儿童急性阑尾炎的非手术治疗。
Non-operative management of acute appendicitis in children.
机构信息
Unit of Pediatric Surgery, Karolinska University Hospital, 17176, Stockholm, Sweden.
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
出版信息
Pediatr Surg Int. 2022 Nov 28;39(1):11. doi: 10.1007/s00383-022-05284-y.
Abstract
Appendicitis is one of the most common surgical emergencies in children and adults. Appendectomy as the standard care has been challenged in the recent years with growing evidence about non-operative treatment as a potential primary treatment in patients presenting with signs and symptoms suggestive of acute appendicitis. This review aims to establish where the recent research stands regarding conservative treatment of acute appendicitis, especially in children. There are several studies that report the potential safety and efficacy of treating acute appendicitis non-operatively. Several studies have challenged the concept of acute appendicitis being a progressive disease that always ends in perforation, rather than a disease that can present as different forms with only a defined number of cases progressing to perforation. The lack of randomized controlled studies is a limitation and well-designed randomized controlled trials are needed to determine the role of non-operative management of acute appendicitis in children.
摘要
阑尾炎是儿童和成人中最常见的外科急症之一。近年来，随着越来越多的证据表明非手术治疗可能是急性阑尾炎患者的主要治疗方法，阑尾切除术作为标准治疗方法受到了挑战。本综述旨在确定最近在保守治疗急性阑尾炎方面的研究进展，特别是在儿童中。有几项研究报告了非手术治疗急性阑尾炎的潜在安全性和有效性。有几项研究质疑了急性阑尾炎是一种进行性疾病的概念，这种疾病总是会导致穿孔，而不是一种可以表现为不同形式的疾病，只有一定数量的病例会进展为穿孔。缺乏随机对照研究是一个限制，需要进行精心设计的随机对照试验来确定非手术治疗儿童急性阑尾炎的作用。
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