儿童中度眶周蜂窝织炎和家庭疗法评估(EPOCH 研究,第二部分):前瞻性单中心队列研究。

IF 4.9 2区 医学 Q1 OPHTHALMOLOGY Clinical and Experimental Ophthalmology Pub Date : 2024-10-23 DOI:10.1111/ceo.14455
Zachary McPherson, Deepali Thosar, Amie Donnelly, Nadine Shaw, Julia Starte, Michael Jones, Shefali Jani
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引用次数: 0

摘要

背景:小儿眶周蜂窝织炎是一种常见的眼部疾病,由于担心眼眶扩散,通常需要住院静脉注射抗生素。本研究旨在评估门诊治疗中度眶周蜂窝织炎患儿的安全性和有效性:在 24 个月的时间里,我们对 84 名在急诊科就诊的 1-16 岁中度眶周蜂窝织炎患儿进行了前瞻性登记。我们收集了人口统计学和临床数据。根据基于指南的决策树,符合条件的患儿接受了静脉注射抗生素治疗,出院后在门诊和眼科诊所接受外周插管随访。数据采用描述性统计:结果:在 84 名儿童中,62 名(73.8%)通过非住院治疗模式进行了治疗。在中度POC类别中,入院治疗的患儿CRP或白细胞计数并不高,接受静脉注射抗生素的时间也相同。非住院治疗诊所每天共提供 132 剂静脉注射抗生素。在该路径下接受治疗的两名患儿因临床症状恶化而需要住院治疗,其中一名患儿需要接受眼科手术治疗。本研究中没有出现死亡或危及视力的并发症:结论:事实证明,对患有中度眶周蜂窝织炎的儿童实施非住院治疗路径是一种有效而安全的管理策略。这种方法在减少医院床位紧张的同时,也促进了以社区为基础的患者护理。
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Evaluation of moderate periorbital cellulitis and home-based therapy in children (EPOCH study, Part 2): A prospective single centre cohort study.

Background: Paediatric periorbital cellulitis, a common eye condition, typically requires inpatient admission for intravenous antibiotics due to concerns about orbital spread. This study aimed to assess the safety and effectiveness of ambulatory management for children with moderate periorbital cellulitis.

Methods: Over a 24-month period, we prospectively enrolled 84 children aged 1 to 16 years who presented with moderate periorbital cellulitis to the emergency department. Demographic and clinical data were collected. Following a guideline-based decision tree, eligible children received intravenous antibiotics and were discharged with a peripheral cannula for follow-up in ambulatory care and ophthalmology clinics. Descriptive statistics were used for data presentation.

Results: Among the 84 children, 62 (73.8%) were managed through the ambulatory care model. Within the category of moderate POC, those who were admitted to the hospital did not have higher CRP or White Cell counts and received IV antibiotics for the same length of time. The ambulatory care clinic provided a total of 132 daily doses of intravenous antibiotics. Two children treated on this pathway required inpatient admission due to clinical deterioration, one of whom required ophthalmic surgical intervention. There was no mortality or sight-threatening complications in this study.

Conclusions: Implementing a directed ambulatory care pathway for children with moderate periorbital cellulitis proved to be an effective and safe management strategy. This approach reduces the strain on hospital bed occupancy while promoting community-based patient care.

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来源期刊
CiteScore
7.60
自引率
12.50%
发文量
150
审稿时长
4-8 weeks
期刊介绍: Clinical & Experimental Ophthalmology is the official journal of The Royal Australian and New Zealand College of Ophthalmologists. The journal publishes peer-reviewed original research and reviews dealing with all aspects of clinical practice and research which are international in scope and application. CEO recognises the importance of collaborative research and welcomes papers that have a direct influence on ophthalmic practice but are not unique to ophthalmology.
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