高压氧对下肢动脉缺血再灌注损伤的影响

The effect of hyperbaric oxygen on lower limb ischemia-reperfusion injury

目的:观察高压氧(Hyperbaric oxygen,HBO)治疗下肢动脉缺血再灌注损伤对患肢及肾功能的影响。方法:将经腔内血管重建后的重症下肢缺血患者72例(80条肢体)随机分为HBO组和常规组,每组40条肢体。HBO组接受高压氧治疗外,两组其它治疗措施完全相同。检测不同时间患肢血液内氧代谢、乳酸脱氢酶(LDH)、肌酐(Cr)、pH值水平,测定踝肱指数(ABI),观察患肢情况。结果:不同时间点HBO组氧代谢水平、LDH、Cr、pH值及ABI与常规组比较差异有统计学意义(均P<0.05)。术后24h内常规组有5条患肢、HBO组有1条患肢出现筋膜室综合症行切开减压。结论:下肢动脉缺血再通后,早期HBO治疗能显著提高氧含量,改善微循环障碍、抑制组织水肿,降低肾功能损害、促进肢体缺血后再灌注损伤的修复。

Objective：To observe the effect of limb and real function about the hyperbaric oxygen （HBO） adjuvant therapy lower extremity arterial limb ischemia-reperfusion injuryon limb and real function in patients with lower extremity arterial limb ischemia reperfusion injury. Method： 72 patients with severe lower limb ischemia （80 limbs） after treated by endovascular revascularization were randomly divided into HBO group and conventional groups. Each group included 40 limbs. Except HBO group received hyperbaric oxygen therapy,other tthe therapeu tic measures are were the same for in both groups except for hyperbaric oxygen therapy practiced in HBO group. Oxygen metabolism, lactate dehydrogenase （LDH）, creatinine （Cr）, pH value were detected at different time, an- kle-brachial index （ABI） was measured, and the limbs were observed. Result： There were statistically significant difference about in oxygen metabolism, LDH, Cr, pH value and the ABI at different time points between HBO group and conventional group （P〈0.05）. Five limbs in conventionai group and one in HBO group, there suffered from occurred compartment syndrome. Conclusion： Once the lower extremity arterial recanalization occured, HBO should be used as soon as possible,It can significantly increase the oxygen content,improve microcirculation, con trol alleviate tissue edema,mitigate renal dysfunction and promote recovery of the limbs with ischemia reperfusion injury of limbs repaired.