荷兰的腹股沟疝手术：患者是否按照指南进行治疗？
Inguinal hernia surgery in The Netherlands: are patients treated according to the guidelines?
机构信息
Department of Surgery, Westfries Gasthuis, P.O. Box 600, 1620 AR, Hoorn, The Netherlands.
出版信息
Hernia. 2010 Apr;14(2):143-8. doi: 10.1007/s10029-009-0578-y. Epub 2009 Nov 2.
PURPOSE
In 2003, a dedicated Dutch committee developed evidence-based guidelines for the treatment of inguinal hernia (IH) in children and adults. The aim of this study was to describe trends in hernia care before and after the publication of the guidelines on IH surgery in The Netherlands.
METHODS
Originally, a retrospective baseline analysis of IH surgery in 90 Dutch hospitals was performed among patients treated for IH in 2001. The results of this baseline analysis were compared with a recently performed second analysis of patients treated for IH in 2005.
RESULTS
In children <4 years of age, the study showed a significant decrease of contralateral explorations. In adults, the study showed that significantly more patients were treated with a mesh-based repair in 2005 (95.9 vs. 78.8%, P < 0.01). Moreover, there was an increase of patients with bilateral hernia treated with an endoscopic technique (41.5 vs. 22.3%, P < 0.01) and more patients were treated in day surgery (53.5 vs. 38.6%, P < 0.01). Lastly, a decline in operations performed for recurrent IH in adults was observed (10.9 vs. 13.3%, P < 0.01).
CONCLUSION
This study showed that most patients with IH in The Netherlands were treated according to the main recommendations of the Dutch evidence-based guidelines.
目的
2003 年，一个专门的荷兰委员会制定了针对儿童和成人腹股沟疝（IH）治疗的循证指南。本研究的目的是描述在荷兰发表 IH 手术指南前后疝治疗的趋势。
方法
最初，对 2001 年在 90 家荷兰医院接受 IH 治疗的患者进行了 IH 手术的回顾性基线分析。将此基线分析的结果与最近在 2005 年对接受 IH 治疗的患者进行的第二次分析进行比较。
结果
在<4 岁的儿童中，研究显示对侧探查的显著减少。在成人中，研究表明，2005 年采用基于网片的修复术治疗的患者显著增加（95.9%对 78.8%，P<0.01）。此外，采用内镜技术治疗双侧疝的患者增加（41.5%对 22.3%，P<0.01），更多的患者在日间手术中接受治疗（53.5%对 38.6%，P<0.01）。最后，观察到成人复发性 IH 手术的数量下降（10.9%对 13.3%，P<0.01）。
结论
本研究表明，荷兰大多数 IH 患者的治疗均符合荷兰循证指南的主要建议。
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