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经手术时给予德克萨米他和儿童桃体切除术后出血的风险:一项随机对照试验
Thomas Q Gallagher1, Courtney Hill, Shilpa Ojha
1Department of Otolaryngology, Naval Medical Center Portsmouth, Portsmouth, Virginia, USA.
德克萨米他在小儿桃体切除术后并没有显著增加严重出血. 然而,它可能会导致更主观的出血事件,因此需要仔细考虑其使用.
科学领域:
- 儿科外科手术 儿科外科手术
- 麻醉学 麻醉学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 皮质类固醇经常用于儿科桃体切除术,以控制恶心和吐.
- 人们担心它们可能会增加术前和术后出血的风险.
研究的目的:
- 评估德克萨米他对儿童桃体切除术后出血的影响.
- 为了测试德克萨米他与安慰剂相比不会增加超过5%的出血事件的假设.
主要方法:
- 一个多中心,随机,双盲,安慰剂对照试验,涉及314名3-18岁儿童.
- 参与者接受了单次术前剂量德克萨米他或安慰剂.
- 使用14天的术后随访和标准化出血量表来评估出血严重程度.
主要成果:
- 这项研究包括每组157名儿童.
- 一级出血 (主观) 发生在甲松组的7.0%,与安慰剂组的4.5%相比.
- 临床显著的出血 (II级和III级) 率较低,并没有显著增加德甲.
结论:
- 在小儿桃体切除术中,外科期间使用德克萨米他与过度临床显著出血 (II/III级) 无关.
- 对主观出血 (I级) 的非劣势值被越过,这表明轻微出血事件的潜在增加.
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