Breslin Kristen, Agrawal Dewesh
Children's National Medical Center, Washington, DC, USA.
Pediatr Emerg Care. 2012 Nov;28(11):1238-45; quiz 1246-8. doi: 10.1097/PEC.0b013e3182724434.
The use of methylprednisolone after acute spinal cord injury has been under discussion for more than 20 years. There is ongoing debate about the efficacy and clinical impact of methylprednisolone in recovery from spinal cord injury, and studies show considerable variability in practice patterns among surgeons. Consensus statements consider methylprednisolone as a treatment option for acute spinal cord injury, but not a standard of care based on available evidence. This review discusses the evidence from prospective trials of methylprednisolone in adults and teenagers after spinal cord injury, consensus statements on the use of methylprednisolone, and practice variability in North America and the United Kingdom over time.
急性脊髓损伤后使用甲泼尼龙的问题已讨论了20多年。关于甲泼尼龙在脊髓损伤恢复中的疗效和临床影响一直存在争议，研究表明外科医生的实践模式存在很大差异。共识声明认为甲泼尼龙可作为急性脊髓损伤的一种治疗选择，但根据现有证据并非标准治疗方法。本综述讨论了甲泼尼龙在成人和青少年脊髓损伤后前瞻性试验的证据、关于使用甲泼尼龙的共识声明以及北美和英国随时间推移的实践差异。
