Jimbo Takahiro, Masumoto Kouji, Takayasu Hajime, Shinkai Toko, Urita Yasuhisa, Uesugi Toru, Gotoh Chikashi, Ono Kentaro, Sasaki Takato
Departments of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Pediatr Int. 2017 Jul;59(7):803-806. doi: 10.1111/ped.13290.
The aim of this study was to evaluate the outcome of an early discharge protocol for pediatric acute appendicitis.
The present new early discharge protocol for appendicitis consisted of both postoperative early feeding and reduced-port laparoscopic surgery, to reduce surgical stress. The outcome was studied in patients with acute appendicitis treated at the present institution from 2012 to 2013.
Data on 36 acute appendicitis patients (mean age, 10.3 years) were collected. Operation time was 95 ± 27 min. Preoperatively, mean white blood cell (WBC) count was 13 850 ± 3644/μL; mean C-reactive protein (CRP), 2.7 ± 2.9 mg/dL; and mean procalcitonin, 0.25 ± 0.37 ng/mL. After surgery there was a significant decrease in WBC count, which fell to within the normal range; CRP peaked at 4.9 ± 3.2 mg/dL on postoperative day (POD) 1. On POD 7, all of the hematological markers were within the normal range. There were no postoperative complications. Mean hospital stay was 2.1 ± 1.1 days. Mean frequency of oral painkiller use was 3.2 ± 3.3 times per person.
The present early discharge protocol is safe and effective for the management of acute non-perforated appendicitis.
本研究旨在评估小儿急性阑尾炎早期出院方案的效果。
目前新的阑尾炎早期出院方案包括术后早期进食和减少切口的腹腔镜手术，以减轻手术应激。对2012年至2013年在本机构接受治疗的急性阑尾炎患者的治疗效果进行了研究。
收集了36例急性阑尾炎患者（平均年龄10.3岁）的数据。手术时间为95±27分钟。术前，平均白细胞（WBC）计数为13850±3644/μL；平均C反应蛋白（CRP）为2.7±2.9mg/dL；平均降钙素原0.25±0.37ng/mL。术后白细胞计数显著下降，降至正常范围内；CRP在术后第1天（POD1）达到峰值4.9±3.2mg/dL。在POD7时，所有血液学指标均在正常范围内。无术后并发症。平均住院时间为2.1±1.1天。平均每人使用口服止痛药的频率为3.2±3.3次。
目前的早期出院方案对于急性非穿孔性阑尾炎的治疗是安全有效的。
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