Lopez A E, Rodriguez S, Flores I
United High School, Laredo, Texas, USA.
Undersea Hyperb Med. 2001 Spring;28(1):35-6.
We report a case of a T8 paraplegic woman who experienced necrosis of the bladder due to inadvertent chronic over distention. After bladder repair, the patient suffered from severe ischemic hemorrhagic cystitis. Despite many attempts to control the bleeding with standard treatments, the hematuria continued. Although hyperbaric oxygen (HBO2) therapy has not been proven to be helpful in patients with hemorrhagic cystitis not related to radiation or chemotherapy, the physiopathologic mechanisms of the cysttis, involving ischemia, led us to believe that outpatient would benefit from HBO2 therapy in analogy to the approved use of HBO2 therapy in radiation cystitis. Since the use of HBO2 therapy has not been previously reported in this situation, we met with some hesitation from the HBO2 therapy department After reviewing the literature and discussing the case, a medical panel reached a consensus to allow us to commence the treatment The patient had a remarkable response, and remains without hematuria 6 mo. after treatment.
我们报告了一例T8截瘫女性患者，该患者因不经意间的慢性膀胱过度扩张而出现膀胱坏死。膀胱修复术后，患者患上了严重的缺血性出血性膀胱炎。尽管多次尝试用标准治疗方法控制出血，但血尿仍持续存在。虽然高压氧（HBO₂）疗法尚未被证明对与放疗或化疗无关的出血性膀胱炎患者有帮助，但膀胱炎的病理生理机制涉及缺血，这使我们相信，类似于HBO₂疗法在放射性膀胱炎中的批准应用，门诊患者可能会从HBO₂疗法中获益。由于此前尚未有在这种情况下使用HBO₂疗法的报道（这一情况），高压氧治疗科室对此有所犹豫。在查阅文献并讨论该病例后，一个医学专家小组达成共识，允许我们开始治疗。患者反应显著，治疗6个月后仍无血尿。
