I ke ao o ka lāʻau lapaʻau hou, ua hōʻoia ʻia nā antibiotics kekahi o nā holomua koʻikoʻi loa, e hoʻohaʻahaʻa nui ana i nā helu hanana a me ka make e pili ana i nā maʻi microbial. ʻO ko lākou hiki ke hoʻololi i nā hopena lapaʻau o nā maʻi bacteria ua hoʻolōʻihi i ke ola o nā poʻe maʻi he nui ʻole. He mea koʻikoʻi nā antibiotics i nā kaʻina hana lapaʻau paʻakikī, me nā ʻoki kino, nā hoʻokomo implant, nā transplants, a me ka chemotherapy. Eia nō naʻe, ʻo ka puka ʻana mai o nā pathogens kūʻē i ka antibiotic he mea hopohopo nui ia, e hoʻemi ana i ka pono o kēia mau lāʻau i ka hala ʻana o ka manawa. Ua hoʻopaʻa ʻia nā hiʻohiʻona o ke kūʻē ʻana i ka antibiotic ma nā ʻano antibiotics āpau i ka wā e hana ʻia ai nā mutations microbial. ʻO ke kaomi koho i hoʻokau ʻia e nā lāʻau antimicrobial ua kōkua i ka piʻi ʻana o nā ʻano kūʻē, e hoʻokau ana i kahi pilikia nui i ke olakino honua.
No ke kaua ʻana i ka pilikia koʻikoʻi o ke kūʻē ʻana i nā antimicrobial, he mea nui e hoʻokō i nā kulekele kaohi maʻi kūpono e hōʻemi ana i ka laha ʻana o nā pathogens kūʻē, me ka hōʻemi ʻana i ka hoʻohana ʻana i nā antibiotics. Eia kekahi, aia kahi pono koʻikoʻi no nā ʻano lapaʻau ʻē aʻe. Ua kū mai ka Hyperbaric Oxygen Therapy (HBOT) ma ke ʻano he ʻano hoʻohiki i kēia ʻano, e pili ana i ka hanu ʻana i ka 100% oxygen ma nā pae kaomi kikoʻī no kekahi manawa. Hoʻonoho ʻia ma ke ʻano he lāʻau lapaʻau mua a hoʻohui paha no nā maʻi, hiki i ka HBOT ke hāʻawi i ka manaʻolana hou i ka mālama ʻana i nā maʻi koʻikoʻi i hoʻokumu ʻia e nā pathogens kūʻē i ka antibiotic.
Ke hoʻohana nui ʻia nei kēia lāʻau lapaʻau ma ke ʻano he lāʻau lapaʻau mua a ʻokoʻa paha no nā ʻano maʻi like ʻole, me ka mumū, ka lāʻau make kalapona monoxide, nā ʻeha mau loa, nā maʻi ischemic, a me nā maʻi. He hohonu nā noi lapaʻau o HBOT i ka mālama ʻana i ka maʻi, e hāʻawi ana i nā pono waiwai nui i nā maʻi.
Nā noi lapaʻau o ka Hyperbaric Oxygen Therapy i ka maʻi
Kākoʻo ikaika nā hōʻike o kēia manawa i ka hoʻopili ʻana o HBOT, ma ke ʻano he lāʻau kūʻokoʻa a me ka lāʻau kōkua, e hōʻike ana i nā pono koʻikoʻi i nā poʻe maʻi i loaʻa i ka maʻi. I ka wā o HBOT, hiki ke piʻi ke kaomi oxygen koko arterial i 2000 mmHg, a ʻo ka hopena o ke kaomi oxygen-ʻiʻo kiʻekiʻe hiki ke hoʻokiʻekiʻe i nā pae oxygen ʻiʻo i 500 mmHg. He mea waiwai nui kēlā mau hopena i ka hoʻolaha ʻana i ka ho'ōla ʻana o nā pane mumū a me nā hoʻopilikia microcirculatory i ʻike ʻia i nā wahi ischemic, a me ka hoʻokele ʻana i ka compartment syndrome.
Hiki i ka HBOT ke hoʻopilikia i nā kūlana e hilinaʻi ana i ka ʻōnaehana pale. Hōʻike ka noiʻi hiki i ka HBOT ke kāohi i nā syndromes autoimmune a me nā pane pale i hoʻokomo ʻia e ka antigen, e kōkua ana i ka mālama ʻana i ka hoʻomanawanui graft ma ka hōʻemi ʻana i ke kahe ʻana o nā lymphocytes a me nā leukocytes me ka hoʻololi ʻana i nā pane pale. Eia kekahi, ʻo HBOTkākoʻo i ka ho'ōla ʻanai nā ʻeha ʻili mau loa ma o ka hoʻoulu ʻana i ka angiogenesis, kahi hana koʻikoʻi no ka hoʻōla maikaʻi ʻana. Paipai pū kēia lāʻau lapaʻau i ka hoʻokumu ʻia ʻana o ka matrix collagen, kahi pae koʻikoʻi i ka ho'ōla ʻana o ka ʻeha.
