高压氧合治疗动脉闭塞性疾病和糖尿病血管病变的疗效评价

A. Begić, M. Dilić
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引用次数: 2

摘要

动脉粥样硬化最严重的并发症之一是动脉闭塞性疾病(AOD)和糖尿病性血管病变(DA),是世界范围内临床实践中常见的慢性问题。高压氧(HBO)治疗是解决各种形式缺氧的一种治疗方式。目的:比较HBO治疗AOD和DA缺血性症状患者与标准治疗(血管扩张剂、抗生素、抗血小板药物和他汀类药物)的治疗效果,并证明治疗方式本身的益处。方法:我们进行临床前瞻性研究,共纳入80例患者,分为两组:动脉闭塞性疾病及下肢创面患者40例,其中高压氧治疗加标准治疗亚组(n=20);糖尿病血管病变及糖尿病下肢创面患者40例,其中高压氧治疗加标准治疗亚组(n=20)。结果:在标准治疗的基础上进行高压氧治疗的患者的治疗效果明显高于未进行高压氧治疗的患者。接受HBO治疗的9例患者有显著改善,而未接受HBO治疗的患者仅有1例患者有显著改善效果。结论:高压氧治疗是糖尿病性下肢AOD和DA患者创伤愈合的有效治疗手段。在我们的患者中,在标准治疗方案之上的HBO治疗可以减少AOD和DA患者下肢截肢的数量。这些结果支持HBO治疗糖尿病下肢伤口愈合的临床应用。
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Evaluation of the Occlusive Arterial Disease and Diabetic Angiopathy Treatment Effects by Hyperbaric Oxygenation
Introduction: One of the most severe complications of atherosclerosis is arterial occlusive disease (AOD) and with diabetic angiopathy (DA), is a common chronic problem in clinical practice worldwide. Hyperbaric oxygen (HBO) therapy is a therapeutic modality for solving all forms of hypoxia. Aim: To compare the treatment with HBO therapy in patients with AOD and DA ischemic symptomatology with standard treatment i.e. vasodilators, antibiotics, antiplatelets and statins, and to demonstrate the benefit of the therapeutic modality itself. Methods: We conducted a clinical prospective study and included a total of 80 patients, divided into two groups: 40 patients with the arterial occlusive disease and lower-extremity wounds, with sub-group (n=20) treated with HBO therapy on the top of the standard therapy and 40 patients with diabetic angiopathy and diabetic lower-extremity wounds, with sub-group (n=20) treated with HBO therapy on top of the standard therapy. Results: The efficacy of therapy in patients treated with HBO therapy on the top of standard therapy was significantly higher than in the group of HBO non-treated patients. There was a significant improvement in 9 patients treated with HBO therapy, while in HBO non-treated patients the significant improvement effect was observed only in one patient. Conclusion: HBO therapy is an effective therapeutic component in the healing of diabetic lower-extremity wounds in the patients with AOD and DA. In our patients HBO therapy on the top of standard therapeutic protocol has an effect of reducing the number of lower-limb amputations in patients with AOD and DA. These results support clinical use of HBO therapy for diabetic lower-extremity wound healing.
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