从循证医学角度谈补片预防造口旁疝的临床价值  

Clinical value of mesh prophylaxis for parastomal hernia based on evidence-based medicine

作　　者：乐飞[1] 李健文[1] Yue Fei;Li Jianwen(General Surgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai Minimally Invasive Surgery Center,Shanghai 200025,China)

机构地区：[1]上海交通大学医学院附属瑞金医院普外科、上海市微创外科临床医学中心,上海200025

出　　处：《中华外科杂志》2023年第6期446-450,共5页Chinese Journal of Surgery

摘　　要：造口旁疝发生率较高,会影响造口患者的健康水平和生活质量。如何有效解决造口旁疝问题,是疝和腹壁外科以及结直肠外科长期关注的热点。2018年发布的《欧洲疝学会造口旁疝防治指南》首度推荐应用补片预防造口旁疝。在随后的5年里,有越来越多的多中心、大样本、双盲、长期随访的随机对照试验的结果被发布,均未证实补片可降低造口旁疝发生率。补片能否通过减轻造口旁疝症状达到减少外科干预的效果,将成为预防性应用补片的潜在价值点,有待进一步的研究结果予以阐释。The incidence of parastomal hernia is substantially high,significantly affecting the quality of life of patients with stoma.How to effectively solve the problem of parastomal hernia is a long-term focus of hernia and abdominal wall surgery and colorectal surgery.The European Hernia Society guidelines on prevention and treatment of parastomal hernia published in 2018 has recommended the use of a prophylactic mesh to prevent parastomal hernia for the first time.In the following 5 years,more randomized controlled trials of multi-center,large-sample,double-blind,long-term follow-up have been published,and no significant effect of mesh prophylaxis has been observed on the incidence of parastomal hernia.However,whether mesh could decrease surgical intervention by limiting the symptoms of parastomal hernias would become a potential value of prophylaxis,which requires further research to elucidate.

关 键 词：疝 腹部 肠造口术 造口旁疝 预防 补片 

分 类 号：R656.2[医药卫生—外科学]