Pono e hāʻawi ʻia ka nānā kūikawā i kekahi mau maʻi, ʻoiai nā maʻi hohonu a paʻakikī ke mālama e like me ka necrotizing fasciitis, osteomyelitis, nā maʻi palupalu mau, a me ka endocarditis infectious. ʻO kekahi o nā hoʻohana lapaʻau maʻamau o HBOT no nā maʻi palupalu ʻili a me ka osteomyelitis e pili ana me nā pae oxygen haʻahaʻa i hoʻokumu pinepine ʻia e ka bacteria anaerobic a i ʻole nā bacteria kūʻē.
1. Nā maʻi wāwae maʻi diabetes
Ka wāwae maʻi diabetesHe pilikia nui nā ʻōpū maʻi diabetes, e pili ana i ka 25% o kēia heluna kanaka. Hoʻomaka pinepine nā maʻi ma kēia mau ʻōpū (e helu ana i 40%-80% o nā hihia) a alakaʻi i ka hoʻonui ʻia o ka maʻi a me ka make. ʻO nā maʻi wāwae diabetes (DFIs) maʻamau he mau maʻi polymicrobial me nā ʻano pathogens bacteria anaerobic i ʻike ʻia. ʻO nā kumu like ʻole, me nā hemahema hana fibroblast, nā pilikia hoʻokumu collagen, nā ʻano hana pale cellular, a me ka hana phagocyte, hiki ke pale i ka ho'ōla ʻana o ka ʻeha i nā maʻi diabetes. Ua ʻike ʻia kekahi mau noiʻi i ka oxygenation ʻili i hoʻopilikia ʻia ma ke ʻano he kumu pilikia ikaika no nā amputations e pili ana i nā DFIs.
Ma ke ʻano he hoʻokahi o nā koho o kēia manawa no ka mālama ʻana iā DFI, Ua hōʻike ʻia ʻo HBOT e hoʻonui nui i nā helu ho'ōla no nā ʻeha wāwae maʻi diabetes, a laila e hōʻemi ana i ka pono no nā ʻoki ʻana a me nā hana ʻoki paʻakikī. ʻAʻole ia e hōʻemi wale i ka pono no nā kaʻina hana e hoʻohana nui ana i nā kumuwaiwai, e like me nā ʻoki flap a me ka hoʻopili ʻana i ka ʻili, akā hōʻike pū kekahi i nā kumukūʻai haʻahaʻa a me nā hopena ʻaoʻao liʻiliʻi i hoʻohālikelike ʻia me nā koho ʻoki. Ua hōʻike ʻia kahi noiʻi na Chen et al. ua alakaʻi ʻia ma mua o 10 mau kau o HBOT i kahi hoʻomaikaʻi 78.3% i nā helu ho'ōla ʻeha i nā poʻe maʻi diabetes.
2. Nā maʻi ʻiʻo palupalu necrotizing
ʻO nā maʻi palupalu necrotizing (NSTIs) he polymicrobial pinepine, e kū mai ana mai ka hui pū ʻana o nā pathogens bacteria aerobic a me anaerobic a pili pinepine ʻia me ka hana ʻana o ke kinoea. ʻOiai he mea kakaikahi nā NSTI, hōʻike lākou i kahi helu make kiʻekiʻe ma muli o ko lākou holomua wikiwiki. ʻO ka ʻike kūpono a me ka mālama ʻana he mea nui ia no ka hoʻokō ʻana i nā hopena maikaʻi, a ua ʻōlelo ʻia ʻo HBOT ma ke ʻano he ala kōkua no ka hoʻokele ʻana i nā NSTI. ʻOiai aia nō ka paio e pili ana i ka hoʻohana ʻana o HBOT i nā NSTI ma muli o ka nele o nā haʻawina i kāohi ʻia.hōʻike nā hōʻike e pili ana paha ia me ka hoʻomaikaʻi ʻana i nā helu ola a me ka mālama ʻana i nā ʻōpū i nā poʻe maʻi NSTIUa hōʻike ʻia kahi noiʻi i hala i hope i ka emi nui ʻana o ka nui o ka make ma waena o nā poʻe maʻi NSTI e loaʻa ana iā HBOT.
1.3 Nā maʻi ʻoki kino
Hiki ke hoʻokaʻawale ʻia nā SSI ma muli o ke kahua anatomical o ka maʻi a hiki ke kū mai nā pathogens like ʻole, me nā bacteria aerobic a me anaerobic. ʻOiai nā holomua i nā hana kaohi maʻi, e like me nā ʻano hana sterilization, ka hoʻohana ʻana i nā antibiotics prophylactic, a me nā hoʻomaikaʻi ʻana i nā hana ʻoki kino, ʻo nā SSIs he pilikia mau loa ia.
