| 摘要 |
Objective: The value of methylprednisolone (MP) treatment in acute traumatic
spinal cord injury (SCI) remains controversial. We attempted to evaluate the
utilization of resources, motor function recovery and adverse effect after the use of
MP.
Methods: We compared 13 demographic and clinical characteristics between MP
and non-MP treatment groups in 110 patients with acute traumatic SCI treated in
hospitals between June 1st, 2000 and May 31st, 2001, and analyzed 10 short-term
outcome variables. These demographic and clinical characteristics included age,
cause of injury, number of associated injuries, Revised Trauma Score, Glasgow Coma
Scale, mean blood pressure, level/completeness and pattern of SCI, number and types
of spinal surgeries, frequency of rehabilitation therapy and the time interval between
trauma and admission.
Results: The MP (64.5%) and non-MP (35.5%) treatment groups showed no
significant differences in all characteristics except the time interval between trauma
and admission (P=0.024). MP treatment was associated with a higher frequency of
infectious complications (P=0.038), but there was no difference between the two
treatment groups in other outcome parameters. The results of analysis stratified by
dosage of MP showed that the length of ICU stay (P=0.021) and the number of
tracheostomies (P=0.005) and pneumonia cases (P=0.004) were increased significantly
in the standard dose group.
Conclusions: Although the rate of infection had risen in patients receiving MP, the
steroid treatment did not significantly increase utilization of resources during
hospitalization and appeared safe in terms of mortality. However, it had not been proven to improve motor function recovery. |
