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頁籤選單縮合
題 名 | Is Hyperbaric Oxygen Therapy an Indispensable Treatment for Burns?=高壓氧在燒傷治療中是否有其角色? |
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作 者 | 江奕翰; 曾元生; 陳錫根; 戴念梓; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷 期 | 26:1 2017.03[民106.03] |
頁 次 | 頁89-98 |
分類號 | 416.141 |
關鍵詞 | 高壓氧治療; 燒傷; 塵爆; Hyperbaric oxygen therapy; Burn; Dust explosion disaster; |
語 文 | 英文(English) |
中文摘要 | 背景:燒傷治療對整形外科醫師來說是具挑戰性的。高壓氧治療有助於急性傷口的癒合及改善缺氧組織的情況。目的及目標:本篇文章的目的在評估高壓氧在燒傷治療上的效能。材料及方法:在2015年06月27日,新北市發生一大規模的火災事件,共有499人燒傷,其中有53名傷患送至三軍總醫院治療。有19位沒有嗆傷之病患接受常規燒傷治療與高壓氧輔助治療。回朔性收集本院自2015年06月至2015年10月八仙塵暴病患資料,其中包含病患年齡、性別、燒傷面積、植皮面積、植皮次數、植皮失敗比例、住院天數、感染狀況、高壓氧治療開始的時間、高壓氧治療的次數和滿意度。結果:19名燒傷病患中,有15位男性及4位女性。他們平均年齡為22.8歲(介於18到34歲);平均燒傷體表面積為29.6%(介於17.5到40%)。所有燒傷病患皆存活且沒有肢體截肢或殘障等情形;平均植皮次數為1.8次(介於0到5次);平均住院天數為47天(介於14到89天);平均住院到做高壓氧治療為9.7天(介於3到30天);平均高壓氧治療次數為9.5次(介於3到19次)。所有接受高壓氧治療之病患皆完成治療、滿意度高且無不適。比較病人接受輔助性高壓氧治療與病人僅接受一般常規治療(對照組),發現高壓氧組病患平均燒傷面積較大並具統計學上差異(29.6±8.9% vs 21.8±14.1%, p=0.04),但在植皮面積、植皮次數、植皮失敗比例、住院天數和感染狀況兩者無統計學上差異。結論:本研究病患在接受輔助性高壓氧治療後並無統計學上之成效。後續須更多前瞻性的研究來建立高壓氧在燒傷的角色。 |
英文摘要 | Background: The treatment of severe burns is a challenge to the plastic surgeon. Hyperbaric oxygen therapy (HBOT) appears to enhance acute wound healing and to counteract tissue hypoxia. Aim and objectives: This study was performed to evaluate the efficacy of HBOT as an adjunctive therapy in patients injured in a thermal burn accident. Materials and Methods: On June 27, 2015, in New Taipei, Taiwan, a mass casualty disaster occurred when a fire erupted over a large crowd, injuring 499 people. Fifty-three patients were treated at Tri-Service General Hospital, and 19 patients without inhalation injuries underwent adjunctive HBOT with routine burn therapy. A retrospective study was performed using the records of all patients injured in this disaster who were treated from June to October 2015. The outcome variables included patients' sex, age, total body surface area (TBSA) of burn, percentage of skin area receiving skin grafts, number of skin graft operations, percentage of skin graft failure, length of hospital stay, infection status, timing of HBOT, sessions and satisfaction of HBOT. Results: The analysis included 15 men and four women with a mean age of 22.8 years (range 18-34) and a mean TBSA of 29.6% (range 17.5-40%). All patients survived and were discharged without requiring limb amputation or becoming disabled. The average TBSA of the skin graft was 12.7% (0-39%), the average number of skin graft operations was 1.8 (range 0-5), and average hospital stay was 47 days (range 14-89). The average time from admission to HBOT was 9.7 days (range 3-30), and the average number of HBOT sessions was 9.5 (range 3-19). No complications occurred during HBOT, and the average rating of the patients' satisfaction with HBOT was 9.3 (7-10). Compared with patients without HBOT, the HBOT group had higher burn area than non-HBOT group (29.6 ± 8.9 % vs 21.8 ± 14.1 %, p=0.04). Percentage of skin area receiving skin grafts, number of skin graft operations, percentage of skin graft failure, length of hospital stay, and infection status showed no significant difference in two groups. Conclusion: Our study showed no statistically significant results in these patients treated with adjunctive HBOT. Prospective studies are warranted to establish the role of HBOT in the treatment of thermal injuries. |
本系統中英文摘要資訊取自各篇刊載內容。