急性尾炎抗生素治疗后一年尾切除术的预测因素:从前性,多中心观察性研究的见解
Hannah Javanmard-Emamghissi1, Brett Doleman1, Jonathan N Lund1
1Division of Medicine and Health Science, University of Nottingham at Derby, Royal Derby Hospital, Derby, UK.
World journal of surgery
|September 26, 2024
概括
对于大多数患者来说,尾炎的非手术治疗是有效的,71%的患者在一年内避免了手术. 然而,诸如皮炎和高成年尾炎得分等因素预测了复发和治疗失败.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床医学 临床医学
背景情况:
- 由于担心尾炎的复发和错过的尾恶性瘤,外科医生不愿意在非手术情况下治疗尾炎.
- 这项研究旨在评估抗生素与尾炎手术治疗的长期疗效.
研究的目的:
- 为了确定非手术 (抗生素) 与非手术治疗对无并发性尾炎的长期疗效.
- 在非手术治疗的患者中确定复发性尾炎和错过的尾恶性瘤的预测因素.
主要方法:
- 进行了多中心COVID:HAREM队列研究 (2020年3月至6月) 的一年后续调查.
- 管理决策 (操作性与非操作性) 是根据具体情况进行的.
- 评估的结果包括1年尾切除率,组织学和抗生素治疗失败的预测因素.
主要成果:
- 在非手术治疗的625名患者中,24%的患者在一年内 (中位数为12天) 接受了尾切除术.
- 在7名患者中发现了恶性病变,所有患者都有先前存在的危险因素.
- 肥病和高成年尾炎评分 (>16) 独立预测了未成功的非手术治疗.
结论:
- 71%的非手术治疗的患者在一年内避免了尾切除.
- 病例复发与肥病和高成年尾炎得分有关.
- 建议对具有尾恶性瘤高风险的患者进行有针对性的随访.
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