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各种类型的皮质类固醇在预防术后化和再化方面的比较疗效:系统性审查和网络元分析
I-Jung Feng1, Jia-Wei Lin2, Chih-Cheng Lai3
1Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.
Frontiers in medicine
|August 9, 2023
概括
甲基普雷迪尼索隆和德克萨米他显著降低了成年人体内化后化和再化风险. 这些皮质类固醇是预防机械通风后这些常见并发症的最有效的治疗方法.
科学领域:
- 关键护理医学 关键护理医学
- 药理学 药理学是指药理学的学科.
- 呼吸系统医学 呼吸系统医学
背景情况:
- 在机械通风的成年人中,管后的管和再管是显著的并发症.
- 皮质类固醇经常用于预防这些不良事件,但它们的比较疗效尚未完全确定.
研究的目的:
- 系统地评估和比较各种皮质类固醇治疗方法的疗效,以预防计划外注的成年人进行后化和再化.
主要方法:
- 进行了随机对照试验 (RCT) 的系统审查和元分析.
- 搜索了主要的数据库 (PubMed,Embase,Cochrane) 和ClinicalTrials.gov,查找到2022年9月29日发布的相关RCT.
- 主要结局是抽后的Stridor;次要结局是重新灌输.
主要成果:
- 分析了11个涉及甲基prednisolone,德克萨梅他,皮和安慰剂的RCT.
- 与安慰剂相比,甲基prednisolone 和dexamethasone 显著降低了 postextubation stridor 的风险 (甲基prednisolone 的OR=0.22,95% CI=0.11-0.41; dexamethasone 的OR=0.39,95% CI=0.22-0.70).
- 与安慰剂相比,这两种药物也显著降低了重新灌输率 (OR=0.42,95% CI=0.25-0.70用于甲基前尼索隆;OR=0.34,95% CI=0.13-0.85用于德克萨米他).
- 甲基普雷迪尼索隆的风险低于皮松 (OR=0.24,95% CI=0.08-0.67).
- 集群分析表明,甲基prednisolone和德克萨米他提供了最低的风险,无论是斯特里多和再输管.
结论:
- 甲基prednisolone和dexamethasone是最有效的皮质类固醇药物,用于防止在机械通风成年人 postextubation stridor和reintubation.
- 这些发现支持在有计划的输出的患者中使用甲基prednisolone或dexamethasone以减轻与呼吸道相关的并发症.
关键词:
德克萨米他是一种这种药物是Hydrocortisone.甲基普雷迪尼索隆 (Methylprednisolone) 是一种可以网络元分析 网络元分析在化后的化过程中,Stridor.重新灌输输道的使用方法更多相关视频
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