重症颅脑损伤术后联用高压氧治疗疗效的评价

Systematic review of the prognosis effect:Hyperbaric oxygen treatment for severe brain injury

目的评价术后联用高压氧治疗重症颅脑损伤的疗效。方法通过检索1997年5月—2012年5月期间CochraneLibrary、Pubmed、Web of Science、Medline、中国学术期刊全文数据库、万方数据库、维普中文科技期刊全文数据库,对纳入研究的方法学进行评价。研究者对纳入文献的质量进行严格评价和资料提取,使用Review manager 5.0软件对符合质量标准的随机临床试验(RCT)行系统评价。结果 5个RCT共209名患者纳入研究,其中治疗组(开颅减压血肿清除术后行高压氧治疗)104例,对照组(开颅减压血肿清除术)105例,两组患者均行脱水降颅内压、营养神经、抗感染等常规治疗。系统评价结果表明治疗组患者术后7日格拉斯哥昏迷(GCS)评分、术后14日GCS评分、术后14日存活率均明显优于对照组,具有统计学差异。结论相比单纯手术治疗,术后行高压氧治疗可显著提升重症颅脑损伤患者的疗效,值得大为推广。

[ Objective] To evaluate the efficacy of postoperative hyperbaric oxygen treatment for severe brain injury. [ Methods] Co- chrane Library, Pubmed, Web of Science, Medline, CNKI, CECDB, CQVIP were searched for the studies from May 1997 to May 2012. The included literatures were strictly evaluated and extracted for data. Review manager 5.0 software was adopted to systemat- ically evaluate the qualified RCT. [ Results] A total of 209 patients in 5 RCT were included in the study, including 104 cases in treatment group （eraniotomy decompression hematoma and postoperative hyperbaric oxygen therapy） , 105 cases in the control group （craniotomy decompression hematoma} , patients of 2 groups underwent dehydration to lower the intracranial pressure, neurotro- phic, anti-infective and other conventional treatment. The systematic evaluation showed that the treatment group patients on the 7th GCS score, the 14th GCS score, the 14th survival rate was significantly better than the control group, with significant difference. [ Conclusion] Compared to simple surgery, surgery combined with postoperative hyperbaric oxygen therapy can significantly en- hance the efficacy of severe traumatic brain injury patients, and is worth of considerably promotion.