Department of Surgery, University of California, Davis, 2315 Stockton Blvd, Room 4206 MH, Sacramento, CA 95817, USA.
Department of Surgery, University of California, Davis, 2315 Stockton Blvd, Room 4206 MH, Sacramento, CA 95817, USA.
Am J Surg. 2014 Apr;207(4):566-72. doi: 10.1016/j.amjsurg.2013.05.011. Epub 2013 Oct 7.
The effectiveness of the nonsteroidal anti-inflammatory drug ketorolac in reducing pulmonary morbidity after rib fractures remains largely unknown.
A retrospective cohort study was conducted spanning January 2003 to June 2011 assessing pneumonia within 30 days and potential adverse effects of ketorolac among all patients with rib fractures who received ketorolac <4 days after injury compared with a random sample of those who did not.
Among 202 patients who received ketorolac and 417 who did not, ketorolac use was associated with decreased pneumonia (odds ratio, .14; 95% confidence interval, .04 to .46) and increased ventilator-free days (difference, 1.8 days; 95% confidence interval, 1.1 to 2.5) and intensive care unit-free days (difference, 2.1 days; 95% confidence interval, 1.3 to 3.0) within 30 days. The rates of acute kidney injury, gastrointestinal hemorrhage, and fracture nonunion were not different.
Early administration of ketorolac to patients with rib fractures is associated with a decreased likelihood of pneumonia, without apparent risks.
非甾体类抗炎药酮咯酸在减少肋骨骨折后肺部发病率方面的有效性在很大程度上仍不清楚。
一项回顾性队列研究于 2003 年 1 月至 2011 年 6 月进行，评估了所有在受伤后 4 天内接受酮咯酸治疗的肋骨骨折患者与随机抽取的未接受酮咯酸治疗的患者在 30 天内肺炎的发生情况以及酮咯酸的潜在不良反应。
在 202 例接受酮咯酸治疗的患者和 417 例未接受酮咯酸治疗的患者中，酮咯酸的使用与肺炎发生率降低（比值比，0.14；95%置信区间，0.04 至 0.46）以及呼吸机无使用天数（差异，1.8 天；95%置信区间，1.1 至 2.5）和重症监护病房无使用天数（差异，2.1 天；95%置信区间，1.3 至 3.0）的增加相关。急性肾损伤、胃肠道出血和骨折不愈合的发生率没有差异。
早期给予肋骨骨折患者酮咯酸治疗与降低肺炎的可能性相关，且无明显风险。
