1.Hyperbaric oxygen therapy can effectively treat diabetic foot wounds
Yunxiang LI ; Haihua XIU ; Qiaoping GAO ; Tao FANG ; Chunni CAO ; Min ZHANG
Chinese Journal of Physical Medicine and Rehabilitation 2022;44(8):722-726
Objective:To observe the effect of supplementing vacuum sealing drainage with hyperbaric oxygen in the short term treatment of diabetic foot ulcers.Methods:A total of 156 persons diagnosed with diabetic foot ulcers were randomly divided into a control group and a treatment group, each of 78. Both groups received life guidance and active treatment to lower blood sugar and lipids, as well as anti-infection treatment guided by bacterial cultures. Both groups′ wounds were debrided. The wound was then covered with foam, sealed, and negative pressure of -75 to -100mmHg was applied during 1 week of drainage. Two courses of this treatment were applied. In addition, the treatment group received hyperbaric oxygen daily during the two weeks. The exposure pressure was incrased to 0.25MPa over 15min with 100% oxygen. That was inhaled in two 30min sessions with a 10min interval. The pressure then decompressed at a constant rate for 25 minutes. Wound healing, hemorheology, wound granulation tissue staining and any changes in TGF-β1 were observed before as well as after 7 and 14 days of the treatment.Results:The average wound size and symptom score of both groups had improved significantly after the treatment, with the largest effect in the treatment group during the first week. Both groups′ hemorheology had improved significantly after one week, but the treatment group′s improvement was greater. After 2 weeks, however, there was no significant difference in the average hemorheologic indicators for either group compared with before the treatment. Hematoxylin-eosin staining of the wound tissues showed that there were many inflamed cells before the treatment, with relatively little fresh granulation tissue or new blood vessels. After one week of treatment much new granulation tissue was observed under the microscope in both groups, with no significant difference between them. One week later, there was still much granulation tissue in the control group, but slightly less in the treatment group. The ave-rage post-treatment TGF-β1 protein levels in the wound tissues of both groups were significantly higher than before the treatment, but after two weeks the average TGF-β1 protein level had decreased significantly in the treatment group compared with the control group.Conclusions:One week of hyperbaric oxygen treatment can effectively improve the hemorheology of persons with diabetic foot ulcers, promote the proliferation of granulation tissue and fibroblasts, and increase the level of TGF-β1 protein in the wound tissues. However, the effects of hyperbaric oxygen treatment weaken gradually with time.
2.Effect of hyperbaric oxygen on the incidence of complications following decompressive cranioectomy in severe traumatic brain injury
Chunni CAO ; Zuofu ZHANG ; Chunhua LIN ; Xiuyu ZHAO ; Yusong BIAN ; Xingyun WU ; Hongxing ZHANG ; Zhengrong PENG
Chinese journal of nautical medicine and hyperbaric medicine 2017;24(1):50-55
Objective To explore the effects of hyperbaric oxygen (HBO) on the incidence of complications and treatment efficacy following decompressive craniectomy(DC) in severe traumatic brain injury.Methods A total of 160 patients who underwent DC for severe traumatic brain injury from January 2010 to December 2014 in the Neurosurgery Department of Yantai Yuhuangding Hospital were chosen for the study.The subjects were divided into the HBO group (86 Patients) and the routine treatment group (74 patients) in accordance with different treatment methods.Incidence of complications,changes in EEG at different time points after surgery,the levels of transforming factor-β1 (TGF-β1) and myelin basic protein (MBP) in cerebrospinal fluid,scores of Glasgow Coma Scale as well as scores of Modified Rankin Scale 6 months after surgery were compared between the two groups.Results Following DC in severe traumatic brain injury,the rates of cerebral herniation (31.4%),postsurgical epilepsy (10.5%) and hydrocrania (11.6%) in the HBO group were all obviously decreased(47.3%,23.0%,24.3%),as compared with those of the control group,and statistical significance could be seen,when comparisons were made between the 2 groups (P < 0.05).The incidence of subdural effusion in the HBO group was 32.6%,while that of the routine treatment group was 41.9%,and there was no statistical significance,when comparisons were made between the 2 groups (P > 0.05).In the HBO group,the levels of TGF-β 1 and MBP in the cerebrospinal fluid 14 and 21 days after surgery were significantly decreased,as compared with those of the routine treatment group.The EEG and GCS scores in the HBO group were significantly improved,1 and 3 months after surgery,as compared with those of the routine treatment group.The scores of the modified Rankin Scale of the HBO group,which were obtained 6 months after surgery,were significantly higher than those of the routine treatment group,and statistical significance could be noted,when comparisons were made between the 2 groups (P < 0.05).Conclusions Following decompressive cranioectomyin,HBO in the treatment of severe traumatic brain injury could obviously decrease the rates of cerebral herniation,postsurgical epilepsy and hydrocrania.HBO could also substantially improve EEG and decrease levels of TGF-β 1 and MBP,14 and 21 days after surgery,and improve the prognosis of the patients.
3.Effect of hyperbaric oxygen on the incidence of complications following decompressive cranioectomy in severe traumatic brain injury
Chunni CAO ; Zuofu ZHANG ; Chunhua LIN ; Xiuyu ZHAO ; Yusong BIAN ; Xingyun WU ; Hongxing ZHANG ; Zhengrong PENG
Chinese journal of nautical medicine and hyperbaric medicine 2017;24(1):50-55
Objective To explore the effects of hyperbaric oxygen (HBO) on the incidence of complications and treatment efficacy following decompressive craniectomy(DC) in severe traumatic brain injury.Methods A total of 160 patients who underwent DC for severe traumatic brain injury from January 2010 to December 2014 in the Neurosurgery Department of Yantai Yuhuangding Hospital were chosen for the study.The subjects were divided into the HBO group (86 Patients) and the routine treatment group (74 patients) in accordance with different treatment methods.Incidence of complications,changes in EEG at different time points after surgery,the levels of transforming factor-β1 (TGF-β1) and myelin basic protein (MBP) in cerebrospinal fluid,scores of Glasgow Coma Scale as well as scores of Modified Rankin Scale 6 months after surgery were compared between the two groups.Results Following DC in severe traumatic brain injury,the rates of cerebral herniation (31.4%),postsurgical epilepsy (10.5%) and hydrocrania (11.6%) in the HBO group were all obviously decreased(47.3%,23.0%,24.3%),as compared with those of the control group,and statistical significance could be seen,when comparisons were made between the 2 groups (P < 0.05).The incidence of subdural effusion in the HBO group was 32.6%,while that of the routine treatment group was 41.9%,and there was no statistical significance,when comparisons were made between the 2 groups (P > 0.05).In the HBO group,the levels of TGF-β 1 and MBP in the cerebrospinal fluid 14 and 21 days after surgery were significantly decreased,as compared with those of the routine treatment group.The EEG and GCS scores in the HBO group were significantly improved,1 and 3 months after surgery,as compared with those of the routine treatment group.The scores of the modified Rankin Scale of the HBO group,which were obtained 6 months after surgery,were significantly higher than those of the routine treatment group,and statistical significance could be noted,when comparisons were made between the 2 groups (P < 0.05).Conclusions Following decompressive cranioectomyin,HBO in the treatment of severe traumatic brain injury could obviously decrease the rates of cerebral herniation,postsurgical epilepsy and hydrocrania.HBO could also substantially improve EEG and decrease levels of TGF-β 1 and MBP,14 and 21 days after surgery,and improve the prognosis of the patients.

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