Primjena hiperbarične komore kod patoloških promjena na perifernim krvnim sudovima

Application of hyperbaric therapy to the patients with pathological changes in peripheral blood vessels

SAŽETAK

UVOD: Primjena hiperbarične terapije je efektivna komponenta kompleksnog liječenja šećerne bolesti, ne samo u liječenju kasnih komplikacija već i u ranoj fazi bolesti. Cilj je da se spriječi razvoj hipoksije i pratećih komplikacija (mikro i makroangiopatije, polineuropatije, retinopatije i nefropatije).Terapija hiperbaričnim kisikom je relativno rijetko primjenjivan metoda liječenja iako postoje brojne studije koje dokazuju pozitivne kliničke efekte kod niza bolesti. Stoga je potrebno istražiti koliko se ta metoda primjenjuje kod nas, kod kojih bolesnika kao i kakvi efekti su zabilježeni.

CILJ RADA: Utvrditi udio odnosno zastupljenost pojedinih bolesti unutar ispitivane grupe bolesnika liječenih u hiperbaričnoj komori; Utvrditi udio bolesnika kod kojih tretman u hiperbaričnoj komori nije mogao biti primijenjen ili je morao biti prekinut zbog nuspojava.

Utvrditi dužinu tretmana ispitivane grupe; Utvrditi uspješnost tretmana.

METODE ISTRAŽIVANJA: Istraživanje je provedeno na Klinici za vaskularne bolesti UKC Sarajevo u periodu od jula do marta 2015.g. Studija je retrospektivna i obuhvatila je 119 pacijenata. Za istraživanje korištene su Historije bolesti i bolnički protokol Klinike.

REZULTATI ISTRAŽIVANJA: Od ukupno 119 pacijenata 87 su bili muškaraci (73,1%) i 32 žene (26,9%). Prosječna starost ispitanika za čitavu grupu je bila 60,12 godina, (muškaraca 60,49 a žena 59,18 godina). Od ukupnog broja tretiranih, 40 pacijenata je bilo sa dijabetičnim ulkusom ekstremiteta, ishemijski arterijski ulkus je imalo 33, a radi Morbus Buerger je tretirano 12 pacijenata. Tretirana su 34 pacijenta sa venskim ulkusom.

ZAKLJUČCI: Od ukupno tretiranih pacijentata, kod 58 je registrovano poboljšavanje stanja, kod 48 pacijenata nije bilo uočljive promjene (poboljšavanja ili pogoršavanja), dok je dok je kod samo 13 pacijenata potpuno izostao učinak hiperbarične oksigenacije.

Najbolji i statistički signifikantan efekt je postignut u tretmanu venske patologije, dok su različita stanja insuficijencije arterijske cirkulacije imale slabiji efekt, koji nije bio statistički signifikantan. Tretman u hiperbaričnoj komori se pokazao kao podnošljiv jer je kod svih ispitanika tretman proveden u planiranom trajanju.

KLJUČNE RIJEČI: hiperbarična komora, dijabetes, stopalo, oksigenacija, tretman

SUMMARY

INTRODUCTION: Application of hyperbaric therapy is an effective component of a complex treatment of diabetes. In addition of treatment of late complications, therapy is also used at early stage of the disease. The main aim of therapy is to prevent the development of hypoxia and related complications (micro and macroangiopathy, neuropathy, retinopathy and nephropathy). Hyperbaric oxygen is relatively rarely applied method of treatment, although there are numerous studies that prove the positive clinical effects in a number of diseases. Therefore, it is necessary to examine how this method is applied in our medical practice, type of treated patients and what effects have been reported.

RESEARCH OBJECTIVE: To determine the precentage and distribution of certain diseases in the studied group of patients treated by hyperbaric therapy; to determine the precentage of patients that hyperbaric therapy could not be applied or had to be interrupted because of side effects; to determine the length of the treatment of the test group; and to determine treatment success.

RESEARCH METHODS: The study was conducted at the Department of Vascular Clinic – University Clinical Center of Sarajevo, in the period from July 2014 to March 2015. The study was retrospective. The study included 119 patients. Documents used for the realization of the study are History of diseases and Vascular Clinical Protocol.

RESEARCH RESULTS: The total number of treated patients was 119, from that 87 were male (73.1%) and 32 female (26.9%). The average age of the respondents was 60.12 years (male 60.49 years and female 59.18 years). Of those patients, 40 patients with Extremity ulcer diabetic, 33 with Ischemic arterial ulcer, 12 patients with Buerger’s disease, and 34 patients with Venous ulcer.

CONCLUSION: From the total number of treated patients, in 58 patients was noted improvement in their health condition, in 48 patients was noted noticeable change (improvement or deterioration), while in only 13 patients resulted totally absent effect of hyperbaric therapy.

The most statistically significant effect is accomplished in the treatment of venous pathology, while weaker effect was noted in patients with insufficiency of arterial circulation, which wasn’t statistically significant. The treatment by hyperbaric therapy proved as a tolerable method of treatment, because in all treated patients treatment carried out in a planned duration.

KEY WORDS: hyperbaric therapy, diabetes, foot, oxygenation, treatment

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