CAJ | 학술논문

目的对比手术治疗和保守治疗急性非复杂性阑尾炎的疗效和安全性.方法检索Cochrane Library、Embase、Medline、Pubmed、CBM、CNKI、VIP和万方数据库,没有语言限制.纳入从1983年1月-2013年5月发表的比较保守治疗与手术治疗急性非复杂性阑尾炎的随机对照试验并对其进行了质量学评价,最后用RevMan 5.1软件进行分析.结果 4个RCT符合研究标准(821个研究对象).在治疗过程中发生复杂性阑尾炎的风险(RR:0.89,95％CI:0.29 ～2.68)与发生腹腔感染方面(RR:0.54,95％ CI:0.13 ～2.35),保守治疗与手术治疗结果相比差异没有统计学意义.虽然保守治疗在住院时间上比手术治疗要长(Mean Difference 0.52,95％ CI:0.16 ～0.88),但是在并发症方面,保守治疗发病率低于手术治疗(RR:0.46,95％ CI:0.32 ～0.67).结论急性非复杂性阑尾炎的保守治疗效果是安全有效的,但是对于反复发作的非复杂性阑尾炎,建议手术治疗.
목적 대비수술치료화보수치료급성비복잡성란미염적료효화안전성.방법 검색Cochrane Library、Embase、Medline、Pubmed、CBM、CNKI、VIP화만방수거고,몰유어언한제.납입종1983년1월-2013년5월발표적비교보수치료여수술치료급성비복잡성란미염적수궤대조시험병대기진행료질량학평개,최후용RevMan 5.1연건진행분석.결과 4개RCT부합연구표준(821개연구대상).재치료과정중발생복잡성란미염적풍험(RR:0.89,95％CI:0.29 ～2.68)여발생복강감염방면(RR:0.54,95％ CI:0.13 ～2.35),보수치료여수술치료결과상비차이몰유통계학의의.수연보수치료재주원시간상비수술치료요장(Mean Difference 0.52,95％ CI:0.16 ～0.88),단시재병발증방면,보수치료발병솔저우수술치료(RR:0.46,95％ CI:0.32 ～0.67).결론 급성비복잡성란미염적보수치료효과시안전유효적,단시대우반복발작적비복잡성란미염,건의수술치료.
Objective To compare clinical effects of appendicectomy and conservative treatment of uncomplicated acute appendicitis.Methods Searched The Cochrane library,Medline,Pubmed,Embase,CBM,CNKI,VIP and Wan Fang database in any language.RCTs that compared conservative treatment with appendicectomy in patients with uncomplicated acute appendicitis were included from January 1983 to May 2013 and qualities of the trials were evaluated.Statistic analyses were carried out using RevMan 5.1 soft-ware.Results Four randomized trials met our inclusion criteria (821partiCI:pants).Antibiotics compared with appendicectomy resulted in similar outcomes with regards to the incidence of complicated appendicitis (RR:0.89,95％ CI:0.29-2.68) and intra-abdominal infection(RR:0.54,95％ CI:0.13-2.35).Antibiotics carries a lower risk of complications (RR 0.46,95％ CI:0.32-0.67),but requires more length of hospital stay (Mean Difference 0.52,95％ CI:0.16-0.88).Conclusions The effect of conservative treatment is safe and effective.But the recurrent uncomplicated appendicitis recommends operation.