使用高壓氧是否能改善創傷性腦損傷患者意識程度

Can Hyperbaric Oxygen Therapy Improve Traumatic Brain Injury Patients' Consciousness?

創傷性腦損傷（TBI）通常由車禍、跌倒和運動傷害等引起，常伴有意識喪失。TBI會導致長期健康問題，如癲癇和認知功能障礙，並增加醫療和經濟負擔。研究指出高壓氧治療可以增加腦部供氧、減輕腦水腫和改善循環，有望提升TBI患者的神經功能和預後，但臨床成效卻一直存在爭議，故期望透過實證方式探討高壓氧對TBI患者意識程度的影響，以提供臨床使用建議。經過設立PICO問題，並以PRISMA流程篩選文獻後得出2篇隨機對照試驗和1篇系統性文獻回顧與統合分析，並以CASP Checklists進行評讀，結果顯示高壓氧治療能提升TBI患者的格拉斯哥昏迷指數（GCS）平均約3分。然而，具體的臨床效果仍需更多研究支持，尤其是在最佳治療壓力、次數和時間方面。因TBI患者執行高壓氧治療需自費，經濟成本較高，並非所有患者均能承受這一費用，因此在實施前應與家屬充分溝通治療目標、利弊和限制，避免過高期望。雖然高壓氧治療副作用相對較少，但仍需密切監控患者生命徵象，確保安全。

Traumatic brain injury (TBI) is commonly caused by car accidents, falls, and sports injuries, and is often accompanied by loss of consciousness. TBI can lead to long-term health issues such as epilepsy and cognitive dysfunction, increasing medical and economic burdens. Studies have indicated that hyperbaric oxygen therapy can increase brain oxygenation, reduce cerebral edema, and improve circulation, potentially enhancing the neurological function and prognosis of TBI patients. However, the clinical efficacy of this treatment remains controversial. Therefore, this study aims to explore the impact of hyperbaric oxygen therapy on the consciousness levels of TBI patients through evidence-based methods, providing clinical usage recommendations. Using the PICO framework and following the PRISMA process for literature screening, two randomized controlled trials and one systematic review with meta-analysis were identified. These studies were evaluated using CASP Checklists. The results show that hyperbaric oxygen therapy can improve the Glasgow Coma Scale (GCS) of TBI patients by an average of approximately 3 points. However, more research is needed to support these findings, particularly regarding the optimal pressure, frequency, and duration of treatment. Since hyperbaric oxygen therapy for TBI patients requires out-of-pocket expenses and is relatively costly, not all patients can afford this treatment. Therefore, it is essential to thoroughly discuss the treatment goals, benefits, and limitations with the patients' families to avoid unrealistic expectations. Although the side effects of hyperbaric oxygen therapy are relatively few, it is still necessary to closely monitor the patients' vital signs to ensure their safety.