生物补片在疝与腹壁外科的临床应用进展
Progress of clinical application of biological patch in hernia and abdominal surgery
陈松耀 1戴伟钢 1陈创奇1
作者信息
- 1. 510080 广州,中山大学附属第一医院胃肠外科
- 折叠
摘要
目前人工合成补片在疝与腹壁外科中应用广泛,并取得良好的效果,但是合成补片具有难以避免的缺点,如补片感染、慢性疼痛、肠粘连、甚至肠瘘等,一旦补片感染则需要移除补片.此外,因合成补片可能增加手术部位感染的概率,故目前不推荐其应用于存在明确污染或感染部位的手术中.生物补片正是针对人工合成补片存在的缺陷而研发出来,它具有耐感染性好、良好组织相容性、完全可吸收等优势.研究证明生物补片可以安全应用于潜在污染或感染部位的疝修补术中.目前生物补片已应用于各种腹壁疝以及腹壁肿瘤、感染或创伤后的腹壁重建等手术中.然而,现阶段有关生物补片的循证医学证据等级较低,不同研究报道生物补片的应用效果差异较大,尚无共识形成,故针对生物补片的临床应用尚需要持谨慎态度.我们期待前瞻性的临床研究来进一步论证生物补片的长期疗效.本文针对生物补片临床应用现状和进展进行简要综述.
Abstract
At present, synthetic patch is widely used in hernia and abdominal wall surgery, which has achieved good outcomes. However, it is difficult to avoid some disadvantages of the synthetic patch, such as patch infection, chronic pain, intestinal adhesion and even intestinal fistula. Once the patch is infected, it needs to be removed. In addition, because the synthetic patch may increase the probability of surgical site infection, it is not recommended to be applied in the area where is a definite contamination or infection. Biological patch is developed for the defects of synthetic patch, which has the advantages of better infection resistance, histocompatibility and completely absorbability. Biological patches have been proved to be safe for herniorrhaphy in potentially contaminated or infected sites. It has been effectively used in ventral hernia and the reconstruction of the abdominal wall tumor, infection or trauma. However, at present, the level of evidence about biological patch was low, and the results of many studies associated with biological mesh were quite different. So it was difficult to get consensus on the application of biological patch. Therefore, it is still necessary to take a cautious attitude towards the clinical application of biological patch. We expect a prospective clinical study to further demonstrate the long-term efficacy of biological patches. This article briefly reviews the current status and progress of clinical application of biological patches.
关键词
腹壁疝/腹壁缺损/生物补片/疝修补术/效果Key words
Ventral hernia/Abdominal defect/Biologic mesh/Herniorrhaphy/Outcome引用本文复制引用
基金项目
广东省科技计划资助项目(2016A0103038)
出版年
2018
NETL
NSTL
维普
万方数据