尾炎尾炎:我们应该早点做手术吗? 一个回顾性队列研究
A G Taib1,2, A Kler1,3, M Prayle1
1Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, UK.
Annals of the Royal College of Surgeons of England
|August 23, 2023
概括
患有尾炎的尾炎患者在12小时内面临更高的复杂尾炎风险. 建议对那些有尾炎的人进行早期尾切除,以防止穿孔.
科学领域:
- 一般外科 整体外科
- 紧急医疗 紧急医疗
- 放射学 放射学是一门学科.
背景情况:
- 将尾切除术推迟至24小时通常是安全的.
- 尾炎是已知的尾炎穿孔的危险因素.
- 尾炎和穿孔风险之间的时间依赖关系尚未研究.
研究的目的:
- 调查一项假设,即通过手术前CT (pCT) 证实尾炎的存在,可以缩短复杂尾炎的时间.
- 探索尾炎存在与复杂尾炎发展之间的时间关联.
主要方法:
- 在2018-2020年期间入院的310名患者进行了回顾性单中心队列研究.
- 纳入标准:年龄≥18岁,由组织病理学证实的尾炎和PCT扫描.
- 复杂的尾炎定义为,,或穿孔在手术内发现.
主要成果:
- 尾炎在25.5%的患者中存在,被确定为穿孔的重要危险因素 (OR3.50,p=0.027).
- 患有尾炎的患者在入院12小时内出现复杂尾炎的比例显著更高 (56.7%对43.3%,p=0.003).
- 尾炎的存在使12小时内尾炎并发症的可能性增加2.05倍 (95% CI 1.28-3.29).
结论:
- 尾炎与尾炎,需要考虑早期的尾切除术.
- 需要进一步的大规模多中心前性研究来验证这些发现并为临床指南提供信息.
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