Post-natal corticosteroid use
Post-natal corticosteroid use
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产后皮质类固醇的使用
DOI：
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发表时间：
2003
影响因子：
3.6
通讯作者：
A. Greenough
中科院分区：
文献类型：
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作者：
O. Williams;A. Greenough
在出生后的头两周内系统地给予皮质类固醇可以减少慢性肺部疾病(CLD)和死亡率，但人们对可能影响处方习惯的长期不良反应表示担忧。这项研究的目的是确定是否仍在开皮质类固醇，如果是，在使用最合适的方案方面是否达成了共识。英国所有223个新生儿病房的儿科顾问医生都收到了一份问卷，询问他们在使用皮质类固醇时使用的路线、时机、剂量和适应症。这项调查的回复率为72%。在那些回答的人中，33%的人从未开过类固醇，3.75%的人只给了吸入型类固醇。21.1%的受试者在出生后2周开始使用皮质类固醇，33.3%的受试者仅在新生儿期以外开始使用。共有48%的人每天开0.5毫克/公斤的处方，33%的人开出较低的剂量，7.9%的人每天开0.1毫克/公斤或更少的剂量。大多数人(77%)只给呼吸机依赖型婴儿开皮质类固醇，其他人也给长期持续气道正压或氧气依赖型婴儿开皮质类固醇。结论：皮质类固醇的使用有很大的差异。这强调了确定是否存在风险/收益比为正的皮质类固醇剂量方案的必要性。
Corticosteroids given systemically in the first 2 weeks after birth may reduce chronic lung disease (CLD) and mortality, but there are concerns regarding the long-term adverse effects which may have influenced prescribing habits. The aim of this study was to determine whether corticosteroids were still prescribed and, if so, was there a consensus regarding the most appropriate regimen to use. Consultant paediatricians at all 223 neonatal units in the United Kingdom were sent a questionnaire asking which route, timing, dosage and indications they used when administering corticosteroids. There was a 72% response rate to the survey. Of those who responded, 33% never prescribed steroids and 3.75% gave inhaled steroids only. Corticosteroids were not prescribed in the 1st week after birth, 21.1% of respondents commenced administration in the 2nd week and 33.3% only outside the neonatal period. A total of 48% prescribed a daily dose of 0.5 mg/kg per day, 33% gave lower doses, with 7.9% prescribing 0.1 mg/kg per day or less. The majority (77%) prescribed corticosteroids only to ventilator-dependent infants, others also gave corticosteroids to chronically continuous positive airway pressure- or oxygen-dependent infants. Conclusion: there are wide variations in corticosteroid usage. This emphasises the need to identify if there is a corticosteroid dosage regimen with a positive risk/benefit ratio.