Adjuvant hyperbaric oxygen therapy (HBO2)for treatment of necrotizing fasciitis reduces mortality and amputation rate.
Adjuvant hyperbaric oxygen therapy (HBO2)for treatment of necrotizing fasciitis reduces mortality and amputation rate.
复制标题
辅助高压氧治疗（HBO2）治疗坏死性筋膜炎可降低死亡率和截肢率。
DOI：
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复制
发表时间：
2005
影响因子：
0.9
通讯作者：
P. Cianci
中科院分区：
文献类型：
--
作者：
SJ Escobar;J. Slade;TK Hunt;P. Cianci
目的
回顾性分析42例接受HBO 2治疗的坏死性软组织感染患者，以确定疗效和安全性。总死亡率为11.9%，发病率为5%。
背景数据摘要
坏死性软组织感染的死亡率和发病率历来很高，包括截肢。常见的误解，防止广泛使用的HBO 2的诊断，包括手术延迟，发病率增加，严重的并发症。
方法
42名连续的坏死性筋膜炎患者（平均年龄56.1岁）在一家主要转诊中心接受了连续性HBO 2治疗，作为积极的手术、抗生素和重症监护计划的一部分。受累部位包括下腹（15例患者）、大腿和会阴（9例患者）、侧腹（4例患者）、小腿（3例患者）以及手臂、肩部和腋窝（2例患者）。合并症包括糖尿病、慢性肾衰竭、静脉药物滥用、外周血管疾病和恶性肿瘤。
结果
死亡率为11.9%（5例患者）。两例截肢（一根手指和一根阴茎）都是在运送到我们的机构之前发生的。每例患者平均手术清创次数为2.8次;在HBO开始前进行了1.25次。平均7次HBO 2治疗后，感染过程得到控制，以确保伤口成功闭合。并发症仅包括3例患者（7%）的轻度耳气压伤和17例患者（41%）的禁闭焦虑，但并未阻止治疗。
结论
与坏死性筋膜炎“标准”治疗方案结局的国家报告相比，我们使用HBO 2的经验表明，全面积极的治疗降低了死亡率（34% v. 11.9%）和发病率（截肢率50% v. 0%）。治疗是安全的，没有手术延迟或干扰标准治疗可归因于HBO 2。
OBJECTIVE
A retrospective analysis of 42 patients with necrotizing soft tissue infections treated with adjunctive HBO2 to ascertain efficacy and safety. Overall mortality was 11.9% and morbidity 5%.
SUMMARY BACKGROUND DATA
Necrotizing soft tissue infections have historically high rates of mortality and morbidity, including amputation. Common misconceptions that prevent widespread use of adjunctive HBO2 for this diagnosis include delays to surgery, increased morbidity, and significant complications.
METHODS
Forty-two consecutive patients (average age 56.1) with necrotizing fasciitis presenting to a major referral center were treated with adjunctive HBO2 as part of an aggressive program of surgery, antibiotics, and critical care. Involved areas included the lower abdomen (15 patients), thigh and perineum (9 patients), flank (4 patients), lower leg (3 patients), and arm, shoulder, and axilla (2 patients). Co-morbidities included diabetes mellitus, chronic renal failure, intravenous drug abuse, peripheral vascular disease, and malignancy.
RESULTS
Mortality was 11.9% (5 patients). Both amputations (a finger and a penis), occurred prior to transport to our facility. The average number of surgical debridements was 2.8 per patient; 1.25 performed prior to the start of HBO. The infectious process was controlled after an average of 7 HBO2 treatments were administered to ensure successful wound closure. Complications consisted of only mild ear barotrauma in 3 patients (7%), and confinement anxiety in 17 (41%) but did not prevent treatment.
CONCLUSION
Compared to national reports of outcomes with "standard" regimens for necrotizing fasciitis, our experience with HBO2, adjunctive to comprehensive and aggressive management, demonstrates reduced mortality (34% v. 11.9%), and morbidity (amputations 50% v. 0%). The treatments were safe and no delays to surgery or interference with standard therapy could be attributed to HBO2.
内皮细胞中血小板活化因子产生的调节。
DOI：
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发表时间：
1989
期刊：
The Journal of biological chemistry
影响因子：
--
作者：
Whatley,RE;Nelson,P;Zimmerman,GA;Stevens,DL;Parker,CJ;McIntyre,TM;Prescott,SM
通讯作者：
Prescott,SM