Schwartz M Z, Tapper D, Solenberger R I
Ann Surg. 1983 Apr;197(4):407-11. doi: 10.1097/00000658-198304000-00005.
A specific treatment plan for management of perforated appendix in children, initiated at the Children's Hospitals in Boston, and later utilized at the Child Health Center in Galveston, has been applied to 143 patients by many surgical housestaff and faculty. The protocol consists of appendectomy, routine use of systemic gentamicin, ampicillin and clindamycin, antibiotic peritoneal irrigation, and transperitoneal drainage through the incision. The average age of the children in this series was 9.1 years (range 14 months to 21 years). The average length of hospitalization was 12.1 days. The use of this protocol resulted in only 11 patients (7.7%) developing significant complications. Complications related to infection occurred in only six of the eleven patients (4.2%). There were no deaths. This protocol of intensive primary therapy can significantly decrease the sequelae from perforated appendicitis in children.
一种针对儿童阑尾穿孔治疗的具体方案，最初由波士顿儿童医院发起，后来在加尔维斯顿儿童健康中心得到应用，许多外科住院医师和教员已将其应用于143例患者。该方案包括阑尾切除术、常规使用全身性庆大霉素、氨苄青霉素和克林霉素、抗生素腹腔灌洗以及通过切口进行经腹引流。该系列儿童的平均年龄为9.1岁（范围为14个月至21岁）。平均住院时间为12.1天。采用该方案仅11例患者（7.7%）出现严重并发症。11例患者中仅有6例（4.2%）发生与感染相关的并发症。无死亡病例。这种强化初始治疗方案可显著减少儿童阑尾穿孔的后遗症。
