[1]廖 帅,刘 阳,曾令勇,等.高压氧治疗对弥漫性轴索损伤疗效和预后的Meta分析[J].医学信息,2022,35(02):94-99,104.[doi:10.3969/j.issn.1006-1959.2022.02.023]
　LIAO Shuai,LIU Yang,ZENG Ling-yong,et al.Meta Analysis of Curative Effect and Prognosis of Hyperbaric Oxygen Therapyfor Diffuse Axonal Injury[J].Medical Information,2022,35(02):94-99,104.[doi:10.3969/j.issn.1006-1959.2022.02.023]
点击复制

高压氧治疗对弥漫性轴索损伤疗效和预后的Meta分析()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
35卷
期数:
2022年02期
页码:
94-99,104
栏目:
论著
出版日期:
2022-01-15

文章信息/Info

Title:
Meta Analysis of Curative Effect and Prognosis of Hyperbaric Oxygen Therapyfor Diffuse Axonal Injury
文章编号:
1006-1959（2022）02-0094-07
作者:
廖 帅; 刘 阳; 曾令勇; 张 海; 徐剑峰
绵阳市第三人民医院神经外科，四川 绵阳 621000
Author(s):
LIAO Shuai; LIU Yang; ZENG Ling-yong; ZHANG Hai; XU Jian-feng
Department of Neurosurgery,the Third Hospital of Mianyang,Mianyang 621000,Sichuan,China
关键词:
弥漫性轴索损伤; 高压氧; 预后
Keywords:
Diffuse axonal injury; Hyperbaric oxygen therapy; Prognosis
分类号:
R651.1；R840.5
DOI:
10.3969/j.issn.1006-1959.2022.02.023
文献标志码:
A
摘要:
目的 对弥漫性轴索损伤（DAI）患者采取高压氧（HBO）治疗的效果和预后进行综合评价。方法 检索PubMed、The Cochrane Library、EMbase、WanFang Data、VIP、CNKI和CBM数据库，筛选采取HBO对比非HBO治疗DAI患者的随机对照试验（RCT），时间截止至2021年5月。采用RevMan5.3进行统计分析。结果 纳入文献12篇，共728例患者；HBO治疗组的清醒率高于对照组（RR=1.37，95%CI=1.22~1.54，P＜0.00001），意识恢复时间短于对照组（MD=-8.21，95%CI=-10.48~-5.95，P＜0.00001）；HBO治疗组6个月后GOS预后良好率高于对照组（RR=1.71，95%CI=1.45~2.02，P＜0.00001）；两组3个月后GOS预后良好率比较，差异无统计学意义（RR=1.60，95%CI=0.82~3.10，P=0.17）。结论 HBO治疗可以促进DAI患者的意识恢复，改善预后，但短时间内预后改善不明显，仍需标准相同、样本足够、多中心的高质量RCT来验证。
Abstract:
Objective To evaluate the effects and prognosis of hyperbaric oxygen (HBO) therapy on patients with diffuse axonal injury (DAI).Methods Searched Pubmed, The Cochrane Library, Embase, WanFang Data, VIP, CNKI and CBM databases to obtain randomized controlled trials (RCTs) of HBO versus non-HBO for DAI patients before May 2021. Two researchers independently selected literature, collected data and evaluated the risk of bias. Revman5.3 was used for statistical analysis.Results Totally 12 literature including 728 patients were selected. The awake rate of HBO treatment group was higher than that of control group (RR=1.37, 95%CI=1.22 to 1.54, P<0.00001), and the recovery time of consciousness was shorter than that of control group (MD=-8.21, 95%CI=-10.48 to -5.95, P<0.00001). The good prognosis rate of GOS after 6 months in HBO treatment group was higher than that in control group (RR=1.71, 95%CI=1.45 to 2.02, P<0.00001). There was no significant difference in good prognosis rate of GOS between the two groups after 3 months (RR=1.60, 95%CI=0.82 to 3.10, P=0.17).Conclusion HBO therapy may promote the recovery of consciousness and improve the prognosis for DAI patients, but it still needs RCT with uniform-standards, polycentric, sufficient-sample andexcellent-quality to verify this conclusion.

