组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2017, Vol. 13 ›› Issue (1): 29-33.doi: 10.3969/j.issn.1673-0364.2017.01.008

• 论著 • 上一篇    下一篇

中小剂量地塞米松预防下肢急性创伤后软组织早期并发症的临床研究

冯宇，张睿，张玲，信维伟   

  1. 上海交通大学医学院附属仁济医院；上海交通大学医学院附属仁济医院南院
  • 发布日期:2020-07-23

Small and Medium Dose of Dexamethasone on Prevention of Early Complications of Soft Tissue after Acute Trauma in Lower Extremity

FENG Yu,ZHANG Rui,ZHANG Ling,XIN Weiwei   

  • Published:2020-07-23
  • Contact: 上海市卫生与计划生育委员会科研课题面上项目

摘要： 目的 探讨中小剂量地塞米松对预防下肢急性创伤后软组织早期并发症的临床效果。方法 采用简单抽样法,选取2015年1月至2016年3月间在我院治疗的符合标准的350例患者,随机分为对照组(116例)、小剂量组(116例)和中等剂量组(117例)。患者入院后均接受基础治疗,对照组静脉推注葡萄糖注射液,小剂量组静脉推注地塞米松磷酸钠(0.1 mg/Kg),中等剂量组静脉推注地塞米松磷酸钠(0.2 mg/Kg)。比较3组患者的患肢水疱发生率、肢体周径比、IL-6与CRP水平、骨筋膜室综合征发生率,以及其他不良反应发生的差异。结果 48 h时,小剂量组及中等剂量组肢体周径比明显小于治疗前(P<0.05),且明显小于对照组(P<0.05);小剂量组及中等剂量组间无显著差异(P>0.05)。48 h时,小剂量组及中等剂量组IL-6、CRP水平明显低于治疗前(P<0.05),并明显低于对照组(P<0.05);中等剂量组亦明显低于小剂量组(P<0.05)。小剂量组及中等剂量组患肢水疱发生率、骨筋膜室综合征发生率均明显低于对照组(P<0.05);中、小剂量组间无明显差异(P>0.05)。三组间其他不良反应发生率差异无统计学意义(P>0.05)。结论 中小剂量地塞米松均可有效预防下肢急性创伤后软组织早期并发症,但该效果没有明显的剂量依赖性。

关键词: 中小剂量, 地塞米松, 下肢急性创伤, 软组织早期并发症

Abstract: Objective To investigate the clinical effect of small and medium dose of dexamethasone on prevention of early complications of soft tissue after acute trauma in lower extremity. Methods From January 2015 to March 2016, 350 patients with acute trauma in lower extremity were selected by using simple sampling method. All the patients were divided into 3 groups through a simple randomization, 116 cases in the control group, 116 cases in the small dose group, 117 cases in the medium dose group. All patients were treated with basic treatment, then the control group were treated with glucose infusion by intravenous injection, small dose group were treated with dexamethasone (0.1 mg/Kg) infusion by intravenous injection, medium dose group were treated with dexamethasone (0.2 mg/Kg) infusion by intravenous injection. The difference of limb blister incidence, limb circumference ratio, IL-6, CRP, osteofascial compartment syndrome occurred rate and adverse reaction rate among the three groups were compared. Results Limb circumference ratio of small dose group and medium dose group at 48 h were significantly less than that before treatment (P0.05). The level of CRP and IL-6 at 48 h in small dose group and medium dose group were significantly lower than that before treatment (P0.05). The adverse reaction among the three groups had no statistical significance ( P>0.05). Conclusion The rate of early complications of soft tissue after acute trauma of lower extremity can be effectively reduced by application of small and medium dose of dexamethasone. However, application of medium dose of dexamethasone can not increase the patient's clinical effect.

Key words: Small and medium dose, Dexamethasone, Acute trauma of lower extremity, Early complications of soft tissue

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