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高压氧疗法(HBOT)在慢性糖尿病伤口治疗中的应用——一项随机试验。

Use of hyperbaric oxygen therapy (HBOT) in chronic diabetic wound - A randomised trial.

作者信息

Nik Hisamuddin N A R, Wan Mohd Zahiruddin W N, Mohd Yazid B, Rahmah S

机构信息

Universiti Sains Malaysia, School of Medical Sciences, Health Campus, Kelantan, Malaysia.

Pusat Perubatan Canselor Tuanku Mukhriz, UKM, Cheras, Malaysia.

出版信息

Med J Malaysia. 2019 Oct;74(5):418-424.

Abstract

INTRODUCTION

The purpose of this study was to investigate the effect of hyperbaric oxygen therapy (HBOT) towards diabetic foot ulcer (DFU) patients in addition to the standard wound care management.

METHODS

Fifty-eight diabetic patients with ulcers at Wagner Grade 2 and above involved in this study after presented at two study centres of tertiary teaching hospitals. The assigned patients received conventional wound care with additional HBOT given at 2.4 ATA for 90 minutes. Patients in the control group who received conventional wound care only were treated and observed for 30 days. The progress of wound healing was observed and measured at day 0, 10, 20 and 30 of study. The data collected were analysed using SPSS software (ver. 22) to study the association of HBOT towards healing of the diabetic foot ulcers.

RESULTS

Repeated Measures ANOVA analysis with Greenhouse-Geisser correction indicated that the means of wound size over time points (Day 0, 10, 20 and 30) among patients under HBOT group were statistically significantly different [F(1,61)=30.86, p<0.001)] compared to conventional therapy group. Multiple logistic regression analysis showed that HBOT group has nearly 44 times higher odds to achieve at least 30% wound size reduction within the study period (95%CI: 7.18, 268.97, p<0.001).

CONCLUSION

The results obtained in this study indicated that as an adjunctive therapy to conventional wound care, HBOT affected the rate of healing in diabetic foot ulcers significantly in terms of wound size reduction when compared to administering the conventional wound care alone.

摘要

引言

本研究的目的是除标准伤口护理管理外,调查高压氧疗法(HBOT)对糖尿病足溃疡(DFU)患者的影响。

方法

58例瓦格纳分级为2级及以上溃疡的糖尿病患者在两家三级教学医院的研究中心就诊后参与本研究。分配的患者接受常规伤口护理,并额外给予2.4ATA的高压氧治疗90分钟。仅接受常规伤口护理的对照组患者接受治疗并观察30天。在研究的第0、10、20和30天观察并测量伤口愈合的进展。使用SPSS软件(版本22)对收集的数据进行分析,以研究高压氧疗法与糖尿病足溃疡愈合的相关性。

结果

采用Greenhouse-Geisser校正的重复测量方差分析表明,与传统治疗组相比,高压氧治疗组患者在不同时间点(第0、10、20和30天)的伤口大小均值在统计学上有显著差异[F(1,61)=30.86,p<0.001]。多元逻辑回归分析显示,高压氧治疗组在研究期间伤口大小至少减少30%的几率几乎高出44倍(95%CI:7.18,268.97,p<0.001)。

结论

本研究获得的结果表明,作为传统伤口护理的辅助疗法,与单独进行传统伤口护理相比,高压氧疗法在减少伤口大小方面显著影响了糖尿病足溃疡的愈合速度。

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