急性尾炎是否可以进行非手术治疗:叙述性综述
Hani Bendib1,2
1Department of General Surgery, EPH Kouba, Algiers, Algeria.
概括
使用抗生素的非手术治疗 (NOT) 是无并发性急性尾炎 (AA) 的可行选择. 虽然发生复发,但与尾切除相比,NOT的发病率和成本较低.
科学领域:
- 手术紧急情况 手术紧急情况
- 胃肠病学 胃肠病学
- 临床证据综合研究
背景情况:
- 急性尾炎 (AA) 是最常见的手术紧急情况.
- 尾切除术一直是标准的治疗方法,而穿孔在历史上被视为不可避免的结果.
- 新出现的证据重新评估了附录的作用,支持保守的管理选择.
研究的目的:
- 审查当前关于成人急性尾炎非手术治疗 (NOT) 的证据.
- 与传统的手术干预相比,评估NOT的疗效和安全性.
- 为考虑AA治疗策略的临床医生提供研究结果的摘要.
主要方法:
- 使用PubMed Medline数据库进行了全面的文献搜索.
- 根据预先定义的审查标准,共选择了48篇文章.
- 审查的重点是关于非操作性管理的证据的叙事综合.
主要成果:
- 最近的试验和元分析支持初级抗生素治疗不复杂的AA.
- 不表明有显著的复发率和治疗失败.
- 重要的是,与尾切除相比,NOT不会增加尾穿孔的风险,并且与减少发病率,降低成本和更好的生活质量有关.
结论:
- 一线非手术治疗是不复杂的,CT确认的急性尾炎的合理策略.
- 仔细的患者选择对于优化NOT的成功率至关重要.
- 在选择的AA患者中,NOT为外科手术提供了潜在的有益替代方案.
相关概念视频
Appendicitis-II: Diagnostic Studies and Management
80
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
80
Appendicitis-I: Introduction
126
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
126
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
79
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
79
Inflammatory Bowel Disease V: Surgical Management
145
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
145
Tonsillitis II: Management
110
This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
110
Acute Pancreatitis II: Clinical Manifestations and Management
122
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
122


