一项前性研究,评估儿科尾炎得分在决策过程中的贡献
Kevin Vevaud1, Aymeric Dallocchio1, Nathalie Dumoitier2
1Service de chirurgie pédiatrique, Hôpital des Enfants, Hôpital Universitaire de Limoges, 8 Avenue Dominique Larrey, Limoges Cedex, 87042, France.
BMC pediatrics
|February 19, 2024
概括
这项研究发现,在初级保健中看到的儿童与直接进入急诊室的儿童之间,急性尾炎 (AA) 诊断得分没有显著差异. 为初级保健机构提出了一种结合疼痛持续时间和炎症标志物的新算法.
科学领域:
- 儿科急救医学 儿科急救医学
- 临床决策支持 临床决策支持
背景情况:
- 评估急性尾炎 (AA) 在儿童呈现到急诊室 (ED) 是至关重要的.
- 以前的初级保健 (PC) 咨询史可能会影响ED诊断途径.
研究的目的:
- 根据他们之前的PC咨询,评估儿童的AA的可能性.
- 为了比较儿童之间的诊断分数与没有事先的PC咨询.
主要方法:
- 预期在ED中招收疑似AA儿童.
- 根据PC咨询状态分类成组 (医生评估,家庭带来的,咨询后入院).
- 使用儿科尾炎评分 (PAS) 和C反应蛋白 (CRP) 水平进行分析.
主要成果:
- 在124名儿童中,29名儿童 (23.4%) 被诊断为AA.
- 没有显著的差异,在之前的PC咨询 (6.69±1.75) 和没有 (7.57±1.6) 的儿童之间的AA病例的平均PAS得分.
- PAS和CRP水平与AA严重程度相关;没有AA病例的PAS<4.
结论:
- 之前的初级保健咨询没有显著改变儿童尾炎得分在怀疑急性尾炎的儿童.
- 建议在初级保健中使用一种新的决策算法,将炎症标志物和疼痛持续时间整合起来.
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