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Pediatrics:抗生素+地塞米松治疗化脓性关节炎更有效

2015-10-25 Seven L 译 MedSci原创

有前瞻性研究表明,对化脓性关节炎儿童在抗生素治疗同时添加地塞米松可以显著改善患者的临床表现和实验室检查结果。研究者进行了一项随机对照试验探究地塞米松对儿童化脓性关节炎的有效性。该研究于2008-2013年间在三级儿科中心收集化脓性关节炎住院的患者相关信息。比较单独使用抗生素和抗生素+地塞米松两组的疗效。最终研究纳入了116名患者,90名为抗生素组(对照组),26名为抗生素+地塞米松组(实验组)。实

有前瞻性研究表明,对化脓性关节炎儿童在抗生素治疗同时添加地塞米松可以显著改善患者的临床表现和实验室检查结果。研究者进行了一项随机对照试验探究地塞米松对儿童化脓性关节炎的有效性。

该研究于2008-2013年间在三级儿科中心收集化脓性关节炎住院的患者相关信息。比较单独使用抗生素和抗生素+地塞米松两组的疗效。最终研究纳入了116名患者,90名为抗生素组(对照组),26名为抗生素+地塞米松组(实验组)。

实验组和对照组的基线资料类似,如年龄、住院前正常持续时间、体温、急性期反应物水平、培养阳性率(整体上21.6%)。

与对照组相比,实验组发热持续时间更短 (平均 2.3 vs 3.9 天, P = .002),临床症状改善更快(疼痛缓解消失或不再加剧) (平均 6.3 vs 10.0 天, P < .001),CRP下降到 <1 mg/dL速度更快 (平均 5.3 vs 8.4 天, P = .002),肠外抗生素治疗时间更短(平均 7.1 vs 11.4 天, P < .001),住院时间更短 (平均 8.0 vs 10.7 天, P = .004)。完成激素治疗后,实验组有4名患者复发发热和关节疼痛症状。

研究结果表明,对于化脓性关节炎儿童,早期抗生素治疗添加地塞米松,可以快速改善其临床症状和实验室检查结果。

原始出处:

Itay Fogel, Jacob Amir,et al.Dexamethasone Therapy for Septic Arthritis in Children.Pediatrics. October 12, 2015.


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    2016-02-05 hbwxf
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objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33596, encryptionId=b77933596af, topicName=化脓性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Sat Mar 19 18:43:00 CST 2016, time=2016-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43495, encodeId=ee2f43495d6, content=这篇文献其实是回顾性队列研究。, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49561660165, createdName=狮子头, createdTime=Sat Nov 21 07:27:00 CST 2015, time=2015-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42853, encodeId=e241428534d, content=这个疗法我国一直有在用么?可是为什么中文文献没见报道。是土方法?还是什么原因呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49561660165, createdName=狮子头, createdTime=Sun Nov 08 16:23:00 CST 2015, time=2015-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42773, encodeId=ec5b42e7335, content=这在中国是老掉牙的用法吧!, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:49:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=41859, encodeId=89be418597e, content=很棒, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=75bb1617091, createdName=Bobby7868, createdTime=Thu Oct 29 11:37:00 CST 2015, time=2015-10-29, status=1, ipAttribution=)]
    2016-02-16 mengli1984

    激素的合理应用

    0

  5. 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createdAvatar=, createdBy=75bb1617091, createdName=Bobby7868, createdTime=Thu Oct 29 11:37:00 CST 2015, time=2015-10-29, status=1, ipAttribution=)]
    2016-06-20 feather89
  6. 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  7. 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createdAvatar=, createdBy=75bb1617091, createdName=Bobby7868, createdTime=Thu Oct 29 11:37:00 CST 2015, time=2015-10-29, status=1, ipAttribution=)]
    2015-11-21 狮子头

