Hiệu quả và an toàn của liệu pháp oxy áp suất cao trong đột quỵ thiếu máu cục bộ cấp tính: một nghiên cứu tổng hợp và phân tích tổng hợp dữ liệu
Tóm tắt
Nghiên cứu này nhằm đánh giá hiệu quả và độ an toàn của liệu pháp oxy áp suất cao bổ sung (HBOT) trong đột quỵ thiếu máu cục bộ cấp tính (AIS) dựa trên các bằng chứng hiện có.
Chúng tôi đã tiến hành tìm kiếm toàn diện đến ngày 15 tháng 4 năm 2023, trên bảy cơ sở dữ liệu chính cho các thử nghiệm ngẫu nhiên có đối chứng (RCT) so sánh liệu pháp oxy áp suất cao bổ sung với các phương pháp điều trị không phải HBOT (không có HBOT hoặc HBOT giả) cho AIS. Việc trích xuất và đánh giá dữ liệu được thực hiện độc lập bởi hai nhà nghiên cứu. Chất lượng của các nghiên cứu được đưa vào được đánh giá bằng công cụ do Tổ chức Cochrane cung cấp. Phân tích tổng hợp dữ liệu được thực hiện bằng cách sử dụng Rev Man 5.3.
Tổng cộng có 8 nghiên cứu với 493 bệnh nhân được đưa vào. Phân tích tổng hợp cho thấy không có sự khác biệt có ý nghĩa thống kê giữa HBOT và nhóm đối chứng về điểm NIHSS (MD = -1.41, 95%CI = -7.41 đến 4.58), chỉ số Barthel (MD = 8.85, 95%CI = -5.84 đến 23.54), TNF-α (MD = -5.78, 95%CI = -19.93 đến 8.36), sICAM (MD = -308.47, 95%CI = -844.13 đến 13227.19), sVCAM (MD = -122.84, 95%CI = -728.26 đến 482.58), sE-selectin (MD = 0.11, 95%CI = -21.86 đến 22.08), CRP (MD = -5.76, 95%CI = -15.02 đến 3.51), tỷ lệ xuất hiện biến cố bất lợi trong ≤ 6 tháng theo dõi (OR = 0.98, 95%CI = 0.25 đến 3.79). Tuy nhiên, HBOT cho thấy sự cải thiện có ý nghĩa trong điểm số Rankin đã chỉnh sửa (MD = 0.10, 95%CI = 0.03 đến 0.17), và tỷ lệ xuất hiện biến cố bất lợi vào cuối điều trị (OR = 0.42, 95%CI = 0.19 đến 0.94) so với nhóm đối chứng.
Mặc dù các phát hiện của chúng tôi không hỗ trợ việc sử dụng thường quy HBOT để cải thiện các kết quả lâm sàng trong AIS, cần có nghiên cứu thêm để khám phá tiềm năng hiệu quả của nó trong các khoảng thời gian điều trị cụ thể và cho các kịch bản tắc nghẽn mạch não khác nhau. Do đó, khả năng HBOT mang lại lợi ích lâm sàng cho AIS không thể hoàn toàn bị loại trừ.
Từ khóa
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