Sen Ramesh K, Tripathy Sujit K, Krishnan Vibhu
Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India.
Musculoskelet Surg. 2012 Jun;96(1):1-8. doi: 10.1007/s12306-011-0156-1. Epub 2011 Jul 20.
Despite a number of studies on steroid therapy as a prophylactic measure in fat embolism syndrome (FES), there is no universal agreement about its role in this critical situation. The present article attempts to search the available literature, and provides a more lucid picture to the readers on this issue. Seven articles (total 483 patients) were reviewed and analyzed. Total of 223 patients received steroid (methyl prednisolone sodium succinate), while the remaining 260 patients formed the control population. Among these subjects, 9 patients in steroid-receiving group and 60 patients in the control group developed FES (P < 0.05). The lack of uniformities in these studies, variable dose and single-center trial are the principal limitations and confuses the surgeons to have definite conclusion. Large-scale, more uniformly designed, multi-centered, randomized, prospective trials are needed to determine the correct situations and dosage in which steroids provide the maximum benefit (with the least possible risk).
尽管已有多项关于类固醇疗法作为脂肪栓塞综合征（FES）预防措施的研究，但对于其在这种危急情况下的作用尚无普遍共识。本文试图检索现有文献，为读者更清晰地呈现这一问题。对7篇文章（共483例患者）进行了回顾和分析。共有223例患者接受了类固醇（甲泼尼龙琥珀酸钠）治疗，其余260例患者作为对照人群。在这些受试者中，接受类固醇治疗组有9例患者发生FES，对照组有60例患者发生FES（P<0.05）。这些研究缺乏一致性、剂量可变以及单中心试验是主要局限性，这使得外科医生难以得出明确结论。需要进行大规模、设计更统一、多中心、随机、前瞻性试验，以确定类固醇能提供最大益处（且风险尽可能低）的正确情况和剂量。