    这篇文献其实是回顾性队列研究。

    0

  8. 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createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/04/14/d0501100fdfe783cab0715811e01c133.jpg, createdBy=51ed1602754, createdName=mengli1984, createdTime=Tue Feb 16 21:04:00 CST 2016, time=2016-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725911, encodeId=48e51e2591125, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Mon Jun 20 08:43:00 CST 2016, time=2016-06-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2079478, encodeId=93a620e947886, content=<a href='/topic/show?id=b77933596af' target=_blank style='color:#2F92EE;'>#化脓性关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33596, encryptionId=b77933596af, topicName=化脓性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Sat Mar 19 18:43:00 CST 2016, time=2016-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43495, encodeId=ee2f43495d6, content=这篇文献其实是回顾性队列研究。, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49561660165, createdName=狮子头, createdTime=Sat Nov 21 07:27:00 CST 2015, time=2015-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42853, encodeId=e241428534d, content=这个疗法我国一直有在用么?可是为什么中文文献没见报道。是土方法?还是什么原因呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49561660165, createdName=狮子头, createdTime=Sun Nov 08 16:23:00 CST 2015, time=2015-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42773, encodeId=ec5b42e7335, content=这在中国是老掉牙的用法吧!, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:49:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=41859, encodeId=89be418597e, content=很棒, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=75bb1617091, createdName=Bobby7868, createdTime=Thu Oct 29 11:37:00 CST 2015, time=2015-10-29, status=1, ipAttribution=)]
    2015-11-08 狮子头

    这个疗法我国一直有在用么?可是为什么中文文献没见报道。是土方法?还是什么原因呢?

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1748153, encodeId=3e4e1e48153a5, content=<a href='/topic/show?id=129533595e9' target=_blank style='color:#2F92EE;'>#化脓性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33595, encryptionId=129533595e9, topicName=化脓性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=443536086917, createdName=hb2020ye, createdTime=Tue Jul 26 02:43:00 CST 2016, time=2016-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1958427, encodeId=b593195842ec9, content=<a href='/topic/show?id=766713993a1' target=_blank style='color:#2F92EE;'>#Pediatric#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13993, encryptionId=766713993a1, topicName=Pediatric)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Fri Feb 05 02:43:00 CST 2016, time=2016-02-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1637187, encodeId=28da163e187e3, content=<a href='/topic/show?id=afda591646' target=_blank style='color:#2F92EE;'>#DIA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5916, encryptionId=afda591646, topicName=DIA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=987022654425, createdName=ms9608593228839890, createdTime=Sat Dec 26 08:43:00 CST 2015, time=2015-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=64496, encodeId=fdee64496a9, content=激素的合理应用, beContent=null, objectType=article, channel=null, level=null, likeNumber=153, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33596, encryptionId=b77933596af, topicName=化脓性关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c22f171, createdName=kord1982, createdTime=Sat Mar 19 18:43:00 CST 2016, time=2016-03-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=43495, encodeId=ee2f43495d6, content=这篇文献其实是回顾性队列研究。, beContent=null, objectType=article, channel=null, level=null, likeNumber=131, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49561660165, createdName=狮子头, createdTime=Sat Nov 21 07:27:00 CST 2015, time=2015-11-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42853, encodeId=e241428534d, content=这个疗法我国一直有在用么?可是为什么中文文献没见报道。是土方法?还是什么原因呢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=119, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49561660165, createdName=狮子头, createdTime=Sun Nov 08 16:23:00 CST 2015, time=2015-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42773, encodeId=ec5b42e7335, content=这在中国是老掉牙的用法吧!, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:49:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=41859, encodeId=89be418597e, content=很棒, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=75bb1617091, createdName=Bobby7868, createdTime=Thu Oct 29 11:37:00 CST 2015, time=2015-10-29, status=1, ipAttribution=)]
    2015-11-07 xjbtdbs150wgf

    这在中国是老掉牙的用法吧!

    0

  10. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=49561660165, createdName=狮子头, createdTime=Sun Nov 08 16:23:00 CST 2015, time=2015-11-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=42773, encodeId=ec5b42e7335, content=这在中国是老掉牙的用法吧!, beContent=null, objectType=article, channel=null, level=null, likeNumber=130, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20151101/IMG5635562CC617F7689.jpg, createdBy=bf351605554, createdName=xjbtdbs150wgf, createdTime=Sat Nov 07 22:49:00 CST 2015, time=2015-11-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=41859, encodeId=89be418597e, content=很棒, beContent=null, objectType=article, channel=null, level=null, likeNumber=129, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=75bb1617091, createdName=Bobby7868, createdTime=Thu Oct 29 11:37:00 CST 2015, time=2015-10-29, status=1, ipAttribution=)]
    2015-10-29 Bobby7868

    很棒

    0

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