JAMA:地塞米松不能降低1岁以下幼儿体外循环心脏手术后不良预后风险

2020-06-24 MedSci原创 MedSci原创

在接受体外循环心脏手术的12个月以下婴儿中,与安慰剂相比,术中应用地塞米松并没有显著降低主要并发症和30天死亡率

皮质类固醇在小儿心脏手术中得到广泛的应用,其目的是减轻全身炎症反应和减少并发症,但其临床疗效尚不确定。近日研究人员考察了术中使用地塞米松对减少儿科心脏手术期间的主要并发症和死亡率的影响。
 
研究在中国、巴西和俄罗斯的4个中心开展,共有394名12个月以下的婴儿接受体外循环心脏手术,并随访至2018年11月。地塞米松组(n=194)给予1 mg/kg地塞米松;对照组(n=200)麻醉诱导后静脉注射等量生理盐水。研究的主要终点为死亡,非致命性心肌梗死,需要体外膜氧合治疗,需要心肺复苏,急性肾损伤,机械通气时间延长或术后30天内出现神经系统并发症的复合。共有17个次要终点,包括机械通气时间、肌力指数、重症监护病房住院时间、再入院重症监护病房时间和住院时间。
 
394名患者(中位年龄,6个月;47.2%为男孩)完成了试验。地塞米松组主要终点发生74例(38.1%),对照组91例(45.5%,绝对风险降低7.4%;危险比:0.82)。在17个预先指定的次要终点中,组间无统计学差异。地塞米松组4例(2.0%)感染,对照组3例(1.5%)感染。
 
在接受体外循环心脏手术的12个月以下婴儿中,与安慰剂相比,术中应用地塞米松并没有显著降低主要并发症和30天死亡率。
 
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  2. [GetPortalCommentsPageByObjectIdResponse(id=2040069, encodeId=1b74204006976, content=<a href='/topic/show?id=b108265523a' target=_blank style='color:#2F92EE;'>#体外循环心脏手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26552, encryptionId=b108265523a, topicName=体外循环心脏手术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5c0050, createdName=lishiwen, createdTime=Sat May 08 13:37:52 CST 2021, time=2021-05-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813329, encodeId=828c8133293a, content=👍, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Wed Aug 26 08:42:18 CST 2020, time=2020-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1336412, encodeId=b3ad133641282, content=<a href='/topic/show?id=071820530c5' target=_blank style='color:#2F92EE;'>#不良预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20530, encryptionId=071820530c5, topicName=不良预后)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c97a2500111, createdName=thinkibmz_44722594, createdTime=Fri Jun 26 09:37:52 CST 2020, time=2020-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1344561, encodeId=54ca13445613a, content=<a href='/topic/show?id=896f26550c8' target=_blank style='color:#2F92EE;'>#体外循环#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26550, encryptionId=896f26550c8, topicName=体外循环)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Fri Jun 26 09:37:52 CST 2020, time=2020-06-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036144, encodeId=93041036144b2, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Wed Jun 24 21:37:52 CST 2020, time=2020-06-24, status=1, ipAttribution=)]
    2020-08-26 14818eb4m67暂无昵称

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    2020-06-24 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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