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目的研究高压氧治疗新生儿缺氧缺血性脑病的临床疗效。这种治疗在中国使用较多而在西方国家非常少。数据来源对西方国家(以Cochrane文献资料库登录的临床对照试验及系统性综述数据库,Medline,Embase, CINAHL和HealthSTAR)和中国(中国医院数字图书馆,中华医学网络杂志)的数据库以及人工检索中国杂志。不设语种限制。综述方法随机或准随机对照试验比较高压氧与“常规治疗”在治疗足月儿缺氧缺血性脑病的疗效。结果包括死亡率和长期神经系统后遗症。标准表格用于提取和分析数据。约克评述与传播中心的标准用于质量评估。主要是定性分析,但包括荟萃分析。结果共检索到20个试验,主要来自中国。根据西方标准(CONSORT:国际学术期刊发表多中心临床试验论文撰写标准),试验的质量较差。几乎所有的研究表明高压氧治疗组较对照组有更好的结果。荟萃分析显示死亡率的比值比(odds ratio)为0．26(95％可信区间0．14～0．46),神经系统后遗症的比值比为0．41(0．27～0．61)。结论高压氧治疗可能会减少足月新生儿缺氧缺血性脑病死亡率和神经系统后遗症的发生。由于所有试验研究的质量均较差,同时可能存在发表带来的偏倚,因此需要进行足够有说服力的、高质量的随机对照研究来证实这些发现。中国的医学文献可能是影响临床实践和进行其他系统性综述的丰富的证据来源。
Objective To study the clinical effect of hyperbaric oxygen therapy on neonatal hypoxic-ischemic encephalopathy. This treatment is used more in China and very little in western countries. DATA SOURCES Databases of Western countries (Cochrane database clinically controlled trials and systematic review databases, Medline, Embase, CINAHL, and HealthSTAR) and China (China Hospital Digital Library, China Medical Network Magazine) and manual search of China magazine. No language restrictions. Summary Methods Randomized or quasi-randomized controlled trials comparing the efficacy of hyperbaric oxygen with “routine treatment” in the treatment of hypoxic-ischemic encephalopathy in term infants. Results include mortality and long-term neurological sequelae. Standard forms are used to extract and analyze data. York Review and Communication Center standards for quality assessment. Mainly qualitative analysis, but including meta-analysis. Results A total of 20 trials were retrieved, mainly from China. According to Western standards (CONSORT: international academic journals publish multicentre clinical trial papers writing standards), the quality of the trial is poor. Almost all studies show that hyperbaric oxygen therapy group has better results than the control group. Meta-analyzes showed odds ratios of 0.26 (95% confidence interval 0.14 to 0.46) and 0.41 (0.27 to 0.61) for neurological sequelae . Conclusions Hyperbaric oxygen therapy may reduce the incidence of neonatal hypoxic-ischemic encephalopathy mortality and neurological sequelae. Because of the poor quality of all experimental studies and possible publication bias, adequate and convincing, high-quality randomized controlled studies are needed to confirm these findings. Chinese medical literature may be a rich source of evidence that influences clinical practice and other systematic reviews.