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對選定的闌尾炎患者進行門診抗生素治療是安全的,可以讓許多患者避免手術和住院,並應將其視為醫病共同決策的一部分。在隨機接受抗生素治療的 726 名參與者中,46% 在 24 小時內從急診室出院。在出院後的一周內,門診追蹤出每 100 名患者中僅有少於 1 起嚴重不良反應相關。

門診管理發現絕大多數的患者中被證明是安全的,並且在所有研究地點有高達 90% 的患者以抗生素治療。與住院(開刀)相比,門診管理發現與隨後的闌尾切除術無關,患者錯過的工作日更少。

這項研究是對抗生素藥物和闌尾切除術結果比較 (CODA) 試驗結果的持續分析,該試驗發現抗生素治療不亞於緊急闌尾切除術。試驗結束後,美國外科學院表示,高品質的證據證實大多數患者可以接受抗生素治療。

研究人員檢查了 2016 年 5 月 1 日至 2020 年 2 月 28 日期間在 25 家醫院接受抗生素治療的 726 名影像學確診闌尾炎患者的數據。

闌尾炎的門診管理對許多人來說是安全的,並且可以減少醫療保健的使用和成本。

參考文獻:

  1. Charles Parsons, Stephen Odom, Randall Cooper, Katherine Fischkoff, Brant Putnam, Dennis Kim, Erin C. Howell, Lara H. Spence, Ross Fleischman, Erika Wolff, Farhood Farjah, Hikmatullah Arif, Kelsey Pullar, Laura Hennessey, Alyssa Hayward, Lillian Adrianna Hayes, Vance Sohn, Bruce Chung, Damien Carter, David MacKenzie, Debra Burris, Joseph Mack, Terilee Gerry, Darin Saltzman, Debbie Mireles, Formosa Chen, Kavitha Pathmarajah, Paul J Schmit, Robert Bennion, Melinda Gibbons, Bruce Wolfe, Elliott Skopin, Heather VanDusen, Kimberly Deeney, Mary Guiden, Meridith Weiss, Miriam Hernandez, Brandon Tudor, Careen Foster, Shaina Schaetzel, Arden Morris, Dayna Morgan, John Tschirhart, Julie Wallick, Katherine Mandell, Ryan Martinez, Sean Wells, Steven Steinberg, Jason Maggi, Kristyn Pierce, Marcovalerio Melis, Mohamad Abouzeid, Paresh Shah, Prashant Sinha, Cathy Fairfield, Dionne Skeete, Cindy Hsu, Krishnan Raghavendran, Nathan Haas, Norman Olbrich, Pauline Park, Hasan Alam, Deepti Patki, Rebekah K. Peacock, Donald M. Yealy, Debbie Lew, Karla Bernardi, Naila Dhanani, Oscar Olavarria, Stephanie Marquez, Tien C. Ko, Amber Sabbatini, Estell Williams, Karen Horvath, Zoe Parr, Karen F. Miller, Kelly M. Moser, Abigail Wiebusch, Julianna Yu, Scott Osborn, Billie Johnsson, Karla Ballman, Lauren Mount, Robert J. Winchell, Sunday Clark, Thomas Diflo, Kathleen O’Connor, Olga Owens, David A. Talan, Gregory J. Moran, Anusha Krishnadasan, Sarah E. Monsell, Brett A. Faine, Lisandra Uribe, Amy H. Kaji, Daniel A. DeUgarte, Wesley H. Self, Nathan I. Shapiro, Joseph Cuschieri, Jacob Glaser, Pauline K. Park, Thea P. Price, Nicole Siparsky, Sabrina E. Sanchez, David A. Machado-Aranda, Jesse Victory, Patricia Ayoung-Chee, William Chiang, Joshua Corsa, Heather L. Evans, Lisa Ferrigno, Luis Garcia, Quinton Hatch, Marc D. Horton, Jeffrey Johnson, Alan Jones, Lillian S. Kao, Anton Kelly, Daniel Kim, Matthew E. Kutcher, Mike K. Liang, Nima Maghami, Karen McGrane, Elizaveta Minko, Cassandra Mohr, Miriam Neufeld, Joe H. Patton, Colin Rog, Amy Rushing, Amber K. Sabbatini, Matthew Salzberg, Callie M. Thompson, Aleksandr Tichter, Jon Wisler, Bonnie Bizzell, Erin Fannon, Sarah O. Lawrence, Emily C. Voldal, Danielle C. Lavallee, Bryan A. Comstock, Patrick J. Heagerty, Giana H. Davidson, David R. Flum, Larry G. Kessler. Analysis of Outcomes Associated With Outpatient Management of Nonoperatively Treated Patients With AppendicitisJAMA Network Open, 2022; 5 (7): e2220039 DOI: 10.1001/jamanetworkopen.2022.20039
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