Okada T, Yoshida H, Matsunaga T, Kouchi K, Ohtsuka Y, Saitou T, Ohnuma N
Department of Pediatric Surgery, Chiba University, Graduate School of Medicine, Chiba, Japan.
Eur J Pediatr Surg. 2004 Aug;14(4):240-4. doi: 10.1055/s-2004-820902.
We hypothesized that hyperbaric oxygenation (HBO) combined with a long tube (LT) [HBO + LT] would be more effective than HBO combined with a short tube (ST) [HBO + ST] for simple adhesive postoperative intestinal obstruction (APIO) in children, assuming that there is synergism between HBO and LT. The objective of this study was to determine retrospectively the effect of HBO + LT compared to HBO + ST for simple APIO in children. Seventy-three patients were diagnosed with simple APIO, and 51 of these patients were treated with HBO + LT during 104 HBO sessions, while 22 were treated with HBO + ST during 34 HBO sessions. HBO was performed at a pressure of 2 atmospheres for 60 minutes once daily. The recovery rates after HBO therapy were 87.5 % for the HBO + LT group and 82.4 % for the HBO + ST group (p = 0.4496). HBO was performed 5 +/- 3 (range 1 to 15) times for the HBO + LT group and 4 +/- 2 (range 1 to 8) times for the HBO + ST group (p = 0.9847) for ultimate recovery from simple APIO. The recovery rate after HBO therapy of up to 6 sessions was 78.2 % for HBO + LT and 92.1 % for HBO + ST (p = 0.0360) among the cases that recovered ultimately. The effect of HBO + LT did not significantly differ from that of HBO + ST, but the insertion of an LT is more intricate and the cost is higher than that of an ST. Therefore, we conclude that the use of an LT is not necessarily required for HBO therapy for simple APIO.
我们假设,对于儿童单纯性粘连性术后肠梗阻(APIO),高压氧治疗(HBO)联合长管(LT)[HBO + LT]比HBO联合短管(ST)[HBO + ST]更有效,前提是HBO与LT之间存在协同作用。本研究的目的是回顾性确定HBO + LT与HBO + ST相比对儿童单纯性APIO的疗效。73例患者被诊断为单纯性APIO,其中51例患者在104次HBO治疗期间接受了HBO + LT治疗,而22例患者在34次HBO治疗期间接受了HBO + ST治疗。HBO治疗时压力为2个大气压,每天1次,持续60分钟。HBO治疗后的恢复率,HBO + LT组为87.5%,HBO + ST组为82.4%(p = 0.4496)。为从单纯性APIO最终恢复,HBO + LT组进行HBO治疗5±3次(范围1至15次),HBO + ST组进行4±2次(范围1至8次)(p = 0.9847)。在最终恢复的病例中,HBO治疗6次及以内时,HBO + LT组的恢复率为78.2%,HBO + ST组为92.1%(p = 0.0360)。HBO + LT的效果与HBO + ST的效果无显著差异,但插入LT更复杂,成本高于ST。因此,我们得出结论,对于单纯性APIO的HBO治疗,不一定需要使用LT。