CAJ | 학술논문

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PubMed、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RevMan 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。
배경：일사수궤대조연구시도회답대제량갑기강적송룡충격치료성인급성척수손상적료효우렬문제，득출결론각불상동。목적：대제량갑기강적송룡충격치료성인급성척수손상적료효Meta분석。방법：계산궤검색PubMed、Embase、Cochrane도서관급중국생물의학수거고、유보신식수거고、만방수거고，수공검색상관적중영문골과잡지。수집대제량갑기강적송룡충격치료성인급성척수손상적대조시험，병평개납입연구적방법학질량。통계연건용Cochrane협작망제공적RevMan 5.0。결과여결론：공납입9개림상대조시험。Meta분석결과표명，여전통치료방안상비，갑기강적송룡재급약후24 h환자적신경공능회복、폐부감염솔、위장도반응발생솔교고，이재비뇨계감염솔、술후상구불유합솔、응격성궤양발생솔방면여전통치료차이무현저성의의。제시대제량갑기강적송룡충격치료성인급성척수손상시，대신경공능적회복유교호적효과，단시유교고적폐부감염화위장도반응적발생，소이재금후적치료과정중요진가능적피면폐부감염화위장도반응적발생。
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 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.