与尾切除相比,抗生素是急性尾炎的有效初始治疗方法吗?
Peter Victoria1, Joshua Easter1, Brit Long1
1Department of Emergency Medicine, University of Virginia, 1215 Lee St, Charlottesville, VA 22908, United States of America.
The American journal of emergency medicine
|January 24, 2026
概括
抗生素治疗是对成年人无并发性急性尾炎的可行的初始治疗方法. 然而,尾炎患者面临更高的并发症风险,可能需要手术.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 基于证据的医学基于证据的医学.
背景情况:
- 急性尾炎是一种常见的手术紧急情况.
- 尾切除术是传统的治疗方法.
- 抗生素治疗正在成为选择患者的非手术替代方案.
研究的目的:
- 审查一项比较抗生素治疗和急性尾炎尾切除的元分析.
- 评估并发症率和治疗结果.
主要方法:
- 六项随机对照试验的个人患者数据元分析.
- 包括2101名成年患者,成像证实了急性尾炎.
- 用混合效应建模进行治疗意向分析;并发症按Clavien-Dindo分类.
主要成果:
- 在抗生素和尾切除组之间,在一年内整体,主要或轻微并发症率没有显著差异.
- 34%接受抗生素治疗的患者需要延迟尾切除;25%患有复杂的尾炎.
- 尾炎患者的并发症率更高 (49%需要手术).
结论:
- 抗生素治疗是不复杂的急性尾炎的合理初步方法.
- 患者对风险的了解至关重要.
- 由于失效率较高,建议在尾炎的尾炎中谨慎使用.
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