篇研究文献,共累计病例5 405例,其中发生切口疝的病人共654例,切口疝总发生率为12.1%,Meta分析结果显示腹部横切口的切口疝发生率为4%,而腹部纵切口的切口疝发生率为10%.不考虑权重的情况下进行横向切口与纵向切口疝发生率的t检验,发现两者差异有统计学意义(P<0.000 1).结论 横向切口可能是预防腹部手术后切口疝发生率高的优选切口.%Objective To investigate the incision hernia rate of vertical versus transverse incision.Methods PubMed and EMBASE Library databases were searched for articles in English published from 1900 to 2017 using the keywords "Horizontal","transverse","midline","vertical","abdominal incision","hernia",and "laparotomy".The types of study included randomized controlled trials or cohort study.Results Totally 22 studies containing 5 405 patients were included.Of all the patients,654 had incisional hernia after abdominal surgery and the incision hernias rate was 12.1%.The meta-incision hernia of transverse incision and vertical incision was 4% and 10%,respectively.The T-test showed that there was statistically significant difference between the two incisions.Conclusions Transverse incision may be considered as a better choice in surgery of the abdomen.