高压氧治疗植物状态临床疗效及时间窗的Meta分析  

Time window of hyperbaric oxygen in treatment of persistent vegetable state and its treatment efficacy： a Meta analysis

作　　者：杨艺[1] 何江弘[1] 焦辉[1] 夏小雨[1] 党圆圆[1] 戴宜武[1] 徐如祥[1] 

机构地区：[1]北京军区总医院附属八一脑科医院,北京100700

出　　处：《中华神经医学杂志》2015年第4期501-505,共5页Chinese Journal of Neuromedicine

摘　　要：目的评价高压氧治疗植物状态的疗效与时间窗。方法运用计算机检索中国知网、万方数据库、维普数据库自1990年1月至2013年12月收录的国内公开发表的高压氧治疗植物状态的临床研究文献，中文检索词为“植物状态”、“植物人”、“高压氧”，并进行Meta分析。结果共检索出165篇相关文献，通过筛选最终纳入19篇关于高压氧治疗植物状态临床疗效的文献，其中包括接受高压氧治疗患者939例，对照组患者659例；研究治疗时间窗的有17篇文献纳入研究，分为治疗时间窗〈60d组和治疗时间窗≥60d组，分别有患者700例和330例。纳入文献Jadad评分普遍不高，最高分为2分；对临床疗效研究的文献进行合并分析显示，治疗组和对照组的有效率分别为67．51％和34．45％，差异有统计学意义（Z=12．16，P=0．000，OR=0．25，95％可信区间为0．20～0.31）。对不同治疗时间窗研究的17篇文献进行合并分析显示，〈60d组和≥60d组有效率分别为63．29％和22．73％，差异有统计学意义（Z=9．72，P=0．000，OR=5．21，95％可信区间为3．74～7．27）。结论高压氧对于植物状态的治疗有明显的疗效，最好的治疗窗口在发病后60d之内。Objective To review systematically the clinical curative effects and time window of hyperbaric oxygen treatment of persistent vegetative state （PVS）. Methods All the clinical research articles about hyperbaric oxygen for PVS from January 1990 to December 2013 were retrieved from China national knowledge internet, Wanfang Database and Vip Database （the Chinese key words： vegetative state, the vegetable, or hyperbaric oxygen）, and then, a Meta-analysis was conducted. Results Search terms yielded 165 pieces of articles and 19 were included in the final analysis for treatment efficacy; the treatment group included 939 patients and the control group included 659 patients. Totally, 17 pieces of articles of time window were included; the patients with onset〈60 d group included 700 patients and the patients with onset≥ 60 d group included 330 patients. The Jadad scores of included articles were not high in general, and the highest scores were two points. Comparable baseline data were demonstrated in all of the articles. Data from articles were pooled and analyzed, and the results showed that the effective rate of treatment group and control group were 67.51% and 34.45%, with significant difference （Z=12.16, P=0.000, odd ratio=0.25, 95% confidence interval=0.20-0.31）. The effective rate of patients with onset〈60 d group and patients with onset ≥ 60 d group was 22.73% and 63.29% （Z=9.72, P=-0.000, odd ratio=5.21, 95% confidence interval=3.74-7.27） Conclusion Hyperbaric oxygen treatment enjoys better treatment efficacy than conventional treatment; patients with onset〈60 d have better prognosis than patients with onsets〉 60 d.

关 键 词：植物状态 高压氧 时间窗 荟萃分析 

分 类 号：R741.05[医药卫生—神经病学与精神病学]