CAJ | 학술논문

目的：观察高压氧（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组除接受高压氧治疗外，其它治疗措施两组完全相同。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，测定踝肱指数（ABI），观察患肢情况。结果不同时间点HBO组的氧代谢水平、LDH、Cr、pH值及ABI与常规组相比差异有统计学意义（P<0.05）。术后24 h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。
목적：관찰고압양（HBO）치료하지동맥결혈재관주손상대환지급신공능적영향。방법장경강내혈관중건후적중증하지결혈환자72례（80조지체）수궤분위HBO조화상규조，매조40조지체。HBO조제접수고압양치료외，기타치료조시량조완전상동。검측불동시간환지혈액내양대사、유산탈경매（LDH）、기항（Cr）、pH치，측정과굉지수（ABI），관찰환지정황。결과불동시간점HBO조적양대사수평、LDH、Cr、pH치급ABI여상규조상비차이유통계학의의（P<0.05）。술후24 h내상규조유5조환지、HBO조유1조환지출현근막실종합증행절개감압。결론하지동맥결혈재통후，조기HBO치료능현저제고양함량，개선미순배장애、억제조직수종，강저신공능손해、촉진지체결혈후재관주손상적수복。
Objective To observe the effect of hyperbaric oxygen (HBO) on the limb and renal function in the treatment of lower limb arterial ischemia-reperfusion injury. Methods Seventy-two patients with severe lower limb ischemia (80 limbs), who underwent endovascular revascularization, were randomly divided into HBO group (40 limbs) and conventional group (40 limbs). Other therapeutic measures were the same for both groups, except HBO group received hyperbaric oxygen treatment. Oxygen metabolism, lactate dehydrogenase (LDH), creatinine (Cr), pH value were detected at different time points. Ankle-brachial index (ABI) was measured, and the limbs were observed. Results There were significant differences in oxygen metabolism, LDH, Cr, pH value and ABI between the two groups at different time points (P<0.05). Within 24 hours after operation, 5 limbs in conventional group and 1 limb in HBO group occurred compartment syndrome, and incision decompression was performed. Conclusion Early HBO treatment can significantly increase the oxygen content, improve microcirculation, control tissue edema, mitigate renal dysfunction and promote the repair of ischemia-reperfusion injury after lower extremity arterial recanalization.