对于模糊尾炎,一夜之间做出决定往往涉及不必要的住院治疗
Daniel R Liesman1, Steven T Papastefan1, Sara Ungerleider2
1Division of Pediatric Surgery, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois; Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
The Journal of surgical research
|October 10, 2025
概括
在儿童中一夜间观察模两可的尾炎导致高负尾切除率. 释放低风险患者可能会减少医院资源的使用,而不会增加错误诊断.
科学领域:
- 儿科手术 儿科手术
- 紧急医疗 紧急医疗
- 诊断成像 诊断成像 诊断成像
背景情况:
- 在儿科医院,对模两可的尾炎的下班咨询经常发生.
- 处置选项包括通过连续检查 (ASE) 的入院或通过返回预防措施的出院.
- 一夜间的ASE仅在我们的机构中使用.
研究的目的:
- 描述一夜间ASE对儿科患者模糊性尾炎的益处和危害.
- 为了评估儿童的结果,对疑似尾炎的非确定的成像.
主要方法:
- 对怀疑尾炎的18岁以下患者进行过夜评估的回顾性审查 (2021年7月至2023年7月).
- 模两可的尾炎通过非确定的成像和外科住院医生的评估来定义.
- 在ASE和出院患者组之间对结果的比较.
主要成果:
- 43名患者 (54%) 属于ASE组,36人 (46%) 已出院.
- 10名ASE患者接受了尾切除术;3名 (30%) 的尾切除术结果为负.
- 低阿尔瓦拉多评分的出院患者很少需要随后的干预.
结论:
- 患有模两可的尾炎的儿童,尽管阿尔瓦拉多分数低,但经常被录取.
- 对模糊尾炎的夜间ASE与高负尾切除率有关.
- 释放低阿尔瓦拉多分数的患者可能会降低资源利用率,而不会增加错误诊断.
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