参考文献/References:

[1]Wang ML,Li WB.Cognitive impairment after traumatic brain injury: The role of MRI and possible pathological basis[J].J Neurol Sci,2016(370):244-250.[2]Graham NSN,Jolly A,Zimmerman K,et al.Diffuse axonal injury predicts neurodegeneration after moderate-severe traumatic brain injury[J].Brain,2020,143(12):3685-3698.[3]Ma J,Zhang K,Wang Z,et al.Progress of Research on Diffuse Axonal Injury after Traumatic Brain Injury[J].Neural Plast,2016(5):1-7.[4]毛振立,宋振全,张海松,等.8-羟基-2-(二丙基氨基)四氢萘干预弥漫性轴索损伤模型大鼠低氧诱导因子1α的表达[J].中国组织工程研究,2020,24(8):1238-1242.[5]Evans LR,Fitzgerald MC,Varma D,et al.A novel approach to improving the interpretation of CT brain in trauma[J].Injury,2017,49(1):56-61.[6]Currie S,Saleem N,Straiton JA,et al.Imaging assessment of traumatic brain injury[J].Postgrad Med J,2016,92(1083):41-50.[7]李民涛,贾竹亭,窦连峰,等.弥漫性轴索损伤102例预后及相关因素分析[J].天津医药,2019,47(1):63-66.[8]王碰起,魏梁锋,周苏键,等.高压氧治疗对亚急性期创伤性脑损伤患者腺垂体功能的影响[J].中华物理医学与康复杂志,2020,42(8):712-715.[9]熊鹏举,朱皓皞,温剑峰,等.呼吸机辅助高压氧舱内吸氧对弥漫性轴索损伤治疗的影响[J].东南国防医药,2020,22(3):258-261.[10]Weaver LK,Chhoeu A,Lindblad AS,et al.Hyperbaric oxygen for mild traumatic brain injury: Design and baseline summary[J].Undersea Hyperb Med,2016,43(5):491-509.[11]蔡沉逐,郭协力,蔡明发,等.早期高压氧治疗弥漫性轴索损伤的临床效果[J].中国当代医药,2017,24(36):45-47.[12]崔永胜,康全利.高压氧在脑弥漫性轴索损伤治疗中的作用[J].贵阳医学院学报,2010,35(5):487-488,492.[13]顾翔,陈水钰,郑巧瑛,等.高压氧在弥漫性轴索损伤治疗中的应用[J].当代医学,2012,18(1):46.[14]李国锋,元少鹏,肖伟利.早期高压氧治疗脑弥漫性轴索损伤30例疗效观察[J].海南医学,2016,27(2):287-288.[15]李军,李春国,陶翔玉.高压氧治疗弥漫性轴索损伤的临床观察[J].神经损伤与功能重建,2007(5):305.[16]刘秋成,雷学,常忠利,等.早期高压氧治疗脑弥漫性轴索损伤35例临床观察[J].河北医药,2009,31(6):662-664.[17]吴崇光,王雷平,姚军.早期高压氧治疗脑弥漫性轴索损伤45例[J].中华创伤杂志,2012(1):40-42.[18]张艳平,杨崇选,任家庚,等.早期高压氧治疗弥漫性轴索损伤的疗效分析[J].牡丹江医学院学报,2013,34(5):17-20.[19]周卫京.早期高压氧治疗弥漫轴索损伤临床分析[J].吉林大学学报(医学版),2012,38(2):381.[20]谢腾,陈治军,罗勇,等.尼莫地平联合高压氧治疗弥漫性轴索损伤的临床研究[J].中国临床神经外科杂志,2011,16(1):27-29.[21]候国涛,刘家传,王春琳,等.不同压力高压氧治疗的弥漫性轴索损伤患者定量脑电图脑电波相对功率变化及其意义[J].山东医药,2016,56(43):79-81.[22]杨艳艳,梅厚东,刘家传,等.不同压力高压氧治疗对重型弥漫性轴索损伤预后的影响[J].中华航海医学与高气压医学杂志,2015,22(5):378-381.