甲强龙预防下肢长骨骨折后脂肪栓塞综合征作用的Meta分析

背景：脂肪栓塞在下肢骨折中较为常见，其主要的预防与治疗措施为糖皮质激素，但各研究结果存在一定的差异。 目的：采用循证医学的方法对甲强龙在预防下肢长骨骨折后脂肪栓塞综合征中的作用进行定量评价。 方法：通过计算机检索Medline、EMBASE、CENTRAL(the Cochrane central register of controlledtrials)、中国生物医学文献数据库系统(CBM)、中国期刊全文数据库(CNKI)、万方数据库等，收集国内外公开发表的关于甲强龙预防下肢长骨骨折后脂肪栓塞综合征的随机对照研究，对照组采用安慰剂治疗。以相对危险度及相应的95%置信区间作为效应指标对结局进行比较。 结果与结论：最终纳入6篇文章，共410例患者，甲强龙组患者184例，安慰剂组206例。合并分析的结果显示接受甲强龙治疗的患者发生脂肪栓塞综征的相对危险度为0.20 (RR=0.20，95%CI=0.09~0.43，Z=4.07，P=0.000)。证实应用甲强龙可以显著降低下肢长骨骨折患者发生脂肪栓塞综合征的风险。

Effect of methylprednisolone on the prevention of fat embolism syndrome after diaphyseal fractures of the lower limb: A Meta-analysis

BACKGROUND:Fat embolism syndorome is common in patients with diaphyseal fractures of the lower limb. Corticosteroids are the main preventive and treatment method. However, there are different results in various relevant studies. OBJECTIVE:To analyze the effect of methylprednisolone on the prevention of fat embolism syndrome after diaphyseal fractures of the lower limb. METHODS:By searching Medline, EMBSE, CENTRAL, CBM, CNKI and Wanfang databases, we collected both domestic and overseas published randomized controlled trials about the effect of methylprednisolone on the prevention of fat embolism syndrome after diaphyseal fractures of the lower limb. The outcome was measured by relative risk (RR) and its 95% confidence interval (CI). RESULTS AND CONCLUSION:Six trials that included a total of 410 patients were analyzed in the systematic review. 184 patients were in the methylprednisolone group and 206 patients were in the placebo group. The pooled relative risk for developing fat embolism syndrome was 0.20 (95%CI=0.09-0.43, Z=4.07, P=0.000) in the methylprednisolone group as compared with the control group. The methylprednisolone decreased the risk of developing fat embolism syndrome after diaphyseal fractures of the lower limb.