Ua noiʻi kekahi loiloi koʻikoʻi i ka pono o HBOT i ka pale ʻana i nā SSI hohonu i ke ʻoki scoliosis neuromuscular. Hiki i ka HBOT ma mua o ke ʻoki ʻana ke hōʻemi nui i ka nui o nā SSI a hoʻomaʻamaʻa i ka ho'ōla ʻana o ka ʻeha. Hoʻokumu kēia lāʻau lapaʻau non-invasive i kahi kaiapuni kahi e hoʻokiʻekiʻe ʻia ai nā pae oxygen i loko o nā ʻiʻo ʻeha, kahi i pili pū me ka hana pepehi oxidative e kūʻē i nā pathogens. Eia kekahi, hoʻoponopono ia i ka hoʻohaʻahaʻa ʻia o ke koko a me nā pae oxygen e kōkua i ka hoʻomohala ʻana o SSIs. Ma waho aʻe o nā hoʻolālā kaohi maʻi ʻē aʻe, ua ʻōlelo ʻia ʻo HBOT no nā ʻoki ʻana i haumia ʻia e like me nā kaʻina hana colorectal.
1.4 Nā kuni
ʻO nā kuni he mau ʻeha i hoʻokumu ʻia e ka wela nui, ke au uila, nā kemika, a i ʻole ka radiation a hiki ke hoʻonui i ka nui o ka maʻi a me ka make. He mea maikaʻi ka HBOT i ka mālama ʻana i nā kuni ma ka hoʻonui ʻana i nā pae oxygen i nā ʻiʻo i hōʻino ʻia. ʻOiai ke hōʻike nei nā haʻawina holoholona a me nā lāʻau lapaʻau i nā hopena i hui pū ʻia e pili ana ika pono o HBOT i ka mālama ʻana i ke kuni, ua hōʻike ʻia kahi noiʻi e pili ana i 125 mau maʻi kuni ʻaʻole i hōʻike ʻo HBOT i ka hopena koʻikoʻi i nā helu make a i ʻole ka helu o nā ʻokiʻoki i hana ʻia akā ua hōʻemi i ka manawa ho'ōla awelika (19.7 mau lā i hoʻohālikelike ʻia me 43.8 mau lā). ʻO ka hoʻohui ʻana iā HBOT me ka hoʻokele kuni piha hiki ke hoʻomalu pono i ka sepsis i nā maʻi kuni, e alakaʻi ana i nā manawa ho'ōla pōkole a me ka hoʻemi ʻana i nā koi wai. Eia nō naʻe, pono ka noiʻi ākea hou aʻe e hōʻoia i ke kuleana o HBOT i ka hoʻokele ʻana i nā kuni nui.
1.5 ʻOsteomyelitis
ʻO ka Osteomyelitis kahi maʻi o ka iwi a i ʻole ka iwi iwi i hoʻokumu pinepine ʻia e nā pathogens bacteria. Hiki ke paʻakikī ka mālama ʻana i ka osteomyelitis ma muli o ka nele o ke koko i nā iwi a me ka palena o ke komo ʻana o nā antibiotics i loko o ka iwi. ʻO ka osteomyelitis mau loa e hōʻike ʻia e nā pathogens mau, ka mumū iki, a me ka hoʻokumu ʻana o nā ʻiʻo iwi necrotic. ʻO ka osteomyelitis refractory e pili ana i nā maʻi iwi mau loa e hoʻomau a hoʻi hou paha me ka nānā ʻole i ka mālama kūpono.
Ua hōʻike ʻia ʻo HBOT e hoʻomaikaʻi nui i nā pae oxygen i loko o nā ʻiʻo iwi i loaʻa i ka maʻi. Hōʻike nā moʻo hihia he nui a me nā haʻawina cohort e hoʻonui ana ʻo HBOT i nā hopena lapaʻau no nā maʻi osteomyelitis. Me he mea lā e hana ana ia ma o nā ʻano hana like ʻole, me ka hoʻoikaika ʻana i ka hana metabolic, ka kāohi ʻana i nā pathogens bacteria, ka hoʻoikaika ʻana i nā hopena antibiotic, ka hoʻēmi ʻana i ka mumū, a me ka hoʻolaha ʻana i ka ho'ōlanā kaʻina hana. Ma hope o ka HBOT, 60% a 85% o nā maʻi me ka osteomyelitis mau loa, refractory e hōʻike ana i nā hōʻailona o ka hoʻopau ʻana i ka maʻi.
1.6 Nā maʻi fungal
Ma ke ao holoʻokoʻa, ʻoi aku ma mua o ʻekolu miliona mau kānaka e ʻeha nei i nā maʻi fungal mau loa a i ʻole invasive, e alakaʻi ana i ka make ʻana o 600,000 i kēlā me kēia makahiki. Hoʻopilikia pinepine ʻia nā hopena lapaʻau no nā maʻi fungal ma