[23]Abu Hamdeh S,Marklund N,Lannsjo M,et al.Extended Anatomical Grading in Diffuse Axonal Injury Using MRI: Hemorrhagic Lesions in the Substantia Nigra and Mesencephalic Tegmentum Indicate Poor Long-Term Outcome[J].J Neurotrauma,2017,34(2):341-352.[24]Liu S,Liu Y,Deng S,et al.Beneficial effects of hyperbaric oxygen on edema in rat hippocampus following traumatic brain injury[J].Exp Brain Res,2015,233(12):3359-3365.[25]万玉艳,黎云.高压氧对进展性脑卒中患者临床作用及机制分析[J].河北医药,2017,39(21):3248-3252.[26]Richer AC.Functional Medicine Approach to Traumatic Brain Injury[J].Med Acupunct,2017,29(4):206-214.[27]Tal S,Hadanny A,Sasson E,et al.Hyperbaric Oxygen Therapy Can Induce Angiogenesis and Regeneration of Nerve Fibers in Traumatic Brain Injury Patients[J].Front Hum Neurosci,2017(11):508.[28]Yang Y,Wei H,Zhou X,et al.Hyperbaric oxygen promotes neural stem cell proliferation by activating vascular endothelial growth factor/extracellular signal-regulated kinase signaling after traumatic brain injury[J].Neuroreport,2017,28(18):1232-1238.[29]Schulze J,Kaiser O,Paasche G,et al.Effect of hyperbaric oxygen on BDNF-release and neuroprotection: Investigations with human mesenchymal stem cells and genetically modified NIH3T3 fibroblasts as putative cell therapeutics[J].PLoS One,2017,12(5):e0178182.[30]Daly S,Thorpe M,Rockswold SB,et al.Hyperbaric Oxygen Therapy in the Treatment of Acute Severe Traumatic Brain Injury:a Systematic Review[J].J Neurotrauma,2017,35(4):623-629.[31]齐亚南,潘树义,郭大志.早期不同压力高压氧对中重型颅脑创伤大鼠的神经功能及IL-1β、IL-10和SOD表达的影响[J].转化医学杂志,2020,9(6):321-325.[32]范鹏涛,杨菲,刘保成,等.高压氧对模型大鼠颅脑损伤CAT、SOD、GSH-Px和Nrf2影响的研究[J].神经解剖学杂志,2017,33(3):280-284.[33]Meng XE,Zhang Y,Li N,et al.Hyperbaric Oxygen Alleviates Secondary Brain Injury After Trauma Through Inhibition of TLR4/NF-κB Signaling Pathway[J].Med Sci Monit,2016(22):284-288.[34]Xing P,Ma K,Li L,et al.The protection effect and mechanism of hyperbaric oxygen therapy in rat brain with traumatic injury[J].Acta Cir Bras,2018,33(4):341-353.

