Papazian O, Alfonso I
Departamento de Neurología, Centro de Espasticidad y Movimientos Involuntarios, Miami Children's Hospital, Florida 33155, USA.
Rev Neurol. 2003;37(4):359-64.
Demand from parents has made hyperbaric oxygenation (HO) inhalation the most popular and rapid growing therapy for children with cerebral palsy (CP). To review peer reviewed articles of HO in children with CP to determine its efficacy and risks, literature was searched on-line using PubMed indexed for MEDLINE (1996-2003) for articles under CP and HO headings.
We found 16 references: 5 articles (1 uncontrolled pilot study, 2 from a single controlled study, 1 case report of complications and 1 revision) and 11 letters to the editor. The control study showed significant improvements in the middle, at the end and 3 months after 40 treatments with OH (O2=100%/1.75 AA) and placebo (O2=21%/1.3 AA) in the gross motor function measure, (2.9% vs 3%), self-control, auditory attention and visual working memory. There were no significant differences between the groups. Side effects included barometric otitis media (48.2% and 22.2% in the OH and placebo groups). The authors and the Advisory Scientific Committee of the American Academy of Cerebral Palsy and Developmental Medicine agreed that the positive results in both groups were due to a participation effect. The Southern Africa Undersea and Hyperbaric Association discouraged the ongoing, widespread, and informal use of HO for children with CP in South Africa based on the results of this randomized controlled study.
There are no scientific evidences for the use of HO in children with CP. Risks include barometric otitis media.
家长的需求使高压氧（HO）吸入成为治疗脑瘫（CP）患儿最受欢迎且增长迅速的疗法。为回顾关于CP患儿HO治疗的同行评审文章以确定其疗效和风险，我们使用MEDLINE索引的PubMed在线搜索了1996 - 2003年期间CP和HO主题下的文章。
我们找到16篇参考文献：5篇文章（1篇非对照试验性研究、2篇来自单一对照研究、1篇并发症病例报告和1篇综述）以及11封给编辑的信。对照研究表明，在进行40次OH（氧气 = 100%/1.75 AA）和安慰剂（氧气 = 21%/1.3 AA）治疗后，中期、末期以及3个月时，粗大运动功能测量、自我控制、听觉注意力和视觉工作记忆方面均有显著改善（分别为2.9%对3%）。两组间无显著差异。副作用包括气压性中耳炎（OH组和安慰剂组分别为48.2%和22.2%）。作者以及美国脑瘫与发育医学学会咨询科学委员会一致认为两组的阳性结果均归因于参与效应。基于这项随机对照研究的结果，南部非洲海底与高压氧协会不鼓励在南非持续、广泛且非正式地将HO用于CP患儿。
没有科学证据支持将HO用于CP患儿。风险包括气压性中耳炎。
