住院延迟对急性尾炎严重性的影响:时间真的很重要吗?
Stefano Agnesi1, Gabriele Mauro Di Lucca1, Fabio Benedetti1
1Department of General and Emergency Surgery, School of Medicine and Surgery, University of Milano-Bicocca, 20900, Monza, Italy.
Updates in surgery
|April 2, 2024
概括
在医院内对尾炎的手术延迟至24小时似乎是安全的,并且不会恶化结果. 从症状开始计算尾切除时间,而不是到达医院,对于预测复杂尾炎至关重要.
科学领域:
- 紧急医疗 紧急医疗
- 外科手术的结果
- 临床决策 临床决策
背景情况:
- 尾炎是紧急腹部手术的常见原因.
- 住院手术延迟对尾炎严重程度的影响仍在争论中.
- 优化手术时间对于患者的治疗结果至关重要.
研究的目的:
- 调查医院内延迟手术和复杂尾炎的发生率之间的关联.
- 为了确定手术前风险分层是否会影响手术延迟的效果.
- 评估延迟尾切除术在入院后24小时内的安全性.
主要方法:
- 对804名因急性尾炎接受尾切除术的患者进行前性队列研究.
- 患者根据风险分层使用阿尔瓦拉多评分系统 (低,中,高).
- 复杂的尾炎被定义为穿孔,,或扩散性腹膜炎.
主要成果:
- 入院延迟与复杂尾炎的比例没有显著相关.
- 中位数的手术延迟因风险组而异,较低风险的患者出现更长的延迟.
- 症状的持续时间,没有入院延迟,预测复杂的尾炎和发病率.
结论:
- 将尾切除术推迟至住院24小时通常是安全的.
- 尾炎的手术时间应该从症状发作开始考虑,而不是医院呈现.
- 进一步的研究可能会根据症状持续时间来改进最佳的外科手术时间协议.
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