2018年版高压氧治疗适应证与禁忌证解读

高压氧治疗是一种通过在高气压环境中吸氧而达到治疗疾病目的的手段.近期的资料显示,我国共有氧舱5 000多台,氧舱数量和治疗患者数量均居世界第一.近年来,国内多数二级及以上医院都配备了高压氧舱,高压氧治疗已成为临床常用的方法之一[1].为推动中国高压氧医学的发展,规范临床治疗,2018年10月,中华医学会高压氧医学分会第八届委员会将新修订的《医用高压氧舱安全管理与应用规范》(以下简称《规范》)在深圳举行的第二十七次全国年会上向与会的同行发布.该规范的形成是在2015年版《规范》的基础上,依据国家现行的法规、标准,参照国内外的指南、共识,并结合了中国的具体国情和临床实践,对原有内容进行了修改和补充.尤其是高压氧治疗适应证与禁忌证部分,较以往版本的《规范》有较大程度的调整,同时也是2018年版《规范》的精华内容,高压氧治疗适应证与禁忌证部分已于2019年2月在《中华航海医学与高气压医学杂志》发表[2].     

高压氧治疗神经系统疾病的临床与实验研究研讨会征文通知

为了总结高压氧治疗神经系统疾病的经验 ,交流科研信息 ,推广新理论、新技术 ,促进 2 1世纪我国高压氧医学事业进一步发展。中华医学会高压氧医学分会定于 2 0 0 2年 10月在西安市召开“高压氧治疗神经系统疾病的临床与实验研究研讨会”,现将征文有关事项通知如下 :一、征文内容1.高压氧治疗神经系统疾病 (脑血管病、脑炎、周围神经疾病、颅脑损伤、一氧化碳中毒及其迟发脑病等 )的临床研究、经验体会 ;2 .高压氧治疗神经系统疾病的实验研究 ;3.具有前瞻性、指导性的文献综述。二、征文要求1.内容要具有科学性、创新性和实用性 ;2 .必须是未…     

北京地区高压氧科的现状与发展对策

高压氧医学是一门新兴学科,在我国起步较晚.但近年来,我国的高压氧医学在医疗、教学、科研上都取得了令人瞩目的成果.目前我国的氧舱数量和治疗患者数量均居世界前列[1].     

高压氧对胎儿和早产儿视网膜的影响

高压氧医学在我国发展已有近40年的历史．高压氧(hyperbaric oxygen，HBO)被广泛应用于各临床学科。因早期曾有报道，认为HBO可能使未成熟儿发生眼的晶体后纤维化．使HBO在围产医学领域的应用受到限制。随着医学的进展。越来越多的人对这一课题展开了新的尝试和探索，并在临床取得许多进展，如对高危妊娠、胎儿宫内发育迟缓、新生儿缺血缺氧性脑病的HBO治疗都取得满意的疗效。与此同时。胎儿及早产儿氧治疗的副作用日益受到关注。HBO治疗是否造成胎儿及早产儿未成熟的视网膜损伤一直是大家关心的问题。     

关于高压氧医学教育的思考

高压氧(hyperbaric oxygen,HBO)医学属高气压医学的一个分支,是一门新兴的边缘交叉性综合学科,也是涉及多个学科的一门临床治疗学.近年来,HBO在临床治疗中的作用越来越受到重视.为更快提高我国HBO医学水平,现就我国HBO医学教育谈几点个人思考.     

2003-2012年高压氧医学相关护理文献分析CSCD

近年来,高压氧治疗被越来越多的人所认识,治疗的疾病涉及临床各个学科,尤其是在各种危重患者的救治过程中,显示了明显的优势[1].随着高压氧医学的发展,高压氧治疗的相关护理也日趋专业化与系统化,高压氧相关的护理论文也日渐增多.科技论文是在科学研究和发展进程中形成的产物,是基础研究和应用研究成果的具体体现,是促成科技成果转化为生产力的重要手段[2].     

《中华航海医学与高气压医学杂志》第三届编辑委员会名单

中华医学会第十二次全国高压氧医学学术会议于2004年9月6～8日在美丽富饶的长春隆重召开，来自全国高压氧医学界各路精英汇聚一堂，以严肃、严谨、严密的治学态度认真交流高压氧治疗在康复医学领域应用的新进展、新成果和新技术。德国高压氧医学会主席海顿博士、德国医学专家弗莱尔博士、高压氧舱工程技术专家豪克斯博士、中国台湾著名医学专家林茂村教授、中国台湾高压氧医学会名誉主席牛柯奇教授应邀出席会议。     

单病种质量管理模式在高压氧医学质量控制中的应用

目的:探讨单病种质量管理模式在高压氧医学质量控制中的应用。方法:为了合理利用医疗资源,规范各相关病种的高压氧诊疗,上海市医用高压氧临床质控中心提出在高压氧质控管理中实施单病种管理模式。通过开展上海市现状调查,筛选出主要治疗病种,建立单病种质控登记表,多学科交叉合作制定单病种质控诊疗规范。结果:筛选出4类主要病种并构建上...     

