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综述:急性脊髓损伤患者使用类固醇及指南更新

Review: Steroid Use in Patients With Acute Spinal Cord Injury and Guideline Update.

作者信息

Lee Byung-Jou, Jeong Je Hoon

机构信息

Department of Neurosurgery and Neuroscience & Radiosurgery Hybrid Research Center, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.

Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.

出版信息

Korean J Neurotrauma. 2022 Apr 19;18(1):22-30. doi: 10.13004/kjnt.2022.18.e21. eCollection 2022 Apr.

Abstract

Acute spinal cord injury (SCI) is a devastating condition that causes enormous damage to a patient's physical, mental, and economic situation and requires a multidisciplinary approach to treatment. Research on SCI has been performed for a long time, and the management of SCI has developed dramatically in recent decades as a mechanism of injury and the pathophysiology of SCI have been revealed from the primitive stage in the past. In the treatment of patients with acute SCI, there is a lot of debate regarding surgical treatment strategies and pharmacological management, such as steroid use. In particular, the efficacy of steroid use, such as methylprednisolone sodium succinate, has been increasing and decreasing and is still intensely debated. The practice guidelines reported so far for this are also at the "suggest" stage with weak recommendations. Therefore, this review aims to summarize the effects of steroid use on SCI. This review provides an overview of current practical guidelines and clinical studies on steroid use in patients with SCI.

摘要

急性脊髓损伤(SCI)是一种毁灭性疾病,会给患者的身体、心理和经济状况造成巨大损害,需要多学科方法进行治疗。对SCI的研究已经开展了很长时间,近几十年来,随着损伤机制和SCI病理生理学从过去的原始阶段逐渐被揭示,SCI的治疗取得了显著进展。在急性SCI患者的治疗中,关于手术治疗策略和药物管理,如类固醇的使用,存在很多争议。特别是,琥珀酸甲泼尼龙等类固醇药物的疗效一直起伏不定,至今仍备受激烈争论。目前针对此的实践指南也处于“建议”阶段,推荐力度较弱。因此,本综述旨在总结类固醇药物使用对SCI的影响。本综述概述了目前关于SCI患者使用类固醇药物的实用指南和临床研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc01/9064751/4e4eb3d58a5c/kjn-18-22-g001.jpg

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