大剂量甲基强的松龙冲击治疗成人急性脊髓损伤疗效的Meta分析  

High-dose methylprednisolone sodium succinate therapy for acute spinal cord injury in adults: a Meta-analysis

作　　者：刘向栋 王磊[2] 董喆[2] 马延辉[2] 呼芳[2] 马改平[2] 王凤凤[3] 杨生军[4] 

机构地区：[1]延安大学附属医院骨科三病区,陕西省延安市716000 [2]延安大学附属医院骨科四病区,陕西省延安市716000 [3]延安大学附属医院血液免疫科,陕西省延安市716000 [4]延安大学附属医院医务科,陕西省延安市716000

出　　处：《中国组织工程研究》2015年第42期6875-6881,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:一些随机对照研究试图回答大剂量甲基强的松龙冲击治疗成人急性脊髓损伤的疗效优劣问题,得出结论各不相同。目的:大剂量甲基强的松龙冲击治疗成人急性脊髓损伤的疗效Meta分析。方法:计算机检索Pub Med、Embase、Cochrane图书馆及中国生物医学数据库、维普信息数据库、万方数据库,手工检索相关的中英文骨科杂志。收集大剂量甲基强的松龙冲击治疗成人急性脊髓损伤的对照试验,并评价纳入研究的方法学质量。统计软件用Cochrane协作网提供的Rev Man 5.0。结果与结论:共纳入9个临床对照试验。Meta分析结果表明,与传统治疗方案相比,甲基强的松龙在给药后24 h患者的神经功能恢复、肺部感染率、胃肠道反应发生率较高,而在泌尿系感染率、术后伤口不愈合率、应激性溃疡发生率方面与传统治疗差异无显著性意义。提示大剂量甲基强的松龙冲击治疗成人急性脊髓损伤时,对神经功能的恢复有较好的效果,但是有较高的肺部感染和胃肠道反应的发生,所以在今后的治疗过程中要尽可能的避免肺部感染和胃肠道反应的发生。BACKGROUND：Some control studies attempt to answer the advantages and disadvantages of high-dose methylprednisolone sodium succinate therapy for acute spinal cord injury in adults, but have arrived at different conclusions. OBJECTIVE：To explore the therapeutic efficacy of high-dose methylprednisolone sodium succinate therapy on acute spinal cord injury in adults by Meta analysis. METHODS：PubMed, Embase, Cochranel Library, CBMdisc, VIP and WanFang Databases were searched by computer, and relevant Chinese and English orthopedic journals were retrieved by hand. Controled trials related to high-dose methylprednisolone sodium succinate therapy of acute spinal cord injury in adults were included. The methodology quality of included trials was criticaly assessed. RevMan 5.0 software was used for data analysis. RESULTS AND CONCLUSION：Nine clinical controled trials were included. Meta-analysis results showed that compared with the conventional therapy, the neurological recovery rate after 24 hours of administration, pneumonia incidence and gastrointestinal reactions increased significantly after high-dose methylprednisolone＆amp;nbsp;sodium succinate therapy. However, there were no statistical differences in the rate of urinary tract infection, nonunion rate and stress ulcer incidence between these two therapies. These findings indicate that the high-dose methylprednisolone sodium succinate therapy on acute spinal cord injury in adults has better outcomes in neurological function recovery, but can lead to higher incidence of lung infection and gastrointestinal reactions. Therefore, lung infection and gastrointestinal reactions should be avoided as much as possible during the course of treatment.

关 键 词：组织构建 组织工程 急性脊髓损伤 甲基强的松龙 大剂量 冲击治疗 并发症 对照试验 META分析 

分 类 号：R318[医药卫生—生物医学工程]