高压氧气疗法用于晚期辐射组织损伤
Zhiliang Caleb Lin1, Michael H Bennett2,3, Glen C Hawkins4
1Hyperbaric Service, Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Australia.
The Cochrane database of systematic reviews
|August 16, 2023
概括
高压氧气疗法 (HBOT) 可能会改善晚期辐射组织损伤 (LRTI) 的结果,但不会预防死亡. 虽然HBOT对LRTI和伤口愈合有好处,但它存在风险,例如视力敏度降低和耳朵巴罗创伤.
科学领域:
- 瘤学和辐射医学
- 高压医学的高压医学.
- 组织的修复和再生.
背景情况:
- 放射治疗是一种常见的癌症治疗方法,幸存者经常经历晚期辐射组织损伤 (LRTI) 治疗后的几个月或几年.
- 建议高压氧疗法 (HBOT) 通过增强对受损组织的血液供应来治疗LRTI.
- 本综述评估了HBOT在管理或预防LRTI方面的疗效和安全性.
研究的目的:
- 评估HBOT治疗或预防LRTI的好处和危害.
- 在随机对照试验 (RCT) 中,将HBOT与没有HBOT的疗法进行比较.
主要方法:
- 在2022年1月之前使用广泛的搜索方法进行了更新的Cochrane审查.
- 包括18个RCT (1071名参与者) 对比HBOT与没有HBOT用于LRTI预防或治疗.
- 使用GRADE标准评估主要结果,包括生存,临床问题解决和特定场所的结果.
主要成果:
- HBOT显示出完全解决或显著改善LRTI (低确定性证据) 的潜力.
- 在头部和部手术后,观察到伤口脱光的减少 (低确定性证据).
- 骨质放射性死 (ORN) 的疼痛评分显示略有改善 (中度确定性证据),但HBOT没有预防一年死亡率.
结论:
- 在头部,部,膀和直肠组织中,HBOT可能为LRTI提供好处,以及减少伤口脱光和疼痛.
- 该疗法带有风险,包括视力敏度降低和耳朵巴罗创伤,需要仔细选择患者.
- 需要进一步的研究来优化HBOT协议,确定理想的患者子组,并评估长期的疗效和成本效益.
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