摘要
目的系统评价糖皮质激素联合高压氧对急性一氧化碳中毒迟发性脑病的防治疗效与安全性。方法计算机检索Pub Med、EMbase、Web of Science、the Cochrane Library、CBM、CNKI、VIP和Wan Fang Data数据库,检索时间均从建库至2015年9月30日。采用End Note X6、Rev Man5.3和Stata软件进行Meta分析。结果共纳入12个随机对照试验,共1 415名研究对象。Meta分析结果显示:1与采用高压氧治疗的对照组相比,采用糖皮质激素联合高压氧的试验组在预防DEACMP的发生[RR=0.23,95%CI(0.14,0.38),P<0.001]、提高治愈率[RR=1.52,95%CI(1.17,1.98),P=0.002]、提高总有效率[RR=1.36,95%CI(1.22,1.51),P<0.001]、减少无效率[RR=0.24,95%CI(0.15,0.40),P<0.001]方面效果更佳,其差异均有统计学意义。2在病死率方面,试验组与对照组差异无统计学意义(P=0.38)。3试验组存在少量的不良反应(1.6%)。结论糖皮质激素联合高压氧治疗虽有少量不良反应,但对急性一氧化碳中毒迟发性脑病的防治效果好于常规高压氧治疗。
Objective To systematically review the efficacy and safety of glucocorticoids combined with conventional high pressure oxygen for delayed encephalopathy after acute carbon monoxide poisoning（ DEACMP）. Methods Databases including Pub Med,EMbase,Web of Science,the Cochrane Library,CBM,CNKI,VIP and Wan Fang Data were searched to retireve the relevant references from the start to September 30 2015. Sensitivity analysis（ Rev Man 5. 3） and Stata 14. 0 were employed for meta-analysis.Results A total of 12 random controlled trials were included for final meta-analysis,involving 1 415 participants. Meta-analysis showed that the test group of corticosteroids and hyperbaric oxygen therapy had better outcomes in reducing the incidence DEACMP（ RR = 0. 23,95% CI： 0. 14 - 0. 38,P〈0. 001）,improving the cure rate（ RR = 1. 52,95% CI： 1. 17 - 1. 98,P = 0. 002）,improving the overall efficiency（ RR = 1. 36,95% CI： 1. 22 - 1. 51,P〈0. 001）,and reducing the inefficiency（ RR = 0. 24,95% CI：0. 15 - 0. 40,P〈0. 001） when compared with the control group receiving hyperbaric oxygen therapy. But there was no significant difference in the mortality between the 2 groups（ P = 0. 38）. The glucocorticoids group had a few adverse reactions（ 1. 6%）. Conclusion Although there are a small number of adverse reactions,the efficacy of corticosteroids combined with hyperbaric oxygen is superior to conventional highpressure oxygen therapy in the prevention and treatment of DEACMP.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2016年第2期207-214,共8页
Journal of Third Military Medical University
基金
卫生部科技教育司卫生行业科研专项(201202006-08)~~
关键词
糖皮质激素
一氧化碳中毒
迟发性脑病
META分析
高压氧
glucocorticoids
carbon monoxide poisoning
delayed encephalopathy
meta-analysis
hyperbaric oxygen