祝贺《中华航海医学与高气压医学杂志》出版

在中华医学会倡导下 ,在中华医学会航海医学分会和中华医学会高压氧医学分会的共同努力下 ,原《中华航海医学杂志》在新世纪到来的这个具有特殊意义时刻 ,经国家科技部批准正式改名为《中华航海医学与高气压医学杂志》。我们中华医学会高压氧医学分会代表全国高压氧医学界全体同仁 ,向新杂志及其编辑部表示热烈的祝贺和致以崇高的敬意。《中华航海医学杂志》从 1 994年创刊以来 ,作了卓有成效的工作 ,出版了 7卷 2 8期 ,刊登了大量论著、论著摘要、专述、综述、个案报道、技术与方法、护理以及包括高压氧临床治疗和基础理论实验研究、潜水医…     

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...     

A systematic review of the application of hyperbaric oxygen in the treatment of severe anemia: an evidence-based approach.

The treatment of severe anemia with hyperbaric oxygen (HBO2) is one of thirteen indications approved by the Hyperbaric Oxygen Therapy Committee of the Undersea and Hyperbaric Medical Society for appropriate use of the therapy (1). This paper systematically reviews the literature reporting the use of HBO2 therapy in the treatment and management of severe anemia. Increasingly, a trend to use standards of evidence-based medicine to evaluate the effectiveness of therapeutic interventions in injury and illness is productively with us in medicine today. At issue is discovery and evaluation of the best evidence available in world medical literature for evaluation of current treatment of the individual patient. The best evidence is a published randomized controlled prospective human trial; at the other end of the spectrum, the least valued evidence is a published expert opinion. In this review thirty-five publications have been reviewed as representing published results of applying HBO2 in treatment of severe anemia. Each article underwent the evidence-based evaluative grading of the American Heart Association system (AHA), the National Cancer Institute Patient Data Query system (NCI-PDQ), and the British Medical Journal's (BMJ) Clinical Evidence system. Comparative results using the three systems of evaluation are presented in tabular form for the reader. All publications report a positive result when HBO2 is delivered as treatment for severe anemia. Other alternatives other than transfusion with autologous or heterologous matched blood products are helpful but most too have not been the subject of prospective human randomized controlled trials. HBO2 may be used adjunctively with hematinics, fluorocarbons, and cell wall free polymerized hemoglobin (currently fluorocarbons and cell wall free polymerized hemoglobin are not available for routine use in the United States, but both are undergoing advanced stage clinical trials at the time of this review).     

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.     

创伤性脊髓损伤与高压氧治疗

创伤性脊髓损伤发病率高,危害严重,主要原因是交通事故和高处坠落。其继发性损伤作用持久,机制复杂,尚不完全清楚。高压氧是临床治疗手段之一,但限于目前救治条件,并未受到足够的重视和广泛的开展。本文就高压氧治疗创伤性脊髓损伤的疗效、治疗时机、作用机制、预处理以及对干细胞移植的影响等作一综述。     

Validation of hyperbaric oxygen treatment software for use with monoplace chambers

Hyperbaric oxygen (HBO2) therapy is increasingly used in the treatment of a wide variety of medical conditions. However, for monoplace chambers, there is some uncertainty when sufficiently high oxygen concentrations are attained, because most chambers are not instrumented to measure oxygen. To remedy this, Microsoft Excel-based software, HBO O2 Smart Guide, was developed to simulate the atmosphere ofmonoplace chambers during treatment. Based upon chamber dimensions, patient weight, oxygen purge rates, desired pressurization, and HBO2 time, the program calculates oxygen concentration, consumption and exposure for each treatment. Software testing was conducted using four different chambers instrumented with an oxygen analyzer. Two purge rate profiles were used: constant, and biphasic (a high initial purge rate was changed to a lower plateau rate when pressurization was reached). Comparison of measured and calculated times to reach 95% oxygen concentration within the chambers demonstrated the software was accurate within 1%. The HBO O2 Smart Guide enables optimum purge profiles to be simulated with resultant potential improvements in HBO2 treatment efficacy, calculation of effective oxygen exposures (actual time during prescribed treatment during which patient breathes > or = 95% oxygen) to enable more accurate comparison of treatment profiles and outcomes, and cost savings in oxygen usage. This software will enable clinicians to provide more consistent HBO2 treatments.     

