Am Surg:口服与静脉注射对乙酰氨基酚治疗老年肋骨骨折的效果

2021-07-23 MedSci原创 MedSci原创

肋骨骨折是外伤患者中常见的损伤,老年肋骨骨折患者发生不良事件和死亡的风险增加。近日,一项单中心、随机、安慰剂对照、双盲的研究旨在确定口服对乙酰氨基酚(PO)在治疗与肋骨骨折相关的疼痛方面是否与静脉注射

肋骨骨折是外伤患者中常见的损伤,老年肋骨骨折患者发生不良事件和死亡的风险增加。近日,一项单中心、随机、安慰剂对照、双盲的研究旨在确定口服对乙酰氨基酚(PO)在治疗与肋骨骨折相关的疼痛方面是否与静脉注射(IV)对乙酰氨基酚一样有效,研究结果已发表于Am Surg。

研究纳入年龄≥65岁且有≥1根肋骨骨折的创伤患者,随机分为静脉注射对乙酰氨基酚和口服安慰剂(n = 63)或静脉注射安慰剂和对乙酰氨基酚口服溶液(n = 75)组。主要结果是24小时内疼痛评分的平均减少,次要结果包括阿片类药物的使用、重症监护室(ICU)住院时间(LOS)、住院时间、住院死亡率、激励性肺活量的差异和肺炎的发生。

 

结果,在纳入的138名患者中,2个研究组在伤后24小时疼痛评分的平均降低方面没有统计学差异(PO:3.24,IV:2.49;P=0.230)。组间阿片类止痛药的使用情况相当(P = .212),组间医院死亡率无明显差异(P = .827)。在ICU住院时间、住院时间或肺炎的发生方面没有统计学差异。

 

总之,对于≥1根肋骨骨折的老年创伤患者(年龄≥65岁),PO醋氨酚与IV醋氨酚控制疼痛的效果相当,在发病率或死亡率方面没有差异。在治疗老年肋骨骨折的创伤患者时,应优先使用口服对乙酰氨基酚而不是静脉注射对乙酰氨基酚。

 

原始出处:

 

Andrew C Antill, et al., Treatment With Oral Versus Intravenous Acetaminophen in Elderly Trauma Patients With Rib Fractures: A Prospective Randomized Trial. Am Surg. 2020 Aug;86(8):926-932. doi: 10.1177/0003134820940268.  

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    2022-01-17 fusion
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    2021-07-23 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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