高压氧对皮肤移植和皮瓣转移术后的影响

Effect of hyperbaric oxygenation on post-operative skin and skin flaps transplantation

目的：探讨高压氧（ＨＢＯ）治疗对皮肤移植及皮瓣转移术后成活的影响。刀法：对３６例皮肤移植和皮瓣转移术后患者加用ＨＢＯ治疗，并以常规治疗者３３例作为对照；同时测定１０例患者高压氧治疗前后血浆中丙二醛（ＭＤＡ）、红细胞超氧化物歧化酶（ＲＢＣ－ＳＯＤ）、谷胱甘肽（ＧＳＨ）及“中分子”物质（第一军医大学未发表资料）含量。结果：ＨＢＯ治疗组皮肤及皮瓣成活率明显提高（Ｐ＜０．０１）；治疗前后血浆中的ＭＤＡ，ＲＢＣ－ＳＯＤ，ＧＳＨ变化不显著（Ｐ＞０．０５）；而治疗后“中分子”物质考量下降，从４０２０±８００Ｕ／Ｌ下降到２３９０±７９０Ｕ／Ｌ。结论：血浆中“中分子”物质与病情密切相关；植皮和皮瓣转移术后早期进行ＨＢＯ治疗可以提高成活率。

Aim:To study the effect of hyperbaric oxygenation (HBO)on the survial rate of skinand skin flaps after transplantation. Methods:Thirtyt-six patients were treated with additional HBO af- ter transplantation of skin and skin flaps and 33 patients as control were treated with conventionalmethod alone. The values of plasma MDA, GSH ,RBC-SOD,and medium molecular substance (MMS)were measured in 10 patients before and after the HBO treatment. Results : The survival rate of skinand skin flaps was significantly increased with HBO treatment (P<0.01).The changes of MDA , GSHand RBC-SOD in plasma after HBO therapy were insignificant (P>0. 05).The content of MMS in plas- ma after HBO therapy was reduced from 4 020±800 U/L to 2 390±790 U/L.Conclusion:The resultssuggest that the content of MMS in plasma is closely related to patient′s condition and that early HBOtherapy after trarisplantation of skin and skin flaps could increase the survival rate of them.