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[用安乃近、氢化可的松和液体疗法治疗镰状细胞贫血危象]

[Treatment of sickle cell anemia crisis with dipyrone, hydrocortisone, and fluid therapy].

作者信息

de Araújo J T, Comerlatti L K, de Araújo R A, Bodemeier L

机构信息

Divisão de Hematologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo.

出版信息

Rev Hosp Clin Fac Med Sao Paulo. 1994 Jan-Feb;49(1):13-6.

PMID:8029608
Abstract

It was observed "in vitro" that dipirone improves hemoglobin S solubility, and that corticosteroids by antiinflammatory action relieve pain in sickle cell anemia crises. In the period between 1983 and 1988, 116 patients with sickle cell anemia having painful crises were studied. All patients were hydrated with DW (5% normal Serum Sodium/NSS) 1:1, in a total volume of 2250 ml/square meters (sgm) day. Patients were distributed as follows: Group 1: 26 patients treated with an association of dipirone and hidrocortisone; Group 2: 21 patients treated with hidrocortisone only; Group 3: 22 patients treated with dipirone only; Group 4: 23 patients treated only with hidration; Group 5: 24 patients treated only with DW 50%. Treatment efficacy was evaluated on the subjective assessment (complete pain relief of patients, 24 hours after the beginning of the treatment). We have concluded that treatment with dipirone and/or hidrocortisone plus hidration was efficient for pain relief in sickle cell crises.

摘要

“体外”研究观察到,安乃近可提高血红蛋白S的溶解度,而皮质类固醇通过抗炎作用可缓解镰状细胞贫血危象时的疼痛。在1983年至1988年期间,对116例患有疼痛性危象的镰状细胞贫血患者进行了研究。所有患者均以1:1的比例用5%葡萄糖水(等渗氯化钠溶液/NSS)进行补液,补液总量为2250毫升/平方米体表面积/天。患者分组如下:第1组:26例患者接受安乃近与氢化可的松联合治疗;第2组:21例患者仅接受氢化可的松治疗;第3组:22例患者仅接受安乃近治疗;第4组:23例患者仅接受补液治疗;第5组:24例患者仅接受50%葡萄糖水治疗。根据主观评估(治疗开始24小时后患者疼痛完全缓解情况)对治疗效果进行评估。我们得出结论,安乃近和/或氢化可的松联合补液治疗对缓解镰状细胞危象时的疼痛有效。

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