Levett Denny, Bennett Michael H, Millar Ian
Anaesthesia and Critical Care Research Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Cochrane Database Syst Rev. 2015 Jan 15;1(1):CD007937. doi: 10.1002/14651858.CD007937.pub2.
Hyperbaric oxygen therapy (HBOT) involves the therapeutic administration of 100% oxygen in a pressure chamber at pressures above one atmosphere absolute. This therapy has been used as an adjunct to surgery and antibiotics in the treatment of patients with necrotizing fasciitis with the aim of reducing morbidity and mortality.
To review the evidence concerning the use of HBOT as an adjunctive treatment for patients with necrotizing fasciitis (NF). Specifically, we wish to address the following questions.1. Does administration of HBOT reduce mortality or morbidity associated with NF?2. What adverse effects are associated with use of HBOT in the treatment of individuals with NF?
We searched the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE Ovid (1966 to September 2014); the Cumulative Index to Nursing and Allied Health Literature (CINAHL) Ovid (1982 to September 2014); EMBASE Ovid (1980 to September 2014); and the Database of Randomised Controlled Trials in Hyperbaric Medicine (DORCTHIM, M Bennett) (from inception to September 2014). In addition, we performed a systematic search of specific hyperbaric literature sources. This included handsearching of relevant hyperbaric textbooks; hyperbaric journals (Hyperbaric Medicine Review, South Pacific Underwater Medicine Society Journal, European Journal of Underwater and Hyperbaric Medicine, Aviation Space and Environmental Medicine Journal); and conference proceedings of the major hyperbaric societies (Undersea and Hyperbaric Medical Society, South Pacific Underwater Medicine Society, European Underwater and Baromedical Society, International Congress of Hyperbaric Medicine).
We included all randomized and pseudo-randomized trials (trials in which an attempt at randomization has been made but the method was inappropriate, for example, alternate allocation) that compared the effects of HBOT with the effects of no HBOT (no treatment or sham) in the treatment of children and adults with necrotizing fasciitis.
We planned independent data collection by two review authors using standardized forms.
We found no trials that met the inclusion criteria.
AUTHORS' CONCLUSIONS: This systematic review failed to locate relevant clinical evidence to support or refute the effectiveness of HBOT in the management of necrotizing fasciitis. Good quality clinical trials are needed to define the role, if any, of HBOT in the treatment of individuals with necrotizing fasciitis.
高压氧疗法（HBOT）是在压力舱内以高于一个绝对大气压的压力给予100%的氧气进行治疗。该疗法已被用作手术和抗生素的辅助手段，用于治疗坏死性筋膜炎患者，旨在降低发病率和死亡率。
综述关于使用高压氧疗法作为坏死性筋膜炎（NF）患者辅助治疗的证据。具体而言，我们希望解决以下问题。1. 高压氧疗法的实施是否能降低与坏死性筋膜炎相关的死亡率或发病率？2. 在治疗坏死性筋膜炎患者中使用高压氧疗法会产生哪些不良反应？
我们检索了Cochrane对照试验中央注册库（CENTRAL）；Ovid MEDLINE（1966年至2014年9月）；护理及相关健康文献累积索引（CINAHL）Ovid（1982年至2014年9月）；EMBASE Ovid（1980年至2014年9月）；以及高压医学随机对照试验数据库（DORCTHIM，M Bennett）（从创建至2014年9月）。此外，我们对特定的高压氧文献来源进行了系统检索。这包括手工检索相关的高压氧教科书；高压氧期刊（《高压氧医学评论》《南太平洋水下医学协会杂志》《欧洲水下与高压氧医学杂志》《航空航天与环境医学杂志》）；以及主要高压氧协会的会议论文集（水下与高压氧医学协会、南太平洋水下医学协会、欧洲水下与气压医学协会、国际高压氧医学大会）。
我们纳入了所有比较高压氧疗法与不进行高压氧疗法（不治疗或假治疗）对坏死性筋膜炎儿童和成人治疗效果的随机和半随机试验（尝试进行随机化但方法不恰当的试验，例如交替分配）。
我们计划由两位综述作者使用标准化表格独立收集数据。
我们未找到符合纳入标准的试验。
本系统综述未能找到相关临床证据来支持或反驳高压氧疗法在坏死性筋膜炎治疗中的有效性。需要高质量的临床试验来确定高压氧疗法在治疗坏死性筋膜炎患者中（若有）的作用。
