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婴儿周围的管理:从APSA结果和基于证据的实践委员会进行系统审查
Shannon N Acker1, Jason Sulkowski2, Henry L Chang3
1Division of Pediatric Surgery, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA; Research Outcomes in Children's Surgery, Center for Children's Surgery, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.
婴儿围腹和内 (FIA) 管理是有争议的. 手术和非手术治疗都是安全的,但婴儿近囊和腹的复发很常见.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 基于证据的医学基于证据的医学.
背景情况:
- 婴儿近部疾病的管理,包括近部腹和内 (FIA),缺乏共识.
- 关于操作与非操作方法的最佳风险和益处存在争议.
研究的目的:
- 建立基于共识的关于婴儿围腹和FIA管理的问题.
- 系统地审查各种治疗策略的证据.
主要方法:
- 按照PRISMA指南进行的3-4级研究的系统审查.
- 进行全面的文献搜索,以确定相关的手稿.
- 对婴儿围疾病治疗结果的数据分析.
主要成果:
- 最初的非操作性管理 (NOM) 失败率为~37.5%.
- 在NOM或切口和排水 (I&D) 后的复发率分别为~21%和~24%.
- 在FIA经营管理后的复发率为~7%;FIA发展率为~20-21%.
结论:
- 手术和非手术方法都对婴儿围腹和FIA安全.
- 不管选择的管理策略如何,复发是常见的.
- 个性化风险益处评估对于治疗决策至关重要.
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