高压氧综合治疗高原创伤性骨折临床分析

在高原地区，由于受低气压、低氧等环境因素的影响，骨延迟愈合或骨不连接已成为高原创伤性骨折最常见的并发症，其发生率高达３０．００％～５２．９０％［１］。我们于１９８９年２月～１９９４年８月采用高压氧（ＨＢＯ）加常规疗法综合治疗高原创伤性四肢长骨骨折３８...     

高压氧在骨科治疗中的应用近况

根据国内外发表的研究论文 ,就近 10年来高压氧 (hy-perbaric oxygen,HBO)疗法在创伤、骨病中拓展应用情况作一综述 ,为骨伤、骨病及神经损伤的 HBO治疗提供参考。一、H BO对骨愈合的作用骨折后的修复过程中 ,所有部位氧分压均不应低于 1.3～ 2 .7k Pa,若血供不足 ,骨折处氧分压不足 ,从而影响骨修复过程 ,导致新骨再生缓慢。因此 ,高氧合作用在骨折愈合过程中 ,具有促进肿胀消退、新骨再生迅速的特点。 Mutschler等 [1 ] 指出 ,HBO在骨外伤、放射性骨坏死、慢性伤口愈合治疗中是很好的辅助治疗方法。徐旭光等 [2 ] 通过动物实验观察…     

高压氧治疗在骨科相关疾病中的应用

随着高压氧(HBO)医学的发展,HBO疗法在临床疾病方面的应用越来越广泛。国内外大量研究显示,HBO在骨科领域应用广泛,对开放性骨创伤、软组织挤压伤、骨折及骨折后骨愈合不良、骨坏死、断肢再植术后、皮瓣移植、骨髓炎、脊髓及周围神经损伤、脊髓压迫症、关节运动损伤、骨放射性损伤等均具有较好的治疗效果。笔者主要从HBO疗效确定...     

微机在高压氧舱中的应用

在微机与高压氧 (HBO)舱联机之前 ,操舱工作及舱内氧浓度的监控都是靠人工操作 ,是一种监测与控制分离的状况。我们在 HBO舱自身安全性能达标条件下 ,实现了操舱全过程及氧浓度监控微机自动化 ,从而进一步保障了 HBO舱的安全。一、材料与方法1.材料 :微机控制系统采用 IPC- 6 10工业控制专用级计算机 ,486 D主芯板 ,4M内存 ,1.44 M软驱和 1.2 G硬盘。各接口电路有 16路开关量输出卡 PCL - 812 PG(16 DO ) ,16路模 /数转换输入卡 PCL - 812 PG(16 A / D) ,16路开关量驱动输出卡 PCL D- 885 ,双通道带隔离数 /模转换输出卡 ACL…     

早期外固定术在重型颅脑创伤合并四肢骨折中的应用

目的 探讨早期(<48 h)骨折外固定术在重型颅脑创伤(GCS≤8)合并四肢骨折患者中的临床应用效果.方法 统计重型颅脑创伤合并四肢骨折年龄、性别、颅脑创伤情况、骨折部位分布及其他全身情况等差异均无统计学意义的患者,根据骨折的早期(＜48 h)治疗方法不同,将重型颅脑创伤患者分为两组.A组:早期骨折外固定组(40例);B组:早期骨牵引、石膏固定等保守治疗组(57例).对比分析两组患者褥疮、肺炎、下肢静脉血栓形成等并发症发生情况,ICU时间、住院时间、骨折愈合时间、病死率等指标.结果 A组在感染率、褥疮、肺炎、下肢静脉血栓发生率方面明显低于B组(P＜0.05).A组的ICU时间、住院时间、骨折愈合时间短于B组(P＜0.05).A组的病死率低于B组,差异有统计学意义(P＜0.05).结论 针对重型颅脑创伤合并四肢骨折的患者,开展早期骨折外固定法与原有早期骨牵引、石膏固定等保守治疗方法相比,减少了并发症,缩短了恢复时间,降低了病死率.     

高压氧在急性硫化氢中毒治疗中的应用

急性硫化氢中毒症状出现特别快，严重在数秒钟内死亡，抢救须分秒必争，而及早进行高压氧治疗可有效保护大脑功能，减少损害，利于尽快苏醒康复，同时减轻肺部炎症及其它合并症。经抢救6例急性硫化氢中毒患(采用立即吸氧，大量维生素C、硫代硫酸钠、亚甲蓝静脉注射等)，结合高压氧治疗，8～15d全部痊愈出院。     