相似文献/References:

[1]陆 晚,黄宗国,廖 胜,等.高压氧治疗胸段脊髓损伤的临床分析[J].医学信息,2018,31(10):84.[doi:10.3969/j.issn.1006-1959.2018.10.025]
　LU Wan,HUANG Zong-guo,LIAO Sheng,et al.Clinical Analysis of Hyperbaric Oxygen Therapy for Thoracic Spinal Injury[J].Medical Information,2018,31(02):84.[doi:10.3969/j.issn.1006-1959.2018.10.025]
[2]李晓兴,王学军,吴继伟,等.补阳还五汤联合高压氧治疗脑外伤后综合征的疗效观察[J].医学信息,2018,31(23):145.[doi:10.3969/j.issn.1006-1959.2018.23.042]
　LI Xiao-xing,WANG Xue-jun,WU Ji-wei,et al.Efficacy of BuyangHuanwu Decoction Combined with Hyperbaric Oxygen in Treating Post Traumatic Brain Syndrome[J].Medical Information,2018,31(02):145.[doi:10.3969/j.issn.1006-1959.2018.23.042]
[3]王 璇.高压氧综合治疗脑卒中并发吞咽障碍的疗效[J].医学信息,2019,32(15):92.[doi:10.3969/j.issn.1006-1959.2019.15.028]
　WANG Xuan.Therapeutic Effect of Hyperbaric Oxygen Therapy on Cerebral Stroke Complicated with Dysphagia[J].Medical Information,2019,32(02):92.[doi:10.3969/j.issn.1006-1959.2019.15.028]
[4]袁秀萍.高压氧联合尼莫地平治疗脑小血管病所致 认知功能障碍的疗效评价[J].医学信息,2019,32(17):79.[doi:10.3969/j.issn.1006-1959.2019.17.024]
　YUAN Xiu-ping.Efficacy Evaluation of Hyperbaric Oxygen Combined with Nimodipine in the Treatment of Cognitive Dysfunction Caused by Cerebral Small Vessel Disease[J].Medical Information,2019,32(02):79.[doi:10.3969/j.issn.1006-1959.2019.17.024]
[5]袁 鹏.HBO联合Valpar职业评估训练对脑外伤后认知功能障碍患者的影响[J].医学信息,2020,33(18):89.[doi:10.3969/j.issn.1006-1959.2020.18.028]
　YUAN Peng.The Effect of HBO Combined with Valpar Occupational Assessment Training on Patients with Cognitive Dysfunction After Brain Injury[J].Medical Information,2020,33(02):89.[doi:10.3969/j.issn.1006-1959.2020.18.028]
[6]王 瑶.高压氧辅助治疗脑动脉硬化症患者的疗效[J].医学信息,2021,34(06):139.[doi:10.3969/j.issn.1006-1959.2021.06.036]
　WANG Yao.Efficacy of Hyperbaric Oxygen in the Treatment of Cerebral Arteriosclerosis Patients[J].Medical Information,2021,34(02):139.[doi:10.3969/j.issn.1006-1959.2021.06.036]
[7]袁 鹏,杜 斌,刘 锌,等.高压氧治疗股骨头坏死短期疗效的Meta分析[J].医学信息,2021,34(12):87.[doi:10.3969/j.issn.1006-1959.2021.12.023]
　YUAN Peng,DU Bin,LIU Xin,et al.Meta-analysis of the Short-term Curative Effect of Hyperbaric Oxygen in the Treatment of Femoral Head Necrosis[J].Medical Information,2021,34(02):87.[doi:10.3969/j.issn.1006-1959.2021.12.023]
[8]吕艳丽.联合高压氧治疗在创面修复中的应用研究[J].医学信息,2021,34(14):32.[doi:10.3969/j.issn.1006-1959.2021.14.009]
　LYU Yan-li.Study on the Application of Combined Hyperbaric Oxygen Therapy in Wound Healing[J].Medical Information,2021,34(02):32.[doi:10.3969/j.issn.1006-1959.2021.14.009]
[9]江 伟,唐向阳,陈祚胜,等.经颅磁刺激联合高压氧治疗腔隙性脑梗死认知损伤的临床研究[J].医学信息,2022,35(02):140.[doi:10.3969/j.issn.1006-1959.2022.02.035]
　JIANG Wei,TANG Xiang-yang,CHEN Zuo-sheng,et al.Clinical Study of Transcranial Magnetic Stimulation Combined with Hyperbaric Oxygenin the Treatment of Cognitive Impairment in Lacunar Cerebral Infarction[J].Medical Information,2022,35(02):140.[doi:10.3969/j.issn.1006-1959.2022.02.035]
[10]周 勇.高压氧联合骨肽治疗对跟骨骨折术后切口血运及骨折愈合的影响[J].医学信息,2022,35(06):126.[doi:10.3969/j.issn.1006-1959.2022.06.031]
　ZHOU Yong.Effect of Hyperbaric Oxygen Combined with Bone Peptide Therapy on Incision Blood Supply and Fracture Healing After Calcaneal Fracture SurgeryZHOU Yong[J].Medical Information,2022,35(02):126.[doi:10.3969/j.issn.1006-1959.2022.06.031]

更新日期/Last Update: 1900-01-01