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小儿急性阑尾炎:一项基于证据的综述。

Acute appendicitis in pediatric patients: an evidence-based review.

作者信息

Becker Callie, Kharbanda Anupam

机构信息

Assistant Professor, Division of Emergency Medicine, Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN.

Chief, Critical Care Services, Children's Hospital Minnesota, Minneapolis, MN.

出版信息

Pediatr Emerg Med Pract. 2019 Sep;16(9):1-20. Epub 2019 Sep 2.

Abstract

Appendicitis is the most common condition in children requiring emergency abdominal surgery. Delayed or missed diagnosis in young children is common and is associated with increased rates of perforation. Although several scoring systems have been developed, there is still no consensus on clinical, laboratory, and imaging criteria for diagnosing appendicitis. This issue reviews key age-based historical and physical examination findings, as well as clinical scoring systems, that can help guide the workup of appendicitis in children. The existing literature is reviewed to provide guidance for the management of children with appendicitis, including recommendations for diagnostic studies, prophylactic antibiotics, pain medication, and surgical consultation.

摘要

阑尾炎是儿童需要紧急腹部手术的最常见病症。幼儿阑尾炎的诊断延误或漏诊很常见,且与穿孔率增加有关。尽管已经开发了几种评分系统,但在阑尾炎的临床、实验室和影像学诊断标准上仍未达成共识。本文回顾了基于年龄的关键病史和体格检查结果,以及临床评分系统,这些有助于指导儿童阑尾炎的检查。对现有文献进行综述,为儿童阑尾炎的管理提供指导,包括诊断性检查、预防性抗生素、止痛药物和手术会诊的建议。

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