高压氧治疗与脑瘫
【摘要】吸入高压氧作为脑瘫患者的一种治疗方式已经广泛用于加拿大、英国、美国等国家，但是，最近的一项研究却指出：对于小儿脑瘫患者，高压氧治疗似乎疗效不大。【全文】Hyperbaric Oxygen Has No Advantage For Cerebral PalsyLancet02/22/2001By Harvey McConnellChildren with cerebral palsy are unlikely to receive any major benefit from treatment with hyperbaric oxygen.Use of hyperbaric oxygen for cerebral palsy has spread world-wide and is being used by several centers in Canada, Britain and the United States. Many families of children with cerebral palsy have heard anecdotal reports of successful treatment, and have asked clinicians for hyperbaric oxygen treatment despite the lack of scientific evidence of efficacy and possible side effects.In a randomised trial, Dr. Jean-Paul Collet and colleagues from McGill University, Montreal, Canada, and other centers in the province of Quebec, assessed the efficacy and side effects of hyperbaric oxygen therapy for children with cerebral palsy.In the trial among 111 children aged between three and 12 years, hyperbaric oxygen was randomly assigned to 57 children and slightly pressurised room air to 54 children. All children received 40 treatments over two months.Hyperbaric oxygen treatment involved spending one hour in a chamber with 100 percent oxygen at 1.75 atmospheres absolute (ATA). Children on slightly pressurised air received air at 1.3 ATA -- the lowest pressure at which pressure can be felt - to ensure experimental masking. Main outcome measure was gross motor function. Secondary outcomes included performance in activities of daily living, attention, working memory and speech.Both groups improved in all outcome measures over the course of the study, but there were no differences between the two treatments. Ear problems occurred in 27 children treated with hyperbaric oxygen, compared with 15 treated with hyperbaric air.In a comment on the findings, Dr. Collet said: "This trial shows that hyperbaric oxygen treatment has no advantages over treatment with slightly pressurised air in children with cerebral palsy. The global improvements seen in both treatments during the course of the study might be related to the context of the intervention and the selection of very motivated parents. A possible effect of increased pressure cannot be ruled out because of the slight increase in alveolar partial pressure of oxygen. Nevertheless, the same increase in blood oxygen can be reached by masked administration of 28 percent fractional inspiration of oxygen without increased pressure-a treatment that needs to be assessed before it can be recommended."Lancet 2001;357:582-86., 百拇医药