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在三级保健中心 COVID-19 大流行期间急性阑尾炎的管理:一项描述性横断面研究。

Management of Acute Appendicitis during COVID-19 Pandemic in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

机构信息

Department of Pediatric Surgery, Kanti Children's Hospital, Maharajganj, Kathmandu, Nepal.

出版信息

JNMA J Nepal Med Assoc. 2021 Mar 31;59(235):252-255. doi: 10.31729/jnma.6307.

Abstract

INTRODUCTION

Acute appendicitis is the most common reason for abdominal surgery in children. Though appendectomy considered the gold standard there are a lot of complications related to it. Conservative management of acute appendicitis is not new to medical science. In pandemic like COVID-19 when all the health systems were about to shut-down because of lack of manpower and resources, we started a trial of non-operative management. The main aim of this study is to find out the management of acute appendicitis during COVID-19.

METHODS

This was a descriptive cross-sectional study conducted in a tertiary care centre. Data collection was done from the record section which included the patients diagnosed with acute appendicitis from February 2020 to July 2020 after obtaining ethical clearance from Institutional Review Committee. Cases of appendicular lump, appendicular abscess, appendicular perforations have been excluded. Data was collected and entry was done in Statistical Package for the Social Science software version 20, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data.

RESULTS

The conservative management of acute appendicitis was done in 44 cases (55.7%) while 35 cases (44.3%) had to undergo appendectomy.

CONCLUSIONS

COVID-19 can complicate the perioperative course as a result of direct lung injury and multiple organ dysfunctions and can also bring serious threats to the safety of medical staffs involved in managing the acute appendicitis case operatively, so conservative management can be considered as an alternative way of management of acute appendicitis in the pandemic outbreak.

摘要

简介

急性阑尾炎是儿童腹部手术最常见的原因。虽然阑尾切除术被认为是金标准,但它也有很多相关的并发症。急性阑尾炎的保守治疗对医学来说并不是新的。在像 COVID-19 这样的大流行期间,由于人力和资源的缺乏,所有的卫生系统都即将关闭,我们开始尝试非手术治疗。本研究的主要目的是找出 COVID-19 期间急性阑尾炎的治疗方法。

方法

这是一项在三级保健中心进行的描述性横断面研究。数据收集是从记录部分进行的,其中包括在获得机构审查委员会的伦理批准后,于 2020 年 2 月至 2020 年 7 月期间诊断为急性阑尾炎的患者。阑尾肿块、阑尾脓肿和阑尾穿孔的病例被排除在外。数据收集并输入社会科学统计软件包 20 版,计算了 95%置信区间的点估计值以及二进制数据的频率和比例。

结果

44 例(55.7%)接受了急性阑尾炎的保守治疗,35 例(44.3%)不得不进行阑尾切除术。

结论

COVID-19 可直接导致肺部损伤和多器官功能障碍,使围手术期过程复杂化,也可能对参与手术治疗急性阑尾炎的医务人员的安全造成严重威胁,因此,在大流行期间,保守治疗可作为急性阑尾炎的另一种治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b74c/8369543/79b67e5175cc/JNMA-59-235-252-g1.jpg

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