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儿童桃体切除术后使用类固醇:系统性审查和元分析
Elizabeth M Puyo1, Jillian L Chen1, Rahul Mullick1
1Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
International journal of pediatric otorhinolaryngology
|October 14, 2025
概括
手术后的类固醇可以提供一些疼痛缓解,并减少小儿桃体切除术患者的恶心/吐. 然而,证据不一致,类固醇并没有显著影响术后出血率.
科学领域:
- 儿科外科手术 儿科外科手术
- 药理学 药理学是指药理学的学科.
- 麻醉学 麻醉学
背景情况:
- 在桃体切除术后治疗儿科疼痛的可代因使用是禁忌的.
- 在腺切除术后需要替代止痛药.
- 类固醇正在被探索作为一种替代性疼痛管理策略.
研究的目的:
- 系统地审查小儿桃体切除术中术后类固醇的疗效.
- 评估类固醇对疼痛,恶心,吐和出血的影响.
- 评估在儿科患者中使用类固醇后的临床结果.
主要方法:
- 在PubMed/MEDLINE,Cochrane图书馆和Embase (2013-2024) 的系统文献综述中.
- 包括随机对照试验,队列和观察性研究.
- 使用随机效应模型计算术后出血的汇集风险比率.
主要成果:
- 八项研究 (4,598名患者) 满足了纳入标准,显示了类固醇协议的异质性.
- 在五项研究中,有三项报告说,在某些时间点显著减少疼痛.
- 术后出血没有显著减少 (RR 0.88);恶心和吐的结果不一致.
结论:
- 术后类固醇可能对疼痛和恶心/吐有好处,但证据有限且不一致.
- 类固醇并不能显著降低儿科桃体切除术中的术后出血率.
- 需要进一步的研究来确定类固醇在康复中的确切作用.
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