Zamboni W A, Wong H P, Stephenson L L, Pfeifer M A
Division of Plastic Surgery, University of Nevada School of Medicine, Las Vegas, USA.
Undersea Hyperb Med. 1997 Sep;24(3):175-9.
The purpose of this study was to prospectively evaluate the effect of hyperbaric oxygen (HBO2) on the healing of diabetic lower extremity wounds. Ten consecutive insulin-dependent diabetic patients with chronic lower extremity wounds were referred for HBO2 treatment. The control group consisted of five patients, two claustrophobic and three rural. The latter refused HBO2 treatments because of logistic reasons. Five patients underwent 30 HBO2 treatments in the problem wound protocol (100% oxygen, 2 atm abs, 2 h/day, 5 days/wk). All patients were evaluated with transcutaneous oxygen measurements and had an initial surgical debridement of the wound. Weekly tracings of the wound surface area were made by a nurse or resident who was blinded to the group assignment. At the end of 7 wk, the mean wound area expressed as a percentage of pretreatment baseline area was compared between groups (analysis of variance, Duncan's post hoc). No significant differences were noted between groups with respect to age, gender, baseline wound area, wound site O2 tension, or presence of osteomyelitis. At the completion of each of the 7-wk treatment periods, a significantly greater reduction in wound surface area was noted in the HBO2 vs. the control group (P < 0.05). HBO2 treatment significantly reduced wound size compared to controls in this small, non-randomized prospective study. These results should serve as a basis for larger multicenter prospective, randomized, double-blind controlled studies to definitively evaluate the effect of HBO2 on the healing of diabetic foot wounds.
本研究的目的是前瞻性评估高压氧（HBO2）对糖尿病下肢伤口愈合的影响。连续10例患有慢性下肢伤口的胰岛素依赖型糖尿病患者被转诊接受HBO2治疗。对照组由5名患者组成，其中2名幽闭恐惧症患者和3名来自农村。后者因后勤原因拒绝接受HBO2治疗。5例患者按照问题伤口治疗方案接受了30次HBO2治疗（100%氧气，2个绝对大气压，每天2小时，每周5天）。所有患者均进行了经皮氧测量，并对伤口进行了初始手术清创。伤口表面积的每周记录由一名对分组情况不知情的护士或住院医生进行。在7周结束时，比较两组间以预处理基线面积百分比表示的平均伤口面积（方差分析，Duncan事后检验）。在年龄、性别、基线伤口面积、伤口部位氧张力或骨髓炎存在方面，两组间未观察到显著差异。在7周治疗期的每个阶段结束时，与对照组相比，HBO2组伤口表面积的减少更为显著（P < 0.05）。在这项小型、非随机的前瞻性研究中，与对照组相比，HBO2治疗显著减小了伤口大小。这些结果应作为更大规模多中心前瞻性、随机、双盲对照研究的基础，以明确评估HBO2对糖尿病足伤口愈合的影响。
