Abstract: 【Abstract】〓Objective〓To analyze and compare the clinical effect and safety of antibiotic therapy and appendectomy for the treatment of acute uncomplicated appendicitis (AUA). Methods Patients who met the inclusion and exclusion criterions were assigned to two groups, antibiotic group (108 cases) and surgery group (111 cases). The cases in the antibiotic group received classes of antimicrobial agents plus metronidazole and the ones in the surgery groups received appendectomy and perioperative antibiotic treatment. The treatment effect was regarded as the primary outcome. The other clinical effects were compared between two groups. Results〓All the cases in the surgery group underwent successful appendectomy, leading to a success incidence of 100%. Moreover, the ones in the antibiotic group had a successful treatment incidence of 77.8% (84/108). The intention to treatment analysis yielded a difference in treatment efficacy of two groups of 22.2%, which was within the range of prespecified noninferiority margin of 24%. Hence efficacy of antibiotic treatment was similar to surgery. Moreover, the cases in the antibiotic group had favor outcomes in the fields of complications, expenses, visual analog scale (VAS) for pain feeling during hospital stay. Conclusion The patients with AUA received antibiotic treatment had a similar curative effect than the ones following appendectomy. Moreover, the AUA patients with antibiotic treatment had less pain, recovered faster and spent less.

Key words: Antibiotic treatment, Appendectomy, Acute uncomplicated appendicitis

摘要： 【摘要】 目的〓分析比较单纯抗生素治疗及阑尾切除术在治疗急性非复杂性阑尾炎(AUA)中的疗效及安全性。方法〓符合入组及排除标准的患者分为2组:抗生素组(108例)及手术组(111例)。抗生素组中的患者接受头孢类联合甲硝唑的抗菌方案,手术组中的患者接受阑尾切除术及围手术期抗菌治疗。研究的首要研究指标是治疗疗效,继而分析两组患者间其他临床疗效因素的异同。结果〓手术组的所有患者中手术顺利,治疗成功率为100.0%。抗生素组中治疗成功率为77.8%(84/108)。意向分析研究结果发现两组患者间疗效相差22.2%,在24%的非劣性研究范围内,认为抗生素治疗效果并不劣于手术治疗。研究发现抗生素组的患者在并发症、住院费用、住院期间疼痛VAS评分方面明显优于手术组。结论〓接受抗生素治疗的AUA患者的疗效与阑尾切除的相近,而且接受抗生素治疗的AUA患者疼痛少、恢复快、花费少,结合较低的急性阑尾炎复发率显示抗生素治疗AUA是可行的方法。

关键词: 急性非复杂性阑尾炎, 抗生素治疗, 阑尾切除术