1例无痛性胆囊炎的循证治疗
吴东;李冬晶;
摘要(Abstract)：
目的采用循证医学方法 为1例不典型老年胆囊炎患者制定诊治方案。方法 根据临床问题检索Co-chrane图书馆、ACP Journal Club、MEDLINE及美国国家指南交换中心,获取并评价相关系统评价的质量及适用性。结果 共获得有关急性胆囊炎物理诊断的系统评价1篇,有关腹腔镜切除胆囊手术时机的系统评价5篇。以上证据表明:单凭腹痛等临床表现通常不足以排除或肯定急性胆囊炎的诊断,仅Murphy征诊断价值相对较高(阳性似然比2.8,阴性似然比0.5);早期(起病4~7d内)腹腔镜胆囊切除术与择期(症状缓解6~12周后)手术相比,住院时间明显缩短,而并发症率和转开腹率无显著差异。结合客观证据、患者意愿和医院技术条件,为患者实施了早期腹腔镜胆囊切除术。经过3个月的随访,证实治疗取得成功。结论循征医学方法 有助于不典型胆系疾病的早期诊断和合理治疗。
关键词(KeyWords)：
急性胆囊炎;腹腔镜胆囊切除术;循征医学
基金项目(Foundation):
作者(Author):
吴东;李冬晶;
Email:
DOI:
参考文献(References)：
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