鞘内巴氯芬治疗遗传性痉挛性截瘫:系统综述。

IF 1.5 4区 医学 Q3 REHABILITATION International Journal of Rehabilitation Research Pub Date : 2024-03-01 Epub Date: 2024-01-20 DOI:10.1097/MRR.0000000000000607
Luisa Viana Pinto, Isabel Romeiro, Filipa Gouveia, Joana Ramalho, Sara Ribeiro Silva, Maria Inês Táboas Simões, Joana Rodrigues Leal
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引用次数: 0

摘要

本系统综述旨在评估鞘内巴氯芬(ITB)在遗传性痉挛性截瘫(HSP)治疗中的应用。我们在两个电子数据库中进行了广泛的检索。我们确定了 1990 年至 2022 年间发表的文章(PubMed、Scopus),并采用了以下纳入标准:干预时诊断为 HSP(家族性或散发性);关于 ITB 对 HSP 患者疗效的报告;通过栓剂注射或连续输注测试进行的试验;以及 ITB 泵植入。我们根据 Cochrane 消费者与沟通审查小组的数据提取模板制作并调整了数据提取表,以收集相关数据。我们进行了定性分析,以叙述总结的方式呈现结果。共有 6 项研究符合我们的纳入标准。51 名 HSP 患者接受了植入前 ITB 试验。从确诊到植入泵的时间从 5 年到 30 年不等。初始栓塞剂量从 20 微克到 50 微克不等,稳态时的平均剂量从 65 微克到 705 微克不等。根据改良的阿什沃斯量表,接受 ITB 治疗的患者痉挛状况有所改善。虽然所有研究都报告了主观步态的改善,但并非所有研究都发现了客观步态的改善。最常见的副作用是导管相关问题。本综述的研究结果支持使用 ITB 作为治疗保守疗法难治的 HSP 痉挛的一种有效且可行的方法。
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Intrathecal baclofen for the management of hereditary spastic paraparesis: a systematic review.

This systematic review aims to evaluate the use of intrathecal baclofen (ITB) for hereditary spastic paraparesis (HSP) treatment. An extensive search in two electronical databases was performed. We identified articles published between 1990 and 2022 (PubMed, Scopus), and applied the following inclusion criteria: diagnosis of HSP at the time of the intervention, either familial or sporadic; report on the effect of ITB in patients with HSP; test trial via either bolus injections or continuous infusion tests; and ITB pump implantation. A data extraction sheet based on the Cochrane Consumers and Communication Review Group's data extraction template was created and adapted to collect relevant data. A qualitative analysis was performed to present the results in narrative summary fashion. A total of 6 studies met our inclusion criteria. 51 patients with HSP had a pre-implantation ITB trial. The time since the diagnosis until the pump implantation ranged from 5 to 30 years. The initial bolus ranged from 20 to 50 μg and the mean doses used at steady state ranged from 65 to 705 μg. An improvement in spasticity was observed on the modified Ashworth Scale in patients treated with ITB. Although all studies reported a subjective gait improvement, not all found an objective improvement in gait. The most common side effect reported was catheter-related problems. The findings of this review support the use of ITB as an effective and a viable option for the treatment of spasticity in HSP refractory to conservative therapies.

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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
88
审稿时长
6-12 weeks
期刊介绍: International Journal of Rehabilitation Research is a quarterly, peer-reviewed, interdisciplinary forum for the publication of research into functioning, disability and contextual factors experienced by persons of all ages in both developed and developing societies. The wealth of information offered makes the journal a valuable resource for researchers, practitioners, and administrators in such fields as rehabilitation medicine, outcome measurement nursing, social and vocational rehabilitation/case management, return to work, special education, social policy, social work and social welfare, sociology, psychology, psychiatry assistive technology and environmental factors/disability. Areas of interest include functioning and disablement throughout the life cycle; rehabilitation programmes for persons with physical, sensory, mental and developmental disabilities; measurement of functioning and disability; special education and vocational rehabilitation; equipment access and transportation; information technology; independent living; consumer, legal, economic and sociopolitical aspects of functioning, disability and contextual factors.
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