Title：Cellulitis in the ED: Admit or Outpatient Therapy?
题目：急诊科就诊的蜂窝组织炎：是住院还是院外治疗？
Author 作者：EMedHome.com
翻译：步涨 校对：陈都，肖锋
There are no widely accepted clinical decision rules to assist clinicians in deciding which stable, non-toxic ED patients with cellulitis should be treated as an outpatient, and which should be admitted.
尚无被广泛接受的临床诊断标准帮助临床医师做出决定，对病情稳定，不严重的蜂窝组织炎急诊病人是应该进行院外治疗还是住院治疗。

Typically, the decision is based upon judgment and gestalt. However, several recent studies have identified clinical findings that may predict the failure of outpatient therapy (1-3).
以往，这个决定往往基于医师的判断和认识。然而最近有几个研究已确定一些临床指标将预测回家治疗可能会失败。
Of note, all 3 of these studies found that the presence of fever (> 100.4°F) upon ED arrival was associated with outpatient treatment failure (OR in the studies ranged from 2.5 to 4.3).
值得注意的是，所有这3项研究中发现，来到急诊科伴有发热（>38 ℃ ）的患者其门诊治疗失败的可能性较高（优势比在这些研究中从2.5到4.3 ）。
Other clinical findings that were found, to a lesser degree, to be independently associated with outpatient treatment failure included: chronic leg ulcers, chronic edema, prior cellulitis in the same area, cellulitis at a wound site, and cellulitis of the hand.
其他临床研究结果发现：以下情况也与院外治疗失败有独立性关系，包括：慢性下肢溃疡，慢性水肿，在同一个区域再次发生的蜂窝组织炎，创伤部位的蜂窝组织炎，以及手的蜂窝织炎。
The presence of one of these risk factors should prompt the clinician to ensure good follow-up, if not consideration of admission.
如果以上这些高风险因素只要有一个存在，如果临床医师不打算让病人住院的话，一定要保证这些病人的密切随访。
References 参考文献：
(1) Peterson D, et al. Acad Emerg Med 2014 May;21(5):526-531.
(2) Volz KA, et al. Am J Emerg Med 2013 Feb;31(2):360-364.
(3) Sabbaj A, et al. Acad Emerg Med 2009 Dec;16(12):1290-1297.