Bakhtiani Parkash, Mansuri Owaise, Yadav Abhijeet, Osuoha Chima, Knight Patty, Baynosa Richard, McLafferty Robert, Jakoby Michael
Undersea Hyperb Med. 2015 May-Jun;42(3):183-90.
Hyperbaric oxygen (HBO2) therapy is an established intervention for treating chronic diabetic lower extremity ulcers, but the impact of glycemic control on its efficacy has not been determined. The purpose of this study was to evaluate the impact of blood glucose control at initiation of HBO2 treatment on wound healing. Hemoglobin A1c (HbA1c) was measured at start of HBO2 therapy for 22 patients undergoing treatment of chronic lower extremity ulcers at two regional wound care centers. Patients with HbA1c < 7.5% were stratified into a "good glycemic control" group (n = 12, mean HbA1c 6.5 ± 0.8%), and patients with HbA1c ≥ 7.5% were stratified into a "poor glycemic control" group (n = 10, mean HbA1c 8.8 ± 1.4%, p = 0.004 compared to "good glycemic control group"). After 20 HBO2 sessions over 30 days in addition to standard wound care interventions, there was no difference in wound healing between the two glycemic control groups as indicated by. reduction from baseline in ulcer surface area, depth, or volume. The diabetic lower extremity wound response to HBO2 therapy is unaffected by glycemic control prior to treatment, and HBO2 treatment should not be delayed for suboptimal blood glucose control.
高压氧（HBO₂）疗法是治疗慢性糖尿病下肢溃疡的一种既定干预措施，但血糖控制对其疗效的影响尚未确定。本研究的目的是评估在开始HBO₂治疗时血糖控制对伤口愈合的影响。在两个地区伤口护理中心，对22例接受慢性下肢溃疡治疗的患者在开始HBO₂治疗时测量糖化血红蛋白（HbA1c）。HbA1c < 7.5%的患者被分层为“血糖控制良好”组（n = 12，平均HbA1c 6.5 ± 0.8%），HbA1c≥7.5%的患者被分层为“血糖控制不佳”组（n = 10，平均HbA1c 8.8 ± 1.4%，与“血糖控制良好”组相比，p = 0.004）。除了标准伤口护理干预外，在30天内进行20次HBO₂治疗后，两个血糖控制组之间的伤口愈合情况没有差异，这通过溃疡表面积、深度或体积相对于基线的减少来表明。糖尿病下肢伤口对HBO₂治疗的反应不受治疗前血糖控制的影响，并且不应因血糖控制不理想而延迟HBO₂治疗。
