早期镇痛与阑尾炎的延迟治疗有关吗？

Is early analgesia associated with delayed treatment of appendicitis?

作者信息

Frei Steven P, Bond William F, Bazuro Robert K, Richardson David M, Sierzega Gina M, Wasser Thomas E

机构信息

Emergency Department, Lehigh Valley Hospital-Muhlenberg, Bethlehem, PA 18017, USA.

出版信息

Am J Emerg Med. 2008 Feb;26(2):176-80. doi: 10.1016/j.ajem.2007.04.024.

DOI:10.1016/j.ajem.2007.04.024

PMID:18272097

Abstract

PURPOSE

We sought to investigate the relationship between delay in treatment of appendicitis and early use of analgesia.

BASIC PROCEDURES

We designed a matched case-control study, with patients having delayed treatment of appendicitis as the cases and patients with no delay in treatment of appendicitis as controls matched for age, sex, Alvarado score, and date of diagnosis. Of 957 patients with appendicitis, there were 103 delayed cases. Matching patients were identified yielding 103 controls.

MAIN FINDINGS

In comparing cases and controls for early opiate use (26/103 cases, 24/103 controls), there was no association with delayed treatment (odds ratio, 1.11; P = .745; 95% confidence interval, 0.59-3.89). When comparing cases and controls for early NSAID use (29/103 cases, 17/103 controls), an association was found with delayed treatment (odds ratio, 1.98; P = .045; 95% confidence interval, 1.01-3.89).

CONCLUSION

For early analgesia in appendicitis, we did not find an association with delayed treatment for opiate analgesia, but there did appear to be an association with nonsteroidal anti-inflammatory analgesia.

摘要

目的

我们试图研究阑尾炎治疗延迟与早期使用镇痛剂之间的关系。

基本步骤

我们设计了一项匹配病例对照研究，将阑尾炎治疗延迟的患者作为病例，将阑尾炎治疗未延迟的患者作为对照，对照在年龄、性别、阿尔瓦拉多评分和诊断日期方面进行匹配。在957例阑尾炎患者中，有103例延迟病例。确定匹配患者后得到103例对照。

主要发现

在比较病例组和对照组早期使用阿片类药物的情况（103例病例中有26例，103例对照中有24例）时，未发现与治疗延迟有关联（比值比，1.11；P = 0.745；95%置信区间，0.59 - 3.89）。在比较病例组和对照组早期使用非甾体抗炎药的情况（103例病例中有29例，103例对照中有17例）时，发现与治疗延迟有关联（比值比，1.98；P = 0.045；95%置信区间，1.01 - 3.89）。