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高压氧疗法(HOT)在某些泌尿系统疾病的治疗中能占有一席之地吗?

Can Hyperbaric Oxygen Therapy (HOT) have a place in the treatment of some urological diseases.

作者信息

Passavanti Giandomenico

机构信息

Dpt. of Urology, Misericordia Hospital, Grosseto.

出版信息

Urologia. 2010 Oct-Dec;77(4):257-62.

Abstract

HOT (Hyperbaric Oxygen Therapy) is used in urological diseases: Scrotal/perineal fasciitis and Radiation-induced cystitis (and proctopathy); in urgency and frequency syndrome and with chronic pelvic pain the use of HOT is still experimental. The basic principle of HOT is to increase oxygen dissolved in the blood when it is administered at high pressure. O2 is then distributed to the tissues through the pressure gradient; tissue hyper-oxygenation has anti-inflammatory and pain-killing effects, it increases bacterial permeability to antibiotics, strengthens neo-angiogenesis, reinforces lymphocytes and macrophages function, augments testosterone secretion (in males), and finally enhances wound healing process. We treated with HOT (integrating other treatments) 17 cases of necrotizing fasciitis, 13 radiation-induced cystitis and 4 cases of urgency and frequency syndrome. We always had good results, with a good cleansing of the dissected areas in Fournier's gangrene; in the cases of radiation-induced cystitis we had an improvement in the symptoms and hematuria, and finally in cases of urgency and frequency syndrome we had a transient reduction of symptomatology and pain. Our experiences and the specific literature on this subject suggest that HOT, sometimes associated with other medical and surgical therapies, can be an effective tool to treat urological diseases; in some cases its efficacy was well demonstrated (Fournier's gangrene and Radiation-induced cystitis), in others (urgency-frequency syndrome and chronic pelvic pain) it is a promising technique which definitely needs further research.

摘要

高压氧疗法(HOT)用于治疗泌尿系统疾病:阴囊/会阴筋膜炎和放射性膀胱炎(及直肠病);对于尿急尿频综合征和慢性盆腔疼痛,高压氧疗法的应用仍处于实验阶段。高压氧疗法的基本原理是在高压下增加血液中溶解的氧气。然后,氧气通过压力梯度分布到组织中;组织过度氧合具有抗炎和止痛作用,可增加细菌对抗生素的通透性,增强新血管生成,增强淋巴细胞和巨噬细胞功能,增加睾酮分泌(男性),最终促进伤口愈合过程。我们采用高压氧疗法(结合其他治疗方法)治疗了17例坏死性筋膜炎、13例放射性膀胱炎和4例尿急尿频综合征患者。我们始终取得了良好的效果,在福尼尔坏疽病例中,切开区域得到了良好的清创;在放射性膀胱炎病例中,症状和血尿有所改善,最后在尿急尿频综合征病例中,症状和疼痛得到了短暂缓解。我们的经验以及关于该主题的特定文献表明,高压氧疗法有时与其他药物和手术疗法联合使用,可成为治疗泌尿系统疾病的有效工具;在某些情况下,其疗效得到了充分证明(福尼尔坏疽和放射性膀胱炎),而在其他情况下(尿急尿频综合征和慢性盆腔疼痛),它是一种有前景的技术,肯定需要进一步研究。

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