Blewett C J, Krummel T M
Department of Surgery, Pennsylvania State University College of Medicine, Hershey Medical Center, Hershey 17033, USA.
Semin Pediatr Surg. 1995 Nov;4(4):234-8.
Although mortality rates for pediatric appendicitis have been reduced to near zero with the development of safe surgical procedures and routine perioperative antibiotic therapy, the incidence of perforated appendicitis in children has remained at a comparatively high level. This article reviews the recent literature on perforated pediatric appendicitis, including a discussion of some of the controversies concerning management of the ruptured appendix. In addition, the future of both the evaluation and treatment of this disease, including laparoscopy, the possibilities for outpatient antibiotic therapy, and the worrisome potential for a change in referral patterns as children with this disease are increasingly enrolled in managed care plans, are considered.
尽管随着安全手术程序和围手术期常规抗生素治疗的发展，小儿阑尾炎的死亡率已降至接近零，但儿童穿孔性阑尾炎的发病率仍处于相对较高的水平。本文回顾了关于儿童穿孔性阑尾炎的最新文献，包括对一些有关破裂阑尾处理的争议的讨论。此外，还考虑了这种疾病评估和治疗的未来，包括腹腔镜检查、门诊抗生素治疗的可能性，以及随着患有这种疾病的儿童越来越多地加入管理式医疗计划，转诊模式改变的令人担忧的可能性。