单人纯氧舱高压氧对微生物抑制的研究

目的探讨单人纯氧舱高压氧治疗对微生物的抑制。方法模拟实验菌的存在环境,接受模拟的高压氧治疗方案。结果高压氧对厌氧菌有高度抑制作用,对需氧菌和真菌有抑制作用,但对铜绿假单胞菌抑制作用不明显。结论在高压氧舱内有交叉污染的可能。     

Hyperbaric Oxygen and Radiotherapy

BACKGROUND: Hyperbaric oxygen (HBO) therapy is the inhalation of 100% oxygen at a pressure of at least 1.5 atmospheres absolute (150 kPa). It uses oxygen as a drug by dissolving it in the plasma and delivering it to the tissues independent of hemoglobin. For a variety of organ systems, HBO is known to promote new vessel growth into areas with reduced oxygen tension due to poor vascularity, and therewith promotes wound healing and recovery of radiation-injured tissue. Furthermore, tumors may be sensitized to irradiation by raising intratumoral oxygen tensions. METHOD: A network of hyperbaric facilities exists in Europe, and a number of clinical studies are ongoing. The intergovernmental framework COST B14 action "Hyperbaric Oxygen Therapy" started in 1999. The main goal of the Working Group Oncology is preparation and actual implementation of prospective study protocols in the field of HBO and radiation oncology in Europe. RESULTS: In this paper a short overview on HBO is given and the following randomized clinical studies are presented: a) reirradiation of recurrent squamous cell carcinoma of the head and neck after HBO sensitization; b) role of HBO in enhancing radiosensitivity on glioblastoma multiforme; c) osseointegration in irradiated patients; adjunctive HBO to prevent implant failures; d) the role of HBO in the treatment of late irradiation sequelae in the pelvic region. The two radiosensitization protocols (a, b) allow a time interval between HBO and subsequent irradiation of 10-20 min. CONCLUSION: Recruitment of centers and patients is being strongly encouraged, detailed information is given on www.oxynet.org.     

高压氧综合疗法对股骨头无菌坏死的临床疗效分析

目的探讨高压氧（HBO）、打孔减压术、中药等治疗方法对股骨头无菌坏死的临床疗效。方法对186例股骨头无菌坏死的患者，在骨科确诊、打孔减压术后2～3d开始用HBO治疗，同时加用中药治疗，作为HBO综合治疗组；165例年龄及病情大致相同的股骨头无菌坏死的患者，只用打孔减压、抗炎和对症治疗作为对照组。结果HBO治疗组总有效率为98．4％，对照组总有效率为75．8％，两者疗效差异有统计学意义（P〈0．01）。结论打孔减压能减轻股骨头内压力，改善血流；HBO能有效提高血液及股骨头内氧分压，促进股骨头的愈合；中药能补肝、益肾、活血、化瘀。因此HBO综合治疗股骨头无菌坏疗效尤为显著。     

Hyperbaric oxygen for neurologic indications--action plan for multicenter trials in: stroke, traumatic brain injury, radiation encephalopathy & status migrainosus

The 2008 Toronto Hyperbaric Medicine Symposium was convened to discuss research into neurologic indications for hyperbaric oxygen therapy (HBO2T). Four topics were particularly addressed: acute ischemic stroke; acute traumatic brain injury; brain radiation necrosis; and status migrainosus. Four multicenter trials were designed and proposed to evaluate the efficacy of HBO2T for these indications and are presented here in addition to brief reviews of the rationale behind each.     

高压氧对高原移居青年血流动力学的影响

目的探讨高压氧对高原移居青年血流动力学的影响。方法将进驻海拔3 700 m半年的20名健康青年随机分为两组,每组10人。分别采用高压氧前(对照组)和高压氧干预2次(A组)及5次(B组)后进行比较。两组在高压氧前后分别用XG-Ⅲ型血液循环功能自动测试仪检测血流动力学。结果两组高压氧组较对照组P、TPR、ALT、η、PAWP、CCP降低,差别有统计学意义(P(0.05);SV、mAP、BK、BV增高,差别有统计学意义(P(0.05)。结论高压氧对高原移居青年血流动力学有明显的改善作用。     

Partnering with a medical specialty society to perform online public health surveillance

While accidental carbon monoxide (CO) poisoning is common, it is felt to be largely preventable through targeted public education. Development of effective education programs requires accurate epidemiologic information about the condition. Many acute, severe cases of CO poisoning are treated with hyperbaric oxygen (HBO2) at hospital-based facilities staffed by members of the Undersea and Hyperbaric Medical Society (UHMS). In 2008, the Centers for Disease Control and Prevention (CDC) began sponsoring a UHMS proposal to use online reporting by UHMS members of cases treated with HBO2. This report describes development and implementation of the internet-based surveillance system, as well as its first year of operation. From August 2008 to July 2009, a total of 740 cases were reported by the 82 hyperbaric facilities participating nationwide. Extensive epidemiologic information about CO poisoning in the United States has been collected, and the utility of partnering with a medical specialty society for disease-specific surveillance demonstrated.