高压氧和突然的感觉神经听力损失:一个系统的审查和元分析
Isaac L Alter1, Mickie Hamiter1,2, Jiying Han3
1Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York, USA.
The Laryngoscope
|August 1, 2025
概括
高压氧气疗法 (HBOT) 与医学疗法相结合,可显著改善突发感神经听力损失 (SSNHL) 患者的听力恢复. 这一元分析证实了HBOT的存在.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 神经外科 神经外科
- 紧急医疗 紧急医疗
背景情况:
- 突然感觉神经听力损失 (SSNHL) 是一个重大的临床挑战,对受影响的个体产生深远的影响.
- 高压氧气疗法 (HBOT) 是SSNHL的潜在治疗方法,但其有效性仍有争议.
研究的目的:
- 系统地审查和元分析关于HBOT在治疗SSNHL中的有效性的现有证据.
- 评估单独或与其他疗法结合的HBOT对SSNHL患者听力恢复的影响.
主要方法:
- 在多个数据库 (PubMed,EMBASE,CENTRAL,MEDLINE,Google Scholar,Web of Science,Clinicaltrials.gov) 进行了全面的文献搜索,截至2025年5月7日.
- 数据提取和选由两名调查人员按照PRISMA指南独立进行.
- 使用随机效应模型计算听力恢复的合并几率比率 (ORs).
主要成果:
- 分析了20项研究,包括16项RCT和4项非随机前性研究,涉及1087名接受HBOT和600名仅接受医学治疗 (MT) 的患者.
- 十项研究的元分析显示,接受HBOT加MT治疗的患者与单独MT治疗相比,听力恢复的几率高出2.61倍 (95%CI1.86-3.68,p<0.001).
- 小组分析表明,当HBOT与全身类固醇 (OR 2.54) 或全身类固醇和内耳类固醇 (OR 2.64) 结合使用时,听力恢复的几率显著更高.
结论:
- 将HBOT与医学治疗结合起来似乎对被诊断为SSNHL的个体的听力恢复有益.
- 建议进行进一步的研究,以标准化治疗方案,并改进数据报告,以便在SSNHL中获得有关HBOT疗效的更确的发现.
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