Q阑尾炎破掉形成浓疡是不是保守治疗比直接进去开刀还要好.PPT

EBM discussion Speaker: 泌尿科R1陳柏仲 Advisor: 一般外VS郭威廷 題目 Q1.闌尾炎真的要開刀嗎？光是吃藥打針不會好嗎？ P: patient with appendicitis I: surgical intervention C: medical treatment O: survival rate、disease-free rate Search Strategy Key word:appendicitis、appendectomy、medical treatment、antibiotics、supportive care…etc. Search web:PubMed, Medline, Cochrane, Key word: appendicitisSearch web: the Cochrane library Key word: appendicitisSearch web: PubMed Key word: appendicitis, antibioticsSearch web: PubMed READING…………. Results of Cochrane Explain the Q1 by Cochrane data Explain the Q1 by Cochrane data Explain the Q1 by Cochrane data Results of Pubmed Conclusion of Q1 Q1.闌尾炎真的要開刀嗎？光是吃藥打針不會好嗎？ 目前現階段的研究並無法確定單用Antibotics及Appendectomy兩者哪個比較好，但就以兩個月內康復及一年不復發的比例來說，Appendectomy較優；但Antibiotics較少Complication rate. Q2.闌尾炎破掉形成濃瘍，是不是保守治療比直接進去開刀還要好？ P: patient with perforating appendicitis I: surgical immediately C: conservative treatment than delay surgery O: survival rate、disease-free rate Search Strategy Key word:appendicitis、appendectomy、early、delay、abscess…etc Search web:PubMed, Medline, Cochrane, NGC Switch the Key word for several times……………. Key word: appendectomySearch web: the Cochrane library Conclusion of Q2 Q2.闌尾炎破掉形成濃瘍，是不是保守治療比直接進去開刀還要好？ 目前並無Level 1A的study。但有Level 2A的study。結論是：複雜性闌尾炎在兩者個治療方式上，住院天數、抗生素使用日數並無顯著差異。 但在腸阻塞、再次手術、感染、濃瘍形成的比例上來說，直接開刀進去的風險較高。 Thanks for attention~~~ * * We want！ We want！ READING…………. READING…………. Non-inferiority analyses Antibiotics: complication rate↓Appendectomy: recurrance rate↓ *