Young I, Moss K W
University of Colorado Health Science Center, Denver 80262, USA.
Alaska Med. 1997 Apr-Jun;39(2):34-42.
To review appendectomy cases in children at a small community hospital and to compare with experience at larger centers.
A five-year retrospective study.
Bartlett Regional Hospital, Juneau, Alaska.
Records of children age 14 and younger who underwent appendectomy from 1991 through 1996 were reviewed; 79 charts were found. Cases were grouped as simple appendicitis, advanced appendicitis, and appendectomy without appendicitis. Variables considered included: length of symptoms at first contact, time from onset until surgery, presence or absence of classical symptoms, post-operative complications, length of hospital stay.
51 cases (64.6%) of simple appendicitis, 22 cases (27.9%) of advanced disease, and 6 cases (7.6%) of normal appendix occurred. Advanced disease was high (66.7%) in children less than 5, and low (22.7%) in ages 10-14. Parental delay > 48 hours in seeking care was a significant factor in advanced disease, professional delay (time from first exam until surgery) was not. Post-surgical complications occurred in 7 (31.8%) cases of advanced disease and in none of the cases with simple appendicitis. Advanced disease cases had an average hospital stay of 8.59 days (+/-2.92) vs. 3.86 days (+/-1.46) for simple appendicitis. Review of appendicitis in children at this hospital compared favorably with the experience at larger medical centers.
回顾一家小型社区医院儿童阑尾炎切除病例，并与大型医疗中心的经验进行比较。
一项为期五年的回顾性研究。
阿拉斯加朱诺市的巴特利特地区医院。
回顾1991年至1996年期间接受阑尾炎切除术的14岁及以下儿童的病历；共找到79份病历。病例分为单纯性阑尾炎、复杂性阑尾炎和无阑尾炎的阑尾切除术。考虑的变量包括：首次就诊时症状持续时间、发病至手术的时间、是否存在典型症状、术后并发症、住院时间。
发生单纯性阑尾炎51例（64.6%），复杂性阑尾炎22例（27.9%），阑尾正常6例（7.6%）。5岁以下儿童复杂性阑尾炎发生率高（66.7%），10 - 14岁儿童发生率低（22.7%）。家长寻求治疗延迟> 48小时是复杂性阑尾炎的一个重要因素，而专业延迟（从首次检查至手术的时间）则不是。7例（31.8%）复杂性阑尾炎病例发生术后并发症，单纯性阑尾炎病例无一发生。复杂性阑尾炎病例的平均住院时间为8.59天（±2.92），而单纯性阑尾炎为3.86天（±1.46）。该医院儿童阑尾炎的回顾与大型医疗中心的经验相比具有优势。
