Thorén Hanna, Snäll Johanna, Kormi Eeva, Numminen Laura, Fäh Reto, Iizuka Tateyuki, Lindqvist Christian, Törnwall Jyrki
Department of Cranio-Maxillofacial Surgery, Bern University Hospital, Inselspital, Bern, Switzerland.
J Oral Maxillofac Surg. 2009 Sep;67(9):1884-8. doi: 10.1016/j.joms.2009.04.089.
To clarify whether perioperative glucocorticosteroid treatment used in association with repair of facial fractures predisposes to disturbance in surgical wound healing (DSWH).
Retrospective review of records of patients who had undergone open reduction, with or without ostheosynthesis, or had received reconstruction of orbital wall fractures during the 2-year period from 2003 to 2004.
Steroids were administered to 100 patients (35.7%) out of a total of 280. Dexamethasone was most often used, with the most common regimen being dexamethasone 10 mg every 8 hours over 16 hours, with a total dose of 30 mg. The overall DSWH rate was 3.9%. The DSWH rate for patients who had received perioperative steroids was 6.0%, and the corresponding rate for patients who did not receive steroids was 2.8%. The difference was not statistically significant. An intraoral surgical approach remained the only significant predictor to DSWH.
With regard to DSWH, patients undergoing operative treatment of facial fractures can safely be administered doses of 30 mg or less of perioperative glucocorticosteroids equivalent to dexamethasone.
明确在面部骨折修复术中联合使用围手术期糖皮质激素治疗是否会导致手术伤口愈合障碍(DSWH)。
回顾性分析2003年至2004年这两年间接受切开复位(无论是否伴有骨固定)或眼眶壁骨折重建手术的患者记录。
在总共280例患者中,100例(35.7%)接受了类固醇治疗。最常使用的是地塞米松,最常见的用药方案是每8小时静脉注射10毫克地塞米松,持续16小时,总剂量为30毫克。总体DSWH发生率为3.9%。接受围手术期类固醇治疗的患者DSWH发生率为6.0%,未接受类固醇治疗的患者相应发生率为2.8%。差异无统计学意义。口腔内手术入路仍然是DSWH的唯一显著预测因素。
就DSWH而言,接受面部骨折手术治疗的患者可安全使用相当于30毫克或更低剂量的围手术期糖皮质激素(如地塞米松)。