自制四肢关节固定带在高压氧舱内的应用

为保证患者在高压氧舱内的整个治疗过程的安全有效，笔者自制了一套四肢关节固定带，防止躁动患者的再次受伤，并减少了对周围患者的影响。     

高压氧在超长心肺复苏后续治疗中的应用

超长心肺复苏(cardiac—pulmonary resuscitation，CPR)指CPR时限超过30min(常规CPR时限)的心肺复苏。超长CPR针对特殊病因和特殊医疗环境下导致的心搏骤停等情况，需要完善的抢救复苏设备和训练有素的复苏人员。近来，超长CPR的有关报道增多。有报道，复苏成功的最长CPR时间达5～6h，然而超长CPR后续治疗是进一步生     

高压氧治疗中的心理问题调查

随着高压氧在临床应用的效果越来越被认可，高压氧疗法也越来越多地被广大适应证患者所接受；但由于实施高压氧治疗时，患者必须置身于密闭的高压氧舱内，气体密度、分压及气压的机械作用等因素必然会对机体产生一定的影响，容易使患者在生理和心理上出现应激反应，产生紧张、恐惧、焦虑等情绪，从而影响治疗效果。本文通过对患者高压氧治疗中焦虑状态的研究，分析产生恐惧心理的原因，评价心理准备在高压氧治疗中的意义。     

Hyperbaric oxygen in trauma and surgical emergencies

Hyperbaric oxygen therapy (HBO), that is the administration of 100% oxygen delivered under pressure, has a beneficial effect in several surgical conditions. Its use has been assessed and audited and its pharmacological effects demonstrated. It is appropriate for use in several acute surgical conditions as evidence-based therapy. These are: Gas Gangrene Crush Injuries, Compartment Syndromes & Acute Traumatic Ischaemias Enhancement of Healing in Selected Problem Wounds Exceptional Blood loss Anaemia Necrotising Soft Tissue Infections Compromised Skin Grafts & Flaps Thermal Burns HBO therapy suffers from previous inappropriate use, lack of knowledge, and scarce hyperbaric facilities. Hyperbaric therapy, when properly supervised by a physician trained in its use, working closely with a surgeon, and ethically used for appropriate indications, can be a useful adjunct to surgical practice. Military surgeons may be in a situation in which they can utilize HBO in acute surgical conditions and trauma. They are urged to identify HBO facilities, both fixed and portable, and to establish communication with hyperbaric therapy colleagues.     

Hyperbaric oxygen therapy and promoting neurological recovery following nerve trauma

There is a constant search for new techniques that induce more extensive and rapid wound healing. Hyperbaric oxygen therapy (HBO2T) involves placing a patient in a sealed chamber and elevating its pressure several-fold above ambient air pressure while the patient breathes 100% oxygen. HBO2T induces a number of physiological actions, and which wounds are selected for HBO2T depends on the specific actions of HBO2T relative to the wound's healing requirements. Although nerve traumas are not yet indicated for HBO2T, there are many animal and clinical examples showing the benefits of HBO2T in inducing neurological recovery following nerve trauma. This review examines the general mechanisms required to induce wound healing and the actions of HBO2T which meet these requirements. It then examines the requirements for inducing axon regeneration and how many are met by HBO2T. Finally, we discuss anecdotal evidence that HBO2T enhances the rate and extent of axon regeneration in both animal models and clinically. Weconclude that HBO2T triggers most of the mechanisms required to induce axon regeneration.     

Hyperbaric oxygen treatment time for cyclophosphamide induced cystitis in rats.

The aim of this study was to evaluate the prophylactic potential of hyperbaric oxygenation treatment and the timing of hyperbaric oxygen (HBO2) therapy for cyclophosphamide-(CYP) induced cystitis in rats. Forty male Sprague-Dawley rats were divided into 5 groups. Four groups received a single dose of CYP (100 mg/kg.) intraperitoneally (i.p.) at the same time (group 1 served as the control). Group 2 received CYP only; group 3 received HBO2 treatment (2.8 atmospheres absolute, 90 minutes, twice daily) before and the day after CYP. Group 4 received HBO2 before and on the day of CYP administration. Group 5 received HBO2 on the day of and the day after CYP. CYP injection resulted in severe cystitis. Prophylactic HBO2 treatment did not prevent the severe cystitis. After CYP injection, however, HBO2 treatment attenuated CYP-induced hemorrhagic cystitis in rats. Hyperbaric oxygen has a beneficial effect on repairing and healing bladder damage, though it does not function to prevent CYP-induced hemorrhagic cystitis.     

181例特重型颅脑创伤术后高压氧治疗及严重并发症的处理

高压氧综合治疗是颅脑创伤术后的主要治疗手段,但由于特重型颅脑创伤多同时伴有颅脑、胸腹部、四肢等多发伤,以及气管切开、肺部感染、胃肠道出血等并发症,治疗极为困难[1-2].