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Lancet：网片对比缝合治疗成年人脐疝的优劣对比

2018-02-19 MedSci MedSci原创

脐疝网片缝合修复
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脐疝的治疗方式有网片修补和缝合修复，但对于小脐疝（直径1-4cm），现还没有证据提示网片修复效果更好。近日Lancet上发表一篇文献，对比网片修复和缝合修复，哪一个可以更好的降低小脐疝的复发率？研究人员在多个国家的12家医院进行一多中心的随机化的双盲对照试验，招募年满18岁的直接1-4cm的原发性脐疝患者，按1：1随机分组，采用网片修复或缝合修复，并按脐疝大小分层（1-2cm或>2-4cm）

脐疝的治疗方式有网片修补和缝合修复，但对于小脐疝（直径1-4cm），现还没有证据提示网片修复效果更好。近日Lancet上发表一篇文献，对比网片修复和缝合修复，哪一个可以更好的降低小脐疝的复发率？研究人员在多个国家的12家医院进行一多中心的随机化的双盲对照试验，招募年满18岁的直接1-4cm的原发性脐疝患者，按1：1随机分组，采用网片修复或缝合修复，并按脐疝大小分层（1-2cm或>2-4cm）。在研究开始时，所有的外科医生都被邀请参加培训，以确保其使用相同的规范化技术进行缝合修补或网片修复。术后2周、3个月、12个月以及24-30个月对患者进行体检。主要评估指标是随访24个月后脐疝的复发率。2006年6月21日-2014年4月16日，共招募300位患者，两组各150位。中位随访时间25.1个月（IQR 15.5-33.4）。在最长随访30个月后，补片组脐疝复发病例少于缝合修复组（6/146[4%] vs 17/138[12%]；2年精确的复发率 3.6%[95% CI 1.4-9.4] vs 11.4%[6.8-18.9]；p=0.01，危险比0.31，95% CI 0.12-0.

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    2018-08-26 guozhenyu

    #网片#

    0

  2. 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    2019-01-26 howi

    #Lancet#

    0

  3. 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    2018-04-13 青山颖钰

    学习了

    0

  4. 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attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Mon Feb 19 22:01:42 CST 2018, time=2018-02-19, status=1, ipAttribution=)]
    2018-02-21 ms4657536712156177

    #疝#

    0

  5. 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createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Tue Feb 20 06:12:58 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289292, encodeId=273d289292d0, content=学习了感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Tue Feb 20 01:21:41 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289258, encodeId=0ace2892582d, content=一起学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Mon Feb 19 22:01:42 CST 2018, time=2018-02-19, status=1, ipAttribution=)]
    2018-02-21 huirong

    #脐疝#

    0

  6. 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createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Tue Feb 20 06:12:58 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289292, encodeId=273d289292d0, content=学习了感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Tue Feb 20 01:21:41 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289258, encodeId=0ace2892582d, content=一起学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Mon Feb 19 22:01:42 CST 2018, time=2018-02-19, status=1, ipAttribution=)]
    2018-02-20 忠诚向上

    努力学习.好好看下

    0

  7. 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authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Tue Feb 20 17:57:39 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289415, encodeId=e2162894159a, content=学习了.涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Tue Feb 20 09:23:13 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289314, encodeId=d06d28931496, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Tue Feb 20 06:12:58 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289292, encodeId=273d289292d0, content=学习了感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Tue Feb 20 01:21:41 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289258, encodeId=0ace2892582d, content=一起学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Mon Feb 19 22:01:42 CST 2018, time=2018-02-19, status=1, ipAttribution=)]
    2018-02-20 1ddf0692m34(暂无匿称)

    学习了.涨知识

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1756417, encodeId=afeb1e564170c, content=<a href='/topic/show?id=39dee9466a4' target=_blank style='color:#2F92EE;'>#网片#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79466, encryptionId=39dee9466a4, topicName=网片)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65ce37134966, createdName=guozhenyu, createdTime=Sun Aug 26 20:19:00 CST 2018, time=2018-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829486, encodeId=884c1829486cf, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, 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authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Tue Feb 20 17:57:39 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289415, encodeId=e2162894159a, content=学习了.涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Tue Feb 20 09:23:13 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289314, encodeId=d06d28931496, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Tue Feb 20 06:12:58 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289292, encodeId=273d289292d0, content=学习了感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Tue Feb 20 01:21:41 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289258, encodeId=0ace2892582d, content=一起学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Mon Feb 19 22:01:42 CST 2018, time=2018-02-19, status=1, ipAttribution=)]
    2018-02-20 changjiu

    学习一下谢谢

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1756417, encodeId=afeb1e564170c, content=<a href='/topic/show?id=39dee9466a4' target=_blank style='color:#2F92EE;'>#网片#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79466, encryptionId=39dee9466a4, topicName=网片)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=65ce37134966, createdName=guozhenyu, createdTime=Sun Aug 26 20:19:00 CST 2018, time=2018-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1829486, encodeId=884c1829486cf, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, 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createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Tue Feb 20 06:12:58 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289292, encodeId=273d289292d0, content=学习了感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Tue Feb 20 01:21:41 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289258, encodeId=0ace2892582d, content=一起学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Mon Feb 19 22:01:42 CST 2018, time=2018-02-19, status=1, ipAttribution=)]
    2018-02-20 lofter

    学习了感谢分享

    0

  10. 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authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Tue Feb 20 17:57:39 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289415, encodeId=e2162894159a, content=学习了.涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Tue Feb 20 09:23:13 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289314, encodeId=d06d28931496, content=学习一下谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Tue Feb 20 06:12:58 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289292, encodeId=273d289292d0, content=学习了感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C20CB8E4EBB36F5B821651C710BCB491/100, createdBy=18de1715848, createdName=lofter, createdTime=Tue Feb 20 01:21:41 CST 2018, time=2018-02-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=289258, encodeId=0ace2892582d, content=一起学习学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/TDiaAWyicHgedzX3wKo3qcxudVJib7AfibfvNeufHRF2jG3Bw8MmZyWjIhtBV1mpJI7Sy9n7RcBKK5t3CuOKuOFxkg/0, createdBy=dd702206933, createdName=wzb521zf, createdTime=Mon Feb 19 22:01:42 CST 2018, time=2018-02-19, status=1, ipAttribution=)]
    2018-02-19 wzb521zf

    一起学习学习

    0

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