| Summary: | 碩士 === 國防醫學院 === 海底醫學研究所 === 88 === ABSTRACT
Diabetic foot is one of the severe complications of diabetes mellitus (DM). Current treatment for diabetic foot is still limited. Adjuvant hyperbaric oxygen (HBO2) is generally accepted as a treatment and appears to be beneficial for the wound healing of diabetic foot. However, HBO2 is clinically used when patient’s diabetic foot condition is in the late stage (ulcer infection combined carious osteomyelitis). Therefore, HBO2 is not clinically used to treat early stage of diabetic foot. This study was done to test the hypotheses that early stage of diabetic foot given HBO2 would heal the wound, improve the neural and vascular function, and prevent the pathologic change.
Twenty-nine patients with diabetic foot were selected from Tri-General Hospital between September 1999 and April 2000. Seventeen and twelve patients were assigned to experimental and control groups, respectively. The patients in the control group were treated like the patients in the experimental group in every way except they did not receive the HBO2 intervention. Data collection included demographic data, blood biochemical examinations, neural and vascular function assessment, and clinical evaluation. The time points for data collection were as follows: (1) blood biochemical examinations and clinical evaluation — before the HBO2 treatment, the fifteenth HBO2 treatment, and after the final HBO2 treatment, (2) neural and vascular function assessment -- before the HBO2 treatment and after the final HBO2 treatment.
The results of this research indicated that 86% patients were in the early stage (Wagner Grade 0, I, II). Blood biochemical examinations showed the patients in the experimental group had lower white blood count (WBC) after HBO2 treatment, (p < 0.05). Motor nerve conduction studies (MNCS) indicated that the experimental group had significantly higher amplitude in peroneal nerve, tibial nerve and lower vibration perception threshold (VPT) than the control group. Transcutaneous oxygen tension (TcPO2) examinations showed that there were no differences between the experimental and control groups before and in the middle of the HBO2 treatment. However, the experimental group had significantly higher transcutaneous oxygen tension (TcPO2) and higher blood flow of foot than the control group after the HBO2 treatment. HBO2 can promote the neural and vascular function, avoid the pathologic change, and further prevent the damage, ulcer, and infection of diabetic foot. In addition, HBO2 can help the wound healing, prevent severe necrosis, and avoid amputation.
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