切换车道:在穿孔尾炎中排放之前没有家庭抗生素或实验室检测
Seth Saylors1, Cory Nonnemacher1, Meredith Elman1
1Children's Mercy Kansas City, USA.
Journal of pediatric surgery
|August 14, 2025
概括
在儿童穿孔性尾炎手术后拒绝门诊抗生素并没有增加腹内的发生率. 这种协议的变化,省略了出院前的实验室测试和抗生素,证明与以前的方法不逊色.
科学领域:
- 儿科手术 儿科手术
- 传染病管理 传染病管理
背景情况:
- 尾炎是一种常见的儿科手术紧急情况,30%的病例呈现出穿孔.
- 以前的协议涉及出院前白细胞计数和门诊抗生素,与8%的腹内 (IAA) 率相关.
研究的目的:
- 评估放出后遗漏抗生素对穿孔尾炎儿童IAA率的影响.
主要方法:
- 一项前性观察性研究包括202名儿科患者 (<18岁),他们因穿孔性尾炎接受了腹腔镜尾切除术.
- 患者接受住院抗生素治疗,如果符合出院标准,则可以在没有口服抗生素的情况下出院.
- 该研究比较了协议更改之前和之后的释放后IAA率.
主要成果:
- 出院后的IAA率为9.9% (20名患者),其中7%需要再入院.
- 据发现,保留释放的抗生素不劣,IAA率有2%的差异 (95%CI:-2%-7%).
- 两组之间没有观察到年龄,BMI,停留时间或抗生素持续时间的显著差异.
结论:
- 忽略门诊抗生素和出院前实验室检测并没有显著改变术后IAA率.
- 这一修订后的协议是一种安全有效的方法,用于管理小儿患者的穿孔性尾炎.
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