Bedioui Haykel, Makni Amin, Magherbi Houcine, Ben Safta Zoubeir
Hopital La Rabta, Tunis, Tunisie.
Tunis Med. 2012 Jun;90(6):427-30.
Despite the growing number of therapeutic methods and the recent introduction of new drugs more active in the therapeutic arsenal, lesions of the ano-perineal Crohn's disease remains difficult to support. Hyperbaric oxygen (HBO) was made before the era of infliximab, an interesting therapeutic approach in which the current position remains unclear.
To assess HBO efficacy in the treatment of anal fistulas refractory Crohn's disease.
Literature review.
Hyperbaric oxygen therapy was used in the 90's when the biotherapy was not part of the armamentarium for Crohn's disease. Research conducted has identified only nine publications evaluating the efficacy of hyperbaric oxygen therapy in the treatment of anal fistulas refractory Crohn's disease. Among the nine publications, we have retained only four: two clinical trials and two clinical cases. The total number of patients was 22: 12 women and 10 men. The average age of patients was 37 years. The average number of session was 42 sessions. Remission was observed in 15 patients (68.18%) whereas with Infliximab rate is 66%. Adverse events were observed in 2 patients (16.6%). Indeed, instead of considering them as two different alternatives, it should be combined to obtain a synergy to increase response rates, shorten the healing and especially to decrease the recurrence rate.
Only a prospective randomized controlled trial (with two arms: biotherapy versus biotherapy associated with hyperbaric oxygen therapy) could accommodate this technique in the armamentarium of perineal lesions of Crohn's disease.
尽管治疗方法的数量不断增加，且最近在治疗手段中引入了更有效的新药，但肛门周围克罗恩病的病变仍然难以治疗。高压氧（HBO）疗法是在英夫利昔单抗时代之前出现的，这是一种有趣的治疗方法，其目前的地位仍不明确。
评估高压氧治疗克罗恩病难治性肛瘘的疗效。
文献综述。
在生物疗法尚未成为克罗恩病治疗手段的20世纪90年代，高压氧疗法就已被使用。已开展的研究仅发现9篇评估高压氧疗法治疗克罗恩病难治性肛瘘疗效的文献。在这9篇文献中，我们仅保留了4篇：2项临床试验和2个临床病例。患者总数为22例，其中女性12例，男性10例。患者的平均年龄为37岁。平均疗程为42次。15例患者（68.18%）观察到缓解，而英夫利昔单抗的缓解率为66%。2例患者（16.6%）观察到不良事件。事实上，不应将它们视为两种不同的选择，而应将它们联合起来以获得协同作用，从而提高缓解率、缩短愈合时间，尤其是降低复发率。
只有前瞻性随机对照试验（两组：生物疗法与生物疗法联合高压氧疗法）才能将该技术纳入克罗恩病会阴病变的治疗手段中。
