Is management of acute traumatic brain injury effective？ A literature review of published Cochrane Systematic Reviews

作     者：LEi Jin GA0 GUO JIANGJi-yao 

作者机构：Neurosurgery Department of Renji Hospital Medical School of Shanghai JiaoTong University Shanghai Institute of Head Trauma Shanghai 200127 China 

出 版 物：《Chinese Journal of Traumatology》 (中华创伤杂志（英文版）)

年 卷 期：2012年第15卷第1期

页      面：17-22页

学科分类：0403[教育学-体育学] 1205[管理学-图书情报与档案管理] 12[管理学] 120501[管理学-图书馆学] 1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 120502[管理学-情报学] 10[医学] 

基　　金：National Nature Science Funds, (30872671) Shanghai Pujiang Program, (2010-2012) 

主　　题：Brain injuries Meta-analysis Review Acute management 

摘      要：Objective：To evaluate all the possible therapeutic measures concerning the acute management of traumatic brain injury（TBI）mentioned in Cochrane Systematic Reviews published in the Cochrane Database of Systematic Reviews（CDSR）.Methods：An exhausted literature search for all published Cochrane Systematic Reviews discussing therapeutic rather than prevention or rehabilitative interventions of TBI was *** retrieved such databases as CDSR and Cochrane Injury Group,excluded the duplications,and eventually obtained 20 results,which stand for critical appraisal for as many as 20 different measures for TBI *** important data of each systematic review,including total population,intervention,outcome,etc,were collected and presented in a designed ***,we also tried to find out the possible weakness of these clinical trials included in each ***：Analysis of these reviews yielded meanfuling observations：（1）The effectiveness of most ordinary treatments in TBI is inconclusive except that corticosteroids are likely to be ineffective or harmful,and tranexamic acid,nimodipine and progesterone show a promising effect in bleeding trauma,traumatic subarachnoid hemorrhage,TBI or severe TBI.（2）A majority of the systematic reviews include a small number of clinical trials and the modest numbers of patients,largely due to the uncertainty of the effectiveness.（3）The quality of most trials reported in the systematic reviews is more or less questionable.（4）In addition,lots of other complex factors together may lead to the inconclusive results demonstrated in the Cochrane Systematic ***：For clinical physicians,to translate these conclusions into practice with caution is *** medication and nursing care deserve additional attention as well and can be *** researchers,high quality trials with perfect design and comprehensive consideration of various factors are urgently required.