高压氧治疗难愈性创面：一项长期回顾性队列研究。

Hyperbaric Oxygen Therapy for Nonhealing Wounds-A Long-term Retrospective Cohort Study.

机构信息

At Hyperbaric Medical Center, Rijswijk, South Holland, the Netherlands, Rutger C. Lalieu, MD, PhD, is Physician and René D. Bol Raap, MD, is Diving Medical Physician. Casper Smit, MD, PhD, is Vascular Surgeon, Reinier de Graaf Hospital, Delft, South Holland, and Vascular Surgeon at the Hyperbaric Medical Center, Rijswijk. Emile FL Dubois, MD, PhD, is Pulmonary Physician and Consultant, Hyperbaric Medical Center, Rijswijk. Rob A. van Hulst, MD, PhD, is Head of the Hyperbaric Department, Amsterdam University Medical Center.

出版信息

Adv Skin Wound Care. 2023 Jun 1;36(6):304-310. doi: 10.1097/01.ASW.0000922696.61546.31. Epub 2023 Apr 4.

DOI:10.1097/01.ASW.0000922696.61546.31

PMID:37017408

Abstract

OBJECTIVE

To analyze wound healing results of hyperbaric oxygen therapy (HBOT) for a variety of different wound types.

METHODS

This retrospective cohort study included all patients treated with HBOT and wound care at a single hyperbaric center between January 2017 and December 2020. The primary outcome was wound healing. Secondary outcome measures were quality of life (QoL), number of sessions, adverse effects, and treatment cost. Investigators also examined possible influencing factors, including age, sex, type and duration of wound, socioeconomic status, smoking status, and presence of peripheral vascular disease.

RESULTS

A total of 774 treatment series were recorded, with a median of 39 sessions per patient (interquartile range, 23-51 sessions). In total, 472 wounds (61.0%) healed, 177 (22.9%) partially healed, 41 (5.3%) deteriorated, and 39 (5.0%) minor and 45 (5.8%) major amputations were performed. Following HBOT, median wound surface area decreased from 4.4 cm 2 to 0.2 cm 2 ( P < .01), and patient QoL improved from 60 to 75 on a 100-point scale ( P < .01). The median cost of therapy was €9,188 (interquartile range, €5,947-€12,557). Frequently recorded adverse effects were fatigue, hyperoxic myopia, and middle ear barotrauma. Attending fewer than 30 sessions and having severe arterial disease were both associated with a negative outcome.

CONCLUSIONS

Adding HBOT to standard wound care increases wound healing and QoL in selected wounds. Patients with severe arterial disease should be screened for potential benefits. Most reported adverse effects are mild and transient.

摘要

目的

分析高压氧治疗（HBOT）对多种不同类型伤口的愈合效果。

方法

本回顾性队列研究纳入了 2017 年 1 月至 2020 年 12 月期间在单一高压氧中心接受 HBOT 和伤口护理治疗的所有患者。主要结局为伤口愈合。次要结局指标为生活质量（QoL）、治疗次数、不良反应和治疗费用。研究人员还检查了可能的影响因素，包括年龄、性别、伤口类型和持续时间、社会经济状况、吸烟状况以及周围血管疾病的存在。

结果

共记录了 774 个治疗系列，每个患者的中位数治疗次数为 39 次（四分位距，23-51 次）。共有 472 个伤口（61.0%）愈合，177 个（22.9%）部分愈合，41 个（5.3%）恶化，39 个（5.0%）进行了小截肢，45 个（5.8%）进行了大截肢。接受 HBOT 治疗后，伤口面积中位数从 4.4 cm 2 降至 0.2 cm 2（P <.01），患者 QoL 从 60 分提高到 75 分（100 分制，P <.01）。治疗的中位数费用为 9188 欧元（四分位距，5947-12557 欧元）。常记录的不良反应有疲劳、高氧性近视和中耳气压伤。接受少于 30 次治疗和患有严重动脉疾病与不良结局均相关。