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高压氧治疗放射性脑病随机对照试验的系统评价

Effect of hyperbaric oxygen in the treatment of radiation encephalopathy: a systematic review of randomized controlled trials

摘要:

目的 系统评价高压氧(hyperbaric oxygen HBO)联合药物治疗放射性脑病(radiation cephalopathy,REP)的有效性和安全性.方法 计算机检索PubMed、The Cochrane Library、Embase、Lancet、CBM、CNKI、VIP和wanFang Data,并辅以手工检索方法收集国内外相关文献,检索时间从建库截止2018年3月.由2位研究者按纳入和排除标准独立筛选义献、提取资料并评价纳入文献方法学质量后,采用RevMan 5.3软件进行Meta分析.结果 最终共纳入16个随机对照试验(randomized controlled trials,RCTs),共计990例患者Meta分析结果显示HBO联合药物治疗的有效率[OR=5.78,95% CI(4.15,8.06),P<0.01]、痊愈率[OR=4.56,95%C1 (2.88,7.20),P<0.01]均优于单用药物治疗组;病灶体积减少多于单用药物治疗组[OR=-2.63,95% CI(-3.70,-1.56),P<0.01].结论 高压氧联合药物治疗放射性脑病疗效好,值得临床推广.

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abstracts:

Objective To assess systematically the efficacy and safety of hyperbaric oxygen (HBO)combined with drugs in treatment of radiation encephalopathy (PREP).Methods Computer-aided information retrieval was made by using such databases as Pubmed,Cochrane Library,Embase,CBM,CNKI,VIP and WanFang data,at the same time,manual data retrieval was also made by searching related literature both at home and abroad.The time span for information retrieval was from the inception of the above-mentioned database to March 2018.After 2 reviewers independently screened the retrieved literature in accordance with the included and excluded criteria,and collected the retrieved papers and evaluated the methodological quality of the retrieved literature,meta-analysis was performed by using RevMan 5.2 software.Results Finally,a total of 16 randomized controlled trials (RCTs) involving 990 patients were included in the study.Meta analysis showed that effective rate and cure rate of the HBO combined with drugs group were respectively [OR =5.78,95% CI (4.15,8.06)] (P<0.01) and [OR=4.56,95c%CI (2.88,7.20)] (P<0.01),which were superior to those of the simple drug treatment group.And the number of foci was less than that of the simple drug treatment group [OR =-2.63,95% CI (-3.70,-1.56)] (P < 0.01).Conclusion Current evidence shows that HBO combined with drug treatment could produce good effects on radiation encephalopathy.For this reason,it is worth further clinical popularization.

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