目的： 荟萃分析随机对照试验,比较预防性应用抗生素和安慰剂在无张力疝修补术中的疗效。方法： 计算机检索中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊数据库、数字化期刊全文数据库以及国外PubMed、Cochrane Library、Embase数据库收录的相关随机对照试验,提取数据进行合并分析。采用RevMan5.3软件进行荟萃分析。结果： 最终纳入10项随机对照试验,抗生素组和安慰剂组共包含3 659例病人。荟萃分析结果显示,抗生素组6项研究低风险环境中发生手术部位浅表感染的相对危险度（RR=0.74, 95%CI：0.45~1.24）,发生手术部位深部感染的相对危险度（RR=0.71, 95%CI：0.23~2.21）,与安慰剂组相比差异均无统计学意义。4项研究高风险环境中发生手术部位浅表感染的相对危险度（RR=0.34, 95%CI：0.12~0.95）优于安慰剂组,P=0.04。结论： 无张力疝修补术前预防性应用抗生素可能有助于降低高风险环境手术部位浅表感染发生率,但对低风险环境无明显作用。

Objective To perform a meta-analysis of randomized controlled trial (RCT) comparing prophylactic antibiotics with placebo in patients with tension-free hernia repair for clinical effectiveness. Methods RCTs were searched from electronic Chinese databases including: ①China Biology Medicine Disc, ②China National Knowledge Infrastructure, ③China Science and Technology Journal Database, and ④Vanfund Urban Investment & Development, as well as electronic foreign databases including: PubMed, Cochrane Library, and Embase. The Review manager software (version 5.3) was used for statistical analysis. Results A total of 10 RCTs with both prophylactic antibiotic group and placebo group involving 3 659 patients were included. It was shown in this meta-analysis that there was no significant difference in the incidence of postoperative superficial incisional surgical site infection (SSSI) in low-risk environments (RR=0.74, 95% CI: 0.45-1.24) or postoperative deep surgical site infection (DSSI) (RR=0.71, 95% CI: 0.23-2.21) between two groups. The results from 4 RCTs showed that incidence of postoperative SSSI in high-risk environments in prophylactic antibiotic group was lower than that in placebo group(RR=0.34, 95%CI: 0.12-0.95, P=0.04). Conclusions Prophylactic antibiotics before tension-free hernia repair may help to reduce the incidence of postoperative SSSI in high-risk environments, but there is no significant evidence for that in low-risk environments.