尾炎的非手术治疗和对急诊室管理的影响:叙述性审查
David A Talan1, Gregory J Moran1, David Machado-Aranda2
1Department of Emergency Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA.
Annals of emergency medicine
|December 5, 2025
概括
用抗生素治疗无并发性尾炎的非手术治疗是手术的安全替代方案. 在大多数情况下,这种方法允许急诊室出院和门诊管理.
科学领域:
- 紧急医疗 紧急医疗
- 手术创新 在外科创新.
- 传染病管理 传染病管理
背景情况:
- 尾炎在历史上被视为手术紧急情况,以防止破裂和败血症.
- 现代成像和证据表明,手术延迟不会增加无并发病例的穿孔风险.
- 无并发性尾炎可能是一种感染过程,可以自发地消失.
研究的目的:
- 审查比较非手术性抗生素治疗与尾切除无并发性尾炎的试验.
- 评估非操作性管理的安全性和可行性.
- 评估对紧急护理和患者处置的影响.
主要方法:
- 综述了4项多中心试验,涉及4000多名患者 (成人和儿童).
- 非手术治疗 (抗生素和选择性手术的观察) 与紧急尾切除术的比较.
- 分析与穿孔,败血症和治疗成功相关的结果.
主要成果:
- 非手术治疗的安全性与无并发性尾炎的紧急尾切除术相提并论.
- 美国外科医生协会现在支持非手术治疗作为一种安全的替代方案.
- 在90%的非手术治疗患者中,急诊室出院和门诊管理是可行的.
结论:
- 无并发性尾炎的非手术治疗是手术的安全有效替代方案.
- 这种方法促进了门诊护理,并减少了住院治疗.
- 紧急服务部门可以安全地为特定的尾炎患者实施非手术策略.
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