高剂量甲基普雷迪尼索隆在Zargar IIB级腐蚀性食道烧伤中的作用:一项随机对照研究
Irtiqa Sheikh1, Nayer Jamshed1, Akhil Neseem1
1Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India.
高剂量的甲基prednisolone没有防止食道收缩后腐蚀性摄入. 然而,它显著降低了食凝肠切除术的需要,并改善了患者的呼吸道损伤.
科学领域:
- 胃肠病学 胃肠病学
- 紧急医疗 紧急医疗
- 临床药理学 临床药理学
背景情况:
- 腐蚀性摄入可以导致严重的食道损伤和狭窄形成.
- 食道狭窄通常需要手术干预和长期管理.
- 高剂量的皮质类固醇有时被考虑用于管理炎症状况.
研究的目的:
- 评估高剂量甲基普雷迪尼索隆在食腐性摄入后预防食道狭窄形成方面的疗效.
- 评估甲基普雷迪尼索隆对相关气道损伤的影响以及需要营养支持的需要.
主要方法:
- 一个单中心的,随机的,单盲的受控研究.
- 随机对30名成年患者进行了随机分类,这些患者在食用腐蚀性物质后24小时内患有Zargar IIB级食道损伤.
- 干预组接受了静脉注射甲基prednisolone (1g/天3天);对照组接受了正常的盐水.
主要成果:
- 甲基普雷迪尼索隆和安慰剂组之间的狭窄形成没有统计学上显著的差异 (33%与46.6%,P=0.462).
- 在甲基普雷迪尼索隆组的患者中,需要食的患者数量显著减少 (7.7%与40%,P=0.048).
- 在干预手臂中观察到呼吸道损伤的临床改善,尽管在统计学上并不显著 (P=0.674). 没有发现增加的不良事件.
结论:
- 高剂量的甲基prednisolone在防止食道收缩后腐蚀性摄入是无效的.
- 甲基普雷尼索隆显著降低了食凝肠术的需要,并显示出在管理相关的呼吸道损伤方面具有潜在的益处.
- 进一步的研究可能会探索皮质类固醇在特定伤害模式或呼吸道管理中的使用.
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