Wojciechowicz K H, Hoffkamp H J, van Hulst R A
Maritime Medical Expertise Centre Royal Netherlands Navy, PO Box 10.000, 1780 CA Den Helder, The Netherlands.
Int Marit Health. 2010;62(4):265-72.
Although the standard treatment for appendicitis (since 1883) is an appendectomy, this is not always possible in a maritime or military setting. To avoid relying on improvisation in such situations this study examines the evidence for conservative management of appendicitis.
PubMed was searched for studies on conservative treatment of appendicitis. Both prospective and retrospective studies with a well-defined description of the protocol were included.
Finally, 5 publications (a total of 342 patients) were included in this overview. For these reports, the success rate for conservative treatment of appendicitis is 90.8% (88-95%) with a risk of relapse within 12 months of 15.9% (5-37%). For complicated appendicitis these mean rates decrease to 89% (67-100%) and 9.8% (0-39.6%), respectively.
This overview indicates that appendicitis can be safely and effectively treated conservatively. The studies differed in their treatment protocols. Appendicitis can best be treated with a third-generation cephalosporin and an imidazole derivative (2 days intravenously and 10 days orally). This is based on evidence from a combination of the studies presented here, and on expert opinion. Currently, this combination is the best available "evidence" on this topic.
尽管阑尾炎的标准治疗方法（自1883年起）是阑尾切除术，但在海上或军事环境中并非总是可行。为避免在这种情况下依赖临时措施，本研究考察了阑尾炎保守治疗的证据。
在PubMed上搜索有关阑尾炎保守治疗的研究。纳入对方案有明确描述的前瞻性和回顾性研究。
最终，本综述纳入了5篇文献（共342例患者）。对于这些报告，阑尾炎保守治疗的成功率为90.8%（88 - 95%），12个月内复发风险为15.9%（5 - 37%）。对于复杂性阑尾炎，这些平均比率分别降至89%（67 - 100%）和9.8%（0 - 39.6%）。
本综述表明阑尾炎可以通过保守治疗安全有效地治愈。这些研究的治疗方案有所不同。阑尾炎最好用第三代头孢菌素和咪唑衍生物治疗（静脉注射2天，口服10天）。这是基于此处呈现的研究组合的证据以及专家意见。目前，这种组合是关于该主题的最佳可用“证据”。
