对于小儿无并发性尾炎的手术或没有手术? 一个系统的审查和元分析,以告知管理层
Alyssa Stetson1, Claudia Orlas1, Raissa Li1
1Pediatric Surgery Trials and Outcomes Research Center (PSTORC), Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Surgery, Division of Pediatric Surgery, Massachusetts General Hospital, Boston, MA; Mass General Brigham, Mass General for Children, Boston, MA.
Surgery
|October 15, 2025
概括
急性无并发性尾炎的非手术治疗失败率很高,在一年内超过20%,长期超过50%. 与手术相比,这种方法导致更多的急诊和再入院.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 临床结果研究研究
背景情况:
- 非手术治疗 (NOM) 越来越多地被认为是急性无并发性尾炎,因为它的安全性.
- 关于NOM长期失败率的有限数据阻碍了患者和临床医生的知情决策.
研究的目的:
- 为了比较儿童急性无并发性尾炎的手术与非手术治疗的长期失败率.
- 评估二次结果,包括紧急部门的访问和再接收.
主要方法:
- 2000-2024年间发表的研究的系统审查和元分析.
- 包括对儿科急性无并发性尾炎的单臂或双臂研究.
- 主要结局:NOM的1年失败率 (复发性尾炎,疼痛手术或间隔尾切除).
主要成果:
- 对NOM的1年失败率为22.3%,超过1年后升至54.2%.
- 与手术管理相比,非手术管理的患者的30天急救诊所和1年的再入院率较高.
- 在分析中包括了48项研究.
结论:
- 急性无并发性尾炎的非手术治疗表明长期失效率很高.
- 非手术治疗的患者经历了更频繁的急诊室访问和再入院.
- 操作管理仍然是预防复发性尾炎和相关的医疗保健利用的更可靠选择.
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