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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 therapy for severe craniocerebral injury. Methods The methodologies of the included studies were evaluated by searching the full-text databases of Cochrane Library, Pubmed, Web of Science, Medline, Chinese Academic Journals, Wanfang Database and VSP Chinese Science Periodicals from May 1997 to May 2012. The researchers performed rigorous evaluation and data extraction on the quality of the included literature and used Review manager 5.0 software to conduct a systematic review of quality-matched randomized clinical trials (RCTs). Results A total of 209 RCT patients were enrolled in the study. Among them, 104 patients in the treatment group (hyperbaric oxygen therapy after craniotomy decompression hematoma) and 105 in the control group (craniotomy decompression hematoma removal) Dehydration decreased intracranial pressure, nutritional nerves, anti-infection and other conventional treatment. The results of systematic reviews showed that the Glasgow Coma Scale (GCS), the GCS score on the 14th postoperative day, the postoperative 14th postoperative survival rate in the treatment group were significantly better than those in the control group, with statistical difference. Conclusion Compared with simple surgical treatment, hyperbaric oxygen therapy after operation can significantly improve the efficacy of patients with severe craniocerebral injury, which is worth to be greatly promoted.