Baroni G, Porro T, Faglia E, Pizzi G, Mastropasqua A, Oriani G, Pedesini G, Favales F
Diabetes Care. 1987 Jan-Feb;10(1):81-6. doi: 10.2337/diacare.10.1.81.
We treated a group of 18 hospitalized adult diabetic patients (all with retinopathy, 17 with symptomatic neuropathy, and 6 with macroangiopathy) presenting with gangrenous lesions of the foot by a combined regime consisting of strict metabolic control, daily debridement of necrotic tissues, and daily hyperbaric oxygen (HBO) treatments given in a multiplace oxygen chamber. Another group of 10 adult subjects with comparable foot lesions (all with retinopathy, 9 with symptomatic neuropathy, and 4 with macroangiopathy) was treated in exactly the same way except for HBO. In the test treatment group, 16 patients were healed, and the remaining 2 showed no improvement and later underwent amputation. The number of HBO treatments required for healing was significantly related to the size of gangrenous lesions. In the non-HBO-treated group, only 1 patient improved, 5 of 10 showed no change, and 4 of 10 worsened until leg amputation was unavoidable. Comparison of the two groups by chi 2-test revealed a highly significant difference (P = .001). In practical terms, HBO treatment drastically reduced leg amputations in patients so treated in the last 3 yr compared with earlier and current figures for patients not receiving HBO treatment.
我们对一组18名住院成年糖尿病患者（均患有视网膜病变，17名有症状性神经病变，6名有大血管病变）进行治疗，这些患者足部出现坏疽性病变，采用的联合治疗方案包括严格的代谢控制、每日对坏死组织进行清创，以及在多人高压氧舱中进行每日高压氧（HBO）治疗。另一组10名有类似足部病变的成年受试者（均患有视网膜病变，9名有症状性神经病变，4名有大血管病变），除未进行HBO治疗外，治疗方式完全相同。在试验治疗组中，16名患者痊愈，其余2名无改善，后来接受了截肢手术。愈合所需的HBO治疗次数与坏疽性病变的大小显著相关。在未接受HBO治疗的组中，只有1名患者有所改善，10名中有5名无变化，10名中有4名病情恶化，直至不可避免地进行腿部截肢。通过卡方检验对两组进行比较，发现差异极具显著性（P = 0.001）。实际上，与未接受HBO治疗的患者早期和当前数据相比，HBO治疗在过去3年中大幅减少了接受该治疗患者的腿部截肢情况。
