甲基强的松龙冲击治疗急性脊髓损伤的早期并发症

目的 探讨应用大剂量甲基强的松龙冲击治疗急性脊髓损伤的早期并发症.方法 回顾了2003年12月～2009年12月我科收治的急性脊髓损伤患者128例,将患者分为甲基强的松龙冲击治疗组(57例)和非甲基强的松龙冲击治疗组(71例),对比分析两组患者发生消化道出血、院内感染、高血糖、MODS、ARDS情况.结果 甲基强的松龙冲击治疗组2周内发生消化道出血4例(4/57)、呼吸道感染和/或泌尿系感染31例(31/57)、ARDS 7例(7/57)、MODS 4例(4/57);非甲基强的松龙冲击治疗组发生消化道出血6例(6/71)、呼吸道感染和/或泌尿系感染24例(24/71)、ARDS 9例(9/71)、MODS 5例(5/71).结论 急性脊髓损伤患者应用甲基强的松龙冲击治疗后,其院内感染发生率明显增加,可引起一过性高血糖,消化道出血、ARDS、MODS发生率无明显增加.应用甲基强的松龙冲击治疗后,应注意血糖的检测及院内感染的预防.

Early complications of methylprednisolone treatment in acute spinal cord injury patients

【Objective】 To evaluate the early complications of high-dose Methylprednisolon(MP) treatment in acute spinal cord injury(ASCI) patients during the acute phase.【Methods】 We reviewed 128 case of ASCI patients between December 2003 and December 2009.The patients were classified as MP-treatment group of 57 cases and non-MP-treatment group of 71 cases.Of the two groups gastrointestinal bleeding,nosocomial infection,MODS,ARDS were compared.【Results】 Of MP-treatment group,4 case(4/57) with gastrointestinal bleeding,31 cases(31/57) with respiratory tract infection or urinary tract infection,7 cases(7/57) with ARDS,4 cases(4/57) with MODS occurred within two weeds.Comparatively,there were 6 cases(6/71) with gastrointestinal bleeding,24 cases(24/71) with respiratory tract infection or urinary tract infection,9 cases(9/71) with ARDS,5 cases(5/71) with MODS in non-MP treatment group.【Conclusion】 The application of MP in ASCI patients increased nosocomial infection and transient hyperglycemia,but not affect gastrointestinal bleeding,ARDS and MODS within two weeks.More attention should be paid on nosocomial infection and transient hyperglycaemia after MP treatment of ASCI patients.