The effect of preoperative high dose methylprednisolone in attenuating the metabolic response after oesophageal resection.
The effect of preoperative high dose methylprednisolone in attenuating the metabolic response after oesophageal resection.
复制标题
术前大剂量甲基泼尼松龙减弱食管切除术后代谢反应的作用。
DOI：
--
复制
发表时间：
1997
期刊：
影响因子：
--
通讯作者：
T. Takano
中科院分区：
文献类型：
--
作者：
S. Takeda;Ryo Ogawa;K. Nakanishi;Chol Kim;M. Miyashita;K. Sasajima;M. Onda;T. Takano
目标
评估术前给予糖皮质激素预防手术应激的效果。
设计
前瞻性随机研究。
设置
日本大学医院。
科目
30例接受食管癌切除术的患者。
干预措施
15 名患者（第 1 组）随机接受甲基强的松龙（30 mg/kg），15 名患者（第 2 组）在术前静脉注射生理盐水。
主要成果指标
结果、重症监护病房 (ICU) 的住院时间、代谢反应和氧合。
结果
接受甲泼尼龙治疗的患者在 ICU 的平均停留时间为 5.1 +/- 1.0 天，而生理盐水组的平均停留时间为 8.2 +/- 4.5 天 (p < 0.01)。生理盐水组有 5 名患者出现术后并发症，而甲泼尼龙组有 0 名患者出现术后并发症 (p = 0.02)。甲泼尼龙组血浆去甲肾上腺素和精氨酸加压素水平显着低于生理盐水组（p < 0.05）。生理盐水组的 PaO2:FiO2 比值显着低于实验组 (p < 0.01)。
结论
术前甲基泼尼松龙可能有助于手术患者的术后管理。
OBJECTIVE
To evaluate the effect of giving glucocorticoids preoperatively for the prophylaxis of surgical stress.
DESIGN
Prospective randomised study.
SETTING
University hospital, Japan.
SUBJECTS
30 patients undergoing resection of oesophageal carcinoma.
INTERVENTIONS
15 patients (group 1) were randomised to be given methylprednisolone (30 mg/kg) and 15 patients (group 2) to be given saline intravenously before operation.
MAIN OUTCOME MEASURES
Outcome, length of stay in the intensive care unit (ICU), metabolic response, and oxygenation.
RESULTS
Patients given methylprednisolone had a mean stay in the ICU of 5.1 +/- 1.0 days compared with 8.2 +/- 4.5 days in the saline group (p < 0.01). 5 patients in the saline group compared with 0 in the methylprednisolone group developed postoperative complications (p = 0.02). Plasma norepinephrine and arginine vasopressin levels in methylprednisolone group were significantly lower than those in the saline group (p < 0.05). The PaO2:FiO2 ratio in the saline group was significantly lower than that in the experimental group (p < 0.01).
CONCLUSIONS
Preoperative methylprednisolone may facilitate the postoperative management of surgical patients.