高压氧治疗新生儿缺氧缺血性脑病疗效的Meta分析  

Meta-analysis of the Effect of Hyperbaric Oxygen on Hypoxic Ischemia Encephalopathy

作　　者：张国荣[1,2] 罗影[1] 于海燕[3] 闵连秋[1] 

机构地区：[1]辽宁医学院附属第一医院,辽宁省锦州市121001 [2]辽宁省盘锦市中心医院 [3]辽宁省锦州市中心医院

出　　处：《中国全科医学》2013年第14期1641-1645,共5页Chinese General Practice

摘　　要：目的探讨高压氧治疗新生儿缺氧缺血性脑病(HIE)的疗效。方法检索PubMed和EMBase、中国知网、维普、万方中文数据库中2001年1月—2012年10月公开发表的采用高压氧治疗新生儿HIE的临床随机对照试验,按纳入标准对文献进行筛选后提取相关信息,采用Stata 11软件Meta分析流程,选择合适方法计算合并的RR值及95%可信区间(CI),并进行敏感性分析和发表偏倚的估计。结果本研究共纳入47篇文献,其中报道高压氧治疗HIE有效率的文献有38篇,病死率的文献有7篇,后遗症发生率的文献有12篇。合并结果显示,干预组较对照组的有效率高〔RR=0.29,95%CI(0.25,0.34),P<0.05〕,干预组病死率及后遗症发生率均低于对照组〔病死率:RR=0.23,95%CI(0.13,0.39),P<0.05;后遗症发生率:RR=0.30,95%CI(0.23,0.39),P<0.05〕。漏斗图示存在明显不对称性,Egger检验结果 (t=-3.95,P<0.05)显示存在发表偏倚。结论高压氧治疗HIE较常规治疗方法更为有效,并且能够有效降低HIE患儿的病死率和神经系统后遗症的发生危险。Objective To evaluate the efficacy of hyperbaric oxygen on hypoxie ischemia eneephalopathy （HIE）. Methods According to the inclusion criteria, random controlled trials related to hyperbaric oxygen in the treatment of HIE pub- lished from January 2001 to October 2012 were searched and selected from PubMed, EMBase, CNKI, VIP, and Wanfang on- line databases. Related variables were extracted and the pooled RRs were calculated after the heterogeneity test with the software Stats 11. Publication bias and sensitivity were evaluated at the same time. Results A total of 47 articles were included in this study. There were 38 papers concerning the effective rate of hyperbaric oxygen therapy, 7 papers concerning the mortality of HIE neonates, and 12 papers concerning the sequela incidence of HIE neonates. Our results indicated that the combined effective rate of hyperbaric oxygen therapy was higher than that of conventional therapy [ RR = 0. 29, 95% CI （ 0. 25, 0. 34 ）, P 〈 0.05 ]. The mortality and the sequela incidence of HIE neonates were decreased after hyperbaric oxygen therapy, for mortality [ RR = 0. 23, 95% CI （0. 13, 0. 39）, P 〈 0. 05 ], for sequela incidence [ RR = 0. 30, 95% CI （0. 23, 0. 39）, P 〈 0. 05 ]. Fun- nel plot showd obvious asymmetry. Egger＇s test results （t = 3.95, P 〈 0.05） indicated publication bias. Conclusion Hyper- baric oxygen therapy shows better efficacy than conventional therapy in the treatment of HIE. It can also decrease the mortality and the risk of neurological sequela. It also can decrease the mortality and the risk of neurological sequela.

关 键 词：高压氧 缺氧缺血 脑 治疗结果 META分析 

分 类 号：R364.4[医药卫生—病理学]