在儿科手术群体中低风险的肺炎肠道病
Nell T Weber1,2, Sarah Ogle1, Emily H Cooper2
1Division of Pediatric Surgery, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 E 16th Ave. Box 323, Aurora, CO, 80045, USA.
Pediatric surgery international
|March 11, 2024
概括
没有风险因素的1岁以上儿童的肺炎肠道 (PI) 可以安全地用抗生素治疗3天. 结果与医生的专业或抗生素持续时间无关,结果相似,支持低风险PI的较短治疗.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 新生儿和儿科手术
- 临床儿科 临床儿科
背景情况:
- 肠道肺炎 (PI) 是肠壁中的空气,严重程度和临床过程各不相同.
- 缺乏基于证据的指导方针来管理儿童较低风险的PI病例.
- 这项研究定义和描述了儿科患者的低风险PI.
研究的目的:
- 描述儿童低风险PI的临床实体.
- 描述患有低风险PI的儿童人口.
- 为了确定管理方法或结果是否根据医生的专业或抗生素持续时间而有所不同.
主要方法:
- 在科罗拉多州儿童医院诊断出PI (2009-2019) 的1岁以上儿童的回顾性审查.
- 排除患有癌症或骨髓移植病史的患者.
- 低风险标准:没有ICU入院,使用血管压缩剂或紧急手术.
主要成果:
- 在91名儿童中,有72名儿童符合低风险标准.
- 在抗生素持续时间 (≤3天与>3天) 之间,并发症 (血液动力学减补偿,复发,C. difficile,死亡) 没有显著差异.
- 在由外科医生或儿科医生管理的儿童之间,结果没有差异.
结论:
- 低风险PI被定义为1岁以上的儿童,没有癌症/BMT病史,不需要ICU,血管压缩剂或紧急手术.
- 对这些儿童来说,缩短3天的抗生素治疗和NPO疗程似乎是安全的.
- 这支持在选择儿科PI病例时采取不那么激进的管理策略.
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