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高压氧疗法治疗下肢静脉溃疡:单中心6年结果回顾性研究

Hyperbaric Oxygen Therapy for Venous Leg Ulcers: A 6 Year Retrospective Study of Results of a Single Center.

作者信息

Lalieu Rutger C, Akkerman Ida, van Hulst Rob A

机构信息

Hyperbaar Geneeskundig Centrum, Rijswijk, Netherlands.

Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, Netherlands.

出版信息

Front Med (Lausanne). 2021 Jul 28;8:671678. doi: 10.3389/fmed.2021.671678. eCollection 2021.

Abstract

Venous leg ulcers (VLUs) are common and have a large impact on healthcare budgets worldwide. Hyperbaric oxygen therapy (HBOT) may improve healing of these ulcers. Retrospective, single-center cohort study between 2013 and 2019. All patients with a VLU from an outpatient clinic providing HBOT and wound care were included. The primary outcome measure was wound healing, determined at discharge from the center. Other outcome measures were improvement in patient related outcome measures (PROMs), as assessed by the EQ-5D-3L questionnaire and including quality of life (QoL) and pain score. Fifty patients were included, 53% female, with a mean age of 73.4 (±12.2). Most wounds (83%) had existed longer than 3 months before starting treatment. Patients received an average of 43 (±20) sessions of HBOT. After treatment, 37 patients (63%) achieved complete or near-complete wound healing. Wound size decreased from a median of 14 cm [interquartile range (IQR) 32 cm] to 0.5 cm (IQR 5.3 cm), a median decrease of 7.5 (IQR 16.2 cm) in cm (94%). Patients mostly reported improvement for all health aspects on the questionnaire. Pain score decreased from 5.7 (±2.5) to 2.1 (±2.2) ( < 0.0001) and health score increased from 57.2 (±15.6) to 69.9 (±18.9) ( = 0.02). Patients with non-healing VLUs may benefit from HBOT to achieve complete or substantial wound healing. We recommend a well-designed randomized clinical trial with a number of patients allowing enough statistical power, and of a reasonable duration, to establish the potential of additional HBOT on hard-to-heal venous ulcers.

摘要

下肢静脉溃疡(VLUs)很常见,对全球医疗保健预算有很大影响。高压氧疗法(HBOT)可能会促进这些溃疡的愈合。这是一项2013年至2019年的回顾性单中心队列研究。纳入了所有来自提供HBOT和伤口护理的门诊诊所的VLU患者。主要结局指标是伤口愈合情况,在患者从中心出院时确定。其他结局指标是患者相关结局指标(PROMs)的改善情况,通过EQ-5D-3L问卷进行评估,包括生活质量(QoL)和疼痛评分。共纳入50例患者,53%为女性,平均年龄73.4岁(±12.2)。大多数伤口(83%)在开始治疗前已存在超过3个月。患者平均接受了43(±20)次HBOT治疗。治疗后,37例患者(63%)实现了完全或接近完全的伤口愈合。伤口大小从中位数14厘米[四分位间距(IQR)32厘米]降至0.5厘米(IQR 5.3厘米),中位数减少7.5厘米(IQR 16.2厘米)(94%)。患者在问卷上大多报告所有健康方面均有改善。疼痛评分从5.7(±2.5)降至2.1(±2.2)(<0.0001),健康评分从57.2(±15.6)升至69.9(±18.9)(=0.02)。未愈合的VLU患者可能从HBOT中获益,以实现完全或显著的伤口愈合。我们建议进行一项设计良好的随机临床试验,纳入足够数量的患者以具备足够的统计效力,并持续合理的时间,以确定额外的HBOT对难愈合静脉溃疡的潜在作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5c0/8355540/9d28c8c6bc9c/fmed-08-671678-g0001.jpg

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