Jiang Ying,Zhao Xiangyou,Deng Keheng,et al.Comparative study of different treatment methods for pediatric periappendiceal abscess[J].Journal of Clinical Pediatric Surgery,,():1069-1073.[doi:10.3760/cma.j.cn101785-202503115-015]
Comparative study of different treatment methods for pediatric periappendiceal abscess
- Keywords:
- Abscess; Appendicitis; Laparoscopy; Ultrasound Guidance; Antibiotics
- Abstract:
- Objective To compare the therapeutic effects of laparoscopic abscess drainage (LAD) plus antibiotic therapy (AT),ultrasound-guided abscess drainage (UGAD) plus AT,and AT alone in children with periappendiceal abscess. Methods The clinical data of 103 children with periappendiceal abscesses admitted to Yichang Central People’s Hospital from July 2020 to June 2023 were retrospectively analyzed.According to the treatment modality,they were divided into LAD+AT group (n=23),UGAD+AT group (n=36),and AT group (n=44).Baseline characteristics (gender,age,duration of illness,abscess diameter,and leukocyte count on admission) and treatment outcomes (time to normalization of body temperature,white blood cell count,and C-reactive protein; duration of antibiotic use; length of hospital stay; hospitalization costs; abscess recurrence rate; and outcome of interval appendectomy) were compared among the three groups. Results No significant differences were found in baseline characteristics among the three groups (P>0.05).Regarding efficacy indicators,the AT group had significantly longer times to normalization of temperature [(4.6±1.6) days],white blood cell [(7.2±1.5) days],and CRP [(9.6±2.1) days],as well as longer antibiotic courses [(13.3±1.3) days]and hospital stays [(16.9±3.9) days],than both the LAD+AT group [(3.3±1.3) days,(5.3±1.1) days,(7.1±1.7) days,(5.6±1.1) days,(10.2±4.3) days]and UGAD+AT group [(2.9±0.78) days,(5.5±1.2) days,(7.4±2.0) days,(5.8±0.9) days,(9.6±3.8) days](P<0.05).Hospitalization cost in the LAD+AT group [(13,258±2,057) yuan]was significantly higher than in the UGAD+AT [(8,762±1,109) yuan]and AT [(7,794±938) yuan]groups (P<0.05).The abscess recurrence in the AT group (15.9%) was markedly higher than in the other two groups (0%,2.8%) (P<0.05). Conclusions The combination of UGAD and antibiotic therapy provides effective treatment with faster recovery and lower cost,making it a safe and efficient option for pediatric periappendiceal abscess.For abscesses unsuitable for ultrasound-guided drainage,LAD+AT serves as an alternative with similarly favorable outcomes.Early implementation of appropriate abscess drainage combined with antibiotic therapy represents an ideal strategy for managing pediatric periappendiceal abscess.
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Memo
收稿日期:2025-3-31。
基金项目:湖北省自然基金联合基金项目(2024AFD184)
通讯作者:郭兆坤,Email:12893437@qq.com