Apolo-Arenas María Dolores, Guerrero-Nogales Laura, Díaz-Muñoz César Luis, Caro-Puértolas Berta, Parraca José Alberto, Caña-Pino Alejandro
Department of Medical-Surgical Therapy, Medicine and Health Sciences Faculty, University of Extremadura, Badajoz, Spain.
Research Group PhysioH (Fisioterapia e Hipoterapia), University of Extremadura, Badajoz, Spain.
Int J Vasc Med. 2024 Dec 30;2024:8450783. doi: 10.1155/ijvm/8450783. eCollection 2024.
Diabetes mellitus (DM) is one of the most common chronic endocrine diseases, characterized by hyperglycemia, due to abnormal nitric oxide synthesis. The trend of an increase in the number of patients with DM continues. The medical and economic burden of DM is not only associated with hyperglycemia management but also with the management of DM-related complications. Most chronic DM-associated complications are vascular in nature. Thus, hyperbaric oxygen therapy (HBOT) can be used for primary and/or secondary prevention of vascular complications. This systematic review is aimed at providing an up-to-date analysis of the effects of HBOT in patients with diabetic foot ulcers (DFUs) on the prevention of amputation, fitting, and rehabilitation of amputees. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to conduct this systematic review. PubMed and Web of Science (WOS) database were employed in the search, which ended in November 2023. A risk of bias analysis was performed using the Evidence Project tool. After analyzing the records obtained, 10 studies were identified. However, seven fulfilled the inclusion criteria and were included in this systematic review. All included patients were over 18 years of age and had DM. The degree of DFU was assessed with the Wagner scale, being between 2 and 4, and the age of previous treatment of these DFU was taken into account. The results of the current systematic review showed that significant improvements can be achieved with HBOT when comparing its effects to those of the control group that followed usual care. Most studies included in the review showed positive results for DFU, amputation prevention, fitting, and rehabilitation of amputees. Therefore, the use of a hyperbaric chamber and standard care, as opposed to standard care alone, is favorable in patients with chronic DFUs. Promising and positive results were achieved for wound healing in DFU and the prevention of amputations.
糖尿病（DM）是最常见的慢性内分泌疾病之一，其特征为高血糖，病因是一氧化氮合成异常。糖尿病患者数量呈持续上升趋势。糖尿病的医疗和经济负担不仅与高血糖管理有关，还与糖尿病相关并发症的管理有关。大多数与糖尿病相关的慢性并发症本质上是血管性的。因此，高压氧疗法（HBOT）可用于血管并发症的一级和/或二级预防。本系统评价旨在对高压氧疗法对糖尿病足溃疡（DFU）患者预防截肢、义肢适配和截肢者康复的效果进行最新分析。本系统评价遵循系统评价和Meta分析的首选报告项目（PRISMA）指南进行。检索使用了PubMed和科学网（WOS）数据库，检索截至2023年11月。使用证据项目工具进行偏倚风险分析。在分析所获得的记录后，确定了10项研究。然而，7项符合纳入标准并被纳入本系统评价。所有纳入患者均年满18岁且患有糖尿病。采用瓦格纳量表评估DFU的程度，范围在2至4级之间，并考虑这些DFU先前治疗的时长。当前系统评价的结果表明，与接受常规护理的对照组相比，高压氧疗法可取得显著改善。本评价纳入的大多数研究在DFU、截肢预防、义肢适配和截肢者康复方面均显示出阳性结果。因此，对于慢性DFU患者，使用高压氧舱加标准护理，而非单纯标准护理，是有益的。在DFU伤口愈合和截肢预防方面取得了有前景的阳性结果。
