Krieg R E, Wolcott J H, Confer A
Aviat Space Environ Med. 1975 Oct;46(10):1241-5.
Mycobacterium ulcerans causes chronic nectotizing ulcers of the skin and subcutaneous tissue and is a serious health problem in some tropical countries. Chemotherapy has not been effective, and the treatment of choice is extensive debridement followed by skin grafting. In spite of this, many infections are complicated by disfiguring scars, contraction deformities, and--rarely--amputation. There are other procedures that may promote healing (e.g., heat treatment, rifampicin), but none has been completely evaluated. In our study, hyperbaric oxygenation (HBO), an effective treatment for many bacterial diseases, including some mycobacterial infections, was used to treat mice with M. ulcerans-infected footpads. Three groups (40 mice/group) were treated daily with 100% oxygen by three different protocols: 2.5 ATA for 2 h; 2.5 ATA for 1.25 h, twice a day; and 2 ATA for 3.5 h. The degree of infection in the treated mice was compared weekly with 40 positive controls (infected, not treated). The HBO therapy was more effective in the group treated at 2.5 ATA for 1.25 h, twice a day. After 25 weeks, there had been two feet autoamputated and only 12 deaths among the mice, as compared to 18 feet amputated and 24 deaths in the control group. Thus, hyperbaric oxygenation has a beneficial effect in mice and, if used in conjunction with other therapeutic procedures in man, may be an effective therapeutic adjunct in treating M. ulcerans infections.
溃疡分枝杆菌可引发皮肤和皮下组织的慢性坏死性溃疡，在一些热带国家是严重的健康问题。化疗效果不佳，目前的首选治疗方法是广泛清创后进行皮肤移植。尽管如此，许多感染仍会并发毁容性瘢痕、挛缩畸形，极少情况下还会导致截肢。还有其他一些可能促进愈合的方法（如热处理、利福平），但均未得到全面评估。在我们的研究中，高压氧疗（HBO）作为一种对包括某些分枝杆菌感染在内的多种细菌性疾病有效的治疗方法，被用于治疗感染溃疡分枝杆菌的小鼠脚垫。将三组（每组40只小鼠）按三种不同方案每日给予100%氧气治疗：2.5个绝对大气压（ATA），持续2小时；2.5 ATA，持续1.25小时，每日两次；以及2 ATA，持续3.5小时。每周将治疗小鼠的感染程度与40只阳性对照（感染但未治疗）小鼠进行比较。每日两次给予2.5 ATA、每次1.25小时治疗的组中，高压氧疗效果更佳。25周后，治疗组小鼠中有两只脚自行截肢，仅12只死亡，而对照组有18只脚截肢，24只死亡。因此，高压氧疗对小鼠有有益作用，如果与人类的其他治疗方法联合使用，可能是治疗溃疡分枝杆菌感染的一种有效辅助治疗手段。
