常规低剂量氧补充对急性中风成年人死亡和残疾的影响:中风氧研究随机临床试验
Christine Roffe1,2, Tracy Nevatte2,3, Julius Sim2
1University Hospital of North Midlands NHS Trust, Stoke-on-Trent, United Kingdom.
JAMA
|October 4, 2017
概括
在非低毒性急性中风患者中,低剂量预防性氧气治疗没有减少死亡或残疾. 这些发现不支持在该患者群体中常规使用氧气.
科学领域:
- 神经学
- 危急护理医学
- 临床试验
背景情况:
- 在急性中风后的最初几天中,低氧是常见的,通常不会被检测出来.
- 补充氧气可以预防二次神经恶化并改善中风恢复.
- 在急性中风患者中,常规低剂量氧气的疗效需要进一步研究.
研究的目的:
- 评估常规低剂量氧气治疗与控制剂量氧气治疗在中风后90天减少死亡和残疾的有效性.
- 为了确定夜间的氧气给药是否比持续的氧气治疗更有效地改善中风的结果.
- 在非低毒性急性中风患者中评估低剂量氧的安全性和有效性.
主要方法:
- 一个单盲随机临床试验,涉及8003名在24小时内入院的急性中风患者.
- 参与者被随机分配为持续接受氧气72小时,夜间氧气3晚,或控制 (只有在临床上有指示时接受氧气).
- 通过顺序逻辑回归分析,使用修改的兰金尺度评分评估了90天的主要结果.
主要成果:
- 与对照组相比,接受预防性氧气的患者在90天内死亡或残疾没有显著减少 (OR0. 97,P=.47).
- 持续氧气治疗没有比夜间氧气治疗更有效 (OR1. 03,P=.61).
- 没有特定的小组从补充氧气中受益,也没有发现明显的危害.
结论:
- 预防性低剂量氧补充剂没有减少非低氧性急性中风患者的死亡或残疾.
- 这些发现不支持在临床环境中常规使用低剂量氧气.
- 可能需要进一步的研究来确定可能受益于氧气治疗的特定中风患者群体.
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