Corona-Cruz José Francisco, Melchor-Ruan Javier, Gracida-Mancilla Noé Isaías, Vega-Chavaje Gerardo Ricardo, Sánchez-Lozada Raúl
Servicio de Cirugía General, Hospital General de México, México D.F., Mexico.
Cir Cir. 2007 Jan-Feb;75(1):25-9.
Appendectomy is the most common non-elective surgery. The postoperative use of antibiotics depends on the stage of the appendix at the time of surgery. Several classifications establish that state. We determine if these classifications are known and used by Mexican surgeons.
A descriptive and observational study was performed. A questionnaire was completed by surgeons asking the following questions: Do you use a classification for acute appendicitis? 2) Which classification do you prefer? 3) Do you use antibiotics postoperatively? 4) For what period of time do you administer antibiotics postoperatively? We evaluated if the postoperative treatment is influenced by the use of a classification, using the chi(2) test.
One hundred and forty two surgeons were interviewed, 99% used a classification, and 48% indicated postoperative antibiotics, despite the stage of the disease, monotherapy (69%), and for three doses (60%). Fifty two percent used antibiotic only in advanced stages, with two different types (61%), and from 7 to 10 days (66%). We did not find any statistical difference in management, regardless of whether or not an appendicitis classification was used.
Although most surgeons use one classification for acute appendicitis, this does not influence postoperative treatment. This incongruity results in the unjustified use of antibiotics.
阑尾切除术是最常见的非选择性手术。术后抗生素的使用取决于手术时阑尾的阶段。有几种分类方法确定了这种状态。我们确定墨西哥外科医生是否知晓并使用这些分类方法。
进行了一项描述性观察研究。由外科医生填写一份问卷，询问以下问题：1）您是否使用急性阑尾炎的分类方法？2）您更喜欢哪种分类方法？3）您术后使用抗生素吗？4）您术后使用抗生素的时间是多久？我们使用卡方检验评估术后治疗是否受分类方法使用的影响。
共采访了142名外科医生，99%的医生使用一种分类方法，48%的医生表示无论疾病处于何阶段都使用术后抗生素，采用单一疗法（69%），用药三剂（60%）。52%的医生仅在疾病晚期使用抗生素，使用两种不同类型（61%），用药7至10天（66%）。无论是否使用阑尾炎分类方法，我们在治疗管理上均未发现任何统计学差异。
尽管大多数外科医生对急性阑尾炎使用一种分类方法，但这并不影响术后治疗。这种不一致导致了抗生素的不合理使用。
