J Pediatr Orthop:非甾体抗炎药对小儿骨折骨愈合的影响

2021-07-23 MedSci原创 MedSci原创

小儿骨折的不愈合是一个相对罕见的临床问题。与成人相比,更厚的骨膜、更大的骨膜下血肿、活跃的肢体和增强的代谢活动促进了更快的愈合,减少了不愈合的发生率。尽管骨折愈合能力有所提高,但非甾体抗炎药(NSAI

小儿骨折的不愈合是一个相对罕见的临床问题。与成人相比,更厚的骨膜、更大的骨膜下血肿、活跃的肢体和增强的代谢活动促进了更快的愈合,减少了不愈合的发生率。尽管骨折愈合能力有所提高,但非甾体抗炎药(NSAIDs)对成人骨折愈合的不利影响足以导致许多医疗机构限制在小儿骨折患者中使用这些药物。目前还没有前瞻性的、随机的临床研究来评估非甾体抗炎药对骨骼不成熟人群的长骨骨折愈合的影响。近日,一项前瞻性、随机、平行、单盲的研究调查了骨折儿童骨愈合的急性期使用NSAIDs是否会导致延迟愈合或不愈合研究结果已发表于J Pediatr Orthop。

研究纳入了骨骼不成熟的长骨骨折患者,随机分为两组,其中一组用于骨折后的疼痛管理。非甾体抗炎药组使用布洛芬,而对照组不使用任何非甾体抗炎药,使用对乙酰氨基酚。两组都被允许使用羟考酮治疗骨折疼痛。主要结果是在2、6和10周时评估骨折愈合。

 

2014年2月6日至2016年9月23日期间共纳入122名患者。95名患者(有97处骨折)完成了6个月的随访(对照组46名患者有47处骨折,NSAID组49名患者有50处骨折)。没有一个人在1-2周时达到愈合。到6周时,对照组45名患者中的37名(82%)和布洛芬组50名患者中的46名(92%)实现了骨折愈合(P=0.22)。在10-12周的随访中,对照组有46人(98%)骨折愈合,布洛芬组有50人(100%)骨折愈合。所有的骨折在6个月前都已愈合。对照组治愈的平均天数为40天,布洛芬组为31天(P=0.76)。对照组使用羟考酮的平均天数为2.4天,NSAID组为1.9天(P=0.48)。

综上,布洛芬是治疗儿童骨折疼痛的有效药物,使用布洛芬不会损害骨骼不成熟患者的临床或影像学长骨骨折愈合。

 

原始出处:

 

Julia A V Nuelle,et al., Effect of NSAID Use on Bone Healing in Pediatric Fractures: A Preliminary, Prospective, Randomized, Blinded Study. J Pediatr Orthop. 2020 Sep;40(8):e683-e689. doi: 10.1097/BPO.0000000000001603.

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    2021-08-24 feather89
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    2021-07-24 redcrab
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    2022-03-26 仁心济世
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    2021-07-23 naninii

    深度好文,学习了!

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1729050, encodeId=e7021e2905000, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Tue Aug 24 22:21:49 CST 2021, time=2021-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2026993, encodeId=55d5202699349, content=<a href='/topic/show?id=921d101668c8' target=_blank style='color:#2F92EE;'>#骨愈合#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101668, encryptionId=921d101668c8, topicName=骨愈合)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=85aa264, createdName=redcrab, createdTime=Sat Jul 24 18:21:49 CST 2021, time=2021-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1639812, encodeId=21af1639812fc, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Sat Mar 26 07:21:49 CST 2022, time=2022-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1338710, encodeId=b7b51338e1078, content=<a href='/topic/show?id=afff99560c4' target=_blank style='color:#2F92EE;'>#非甾体抗炎药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99560, encryptionId=afff99560c4, topicName=非甾体抗炎药)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/7F67E3BE360D6DD1D0A62E3E71E23CB6/100, createdBy=9d8a2500148, createdName=ms8888626721583891, createdTime=Sun Jul 25 04:21:49 CST 2021, time=2021-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1346787, encodeId=f3681346e87ce, content=<a href='/topic/show?id=f20155404fc' target=_blank style='color:#2F92EE;'>#抗炎药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55404, encryptionId=f20155404fc, topicName=抗炎药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Sun Jul 25 04:21:49 CST 2021, time=2021-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1002004, encodeId=c1af100200452, content=深度好文,学习了!, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210723/f3898754b7724857820691702988bada/934b32939fc040218231218df688e493.jpg, createdBy=3a9c5485177, createdName=naninii, createdTime=Fri Jul 23 14:28:21 CST 2021, time=2021-07-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1002002, encodeId=e521100200294, content=已读已读已读已读已读已读,学习学习学习学习,受益匪浅, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Fri Jul 23 14:21:13 CST 2021, time=2021-07-23, status=1, ipAttribution=)]
    2021-07-23 ms5000000518166734

    已读已读已读已读已读已读,学习学习学习学习,受益匪浅

    0

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