高压氧综合治疗颅脑损伤疗效的系统评价

Systematic review of the effects of hyperbaric oxygen adjunctive therapy on brain injury

目的评价高压氧(HBO)综合治疗颅脑损伤患者的临床疗效。方法使用国际Cochrane协作网提供的RevMan4.2统计软件对国内发表的所有关于HBO综合治疗颅脑损伤临床疗效的试验研究进行系统评价。结果至2008年3月,共搜索到关于HBO综合治疗颅脑损伤临床疗效和评价的试验报道623篇,其中9个(共包括3916例患者)随机对照试验符合本研究的纳入标准。与对照组相比,HBO综合治疗组总有效率显著提高(95.12%vs 74.85%;OR 6.37;95%CI 5.04,8.06;P<0.01);GCS评分比对照组提高了1.67(95%CI 1.2,2.14;P<0.01);病死率明显降低(10.76%vs 18.78%;OR 0.51;95%CI 0.29,0.90;P<0.05),NNT=12.5,提示用HBO每综合治疗12.5例颅脑损伤患者可避免1例半年内死亡。结论HBO综合治疗颅脑损伤是一种有前途的治疗方法,可以明显提高总有效率,降低病死率。

Objective To evaluate the effects of hyperbaric oxygen（HBO）adjunctive therapy on brain injury.Methods The statistics software RevMan4.2 provided by Central Cochrane was applied to systematically review all theses published domestically about the effects of HBO adjunctive therapy on brain injury.Results Up to March 2008,623 theses about the effects of HBO adjunctive therapy on brain injury were sorted out.In accord with the inclusion criteria for analysis,9 clinical trials（involving 3916 subjects） could be made use of systematic review.As compared with the control,the total effective ratio in HBO adjunctive treatment groups was significantly improved（95.12% vs.74.85%,OR 6.37,95% CI 5.04,8.06,P〈0.01）,the value of GCS grading in treatment was markedly increased with 1.67（95% CI 1.2,2.14,P〈0.01）,the mortality rate in treatment was obviously decreased（10.76% vs.18.78%,OR 0.51,95% CI 0.29,0.90,P〈0.05） with NNT（Number Needed to Treat）=12.5,which suggested that one patient could be avoided from death in six months in every 12.5 patients with brain injury when adjunctively treated with HBO therapy.Conclusion HBO adjunctive therapy is a desirable adjunctive therapy manner for the patients with brain injury,which can significantly improve total effective rate and decrease mortality rate.