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高压氧疗法在骨科和风湿性疾病中的作用

The Role of Hyperbaric Oxygen Therapy in Orthopedics and Rheumatological Diseases.

作者信息

Barilaro Giuseppe, Francesco Masala Ignazio, Parracchini Renato, Iesu Cesare, Caddia Giulia, Sarzi-Puttini Piercarlo, Atzeni Fabiola

机构信息

Department of Internal Medicine, IRCCS San Raffaele Pisana, Rome, Italy.

Orthopedic Unit, Santissima Trinità Unit Hospital, Cagliari, Italy.

出版信息

Isr Med Assoc J. 2017 Jul;19(7):429-434.

Abstract

Hyperbaric oxygen therapy (HBOT) has been investigated as a primary/adjunctive treatment for a number of injuries and medical conditions including traumatic ischemia, necrotizing soft tissue injuries, non-healing ulcers and osteoradionecrosis, but the results are controversial. There is insufficient evidence to support or reject the use of HBOT to quicken healing or to treat the established non-union of fractures. However, in patients with fibromyalgia, HBOT reduces brain activity in the posterior cortex and increases it in the frontal, cingulate, medial temporal and cerebellar cortices, thus leading to beneficial changes in brain areas that are known to function abnormally. Moreover, the amelioration of pain induced by HBOT significantly decreases the consumption of analgesic medications. In addition, HBOT has anti-inflammatory and oxygenatory effects in patients with primary or secondary vasculitis. This review analyzes the efficacy and limitations of HBOT in orthopedic and rheumatologic patients.

摘要

高压氧疗法(HBOT)已被研究作为多种损伤和疾病的主要/辅助治疗方法,包括创伤性缺血、坏死性软组织损伤、不愈合溃疡和放射性骨坏死,但结果存在争议。目前尚无足够证据支持或反对使用HBOT来加速愈合或治疗已形成的骨折不愈合。然而,在纤维肌痛患者中,HBOT可降低后皮质的脑活动,并增加额叶、扣带回、颞中回和小脑皮质的脑活动,从而导致已知功能异常的脑区发生有益变化。此外,HBOT诱导的疼痛改善显著减少了镇痛药的消耗。此外,HBOT对原发性或继发性血管炎患者具有抗炎和充氧作用。本综述分析了HBOT在骨科和风湿科患者中的疗效和局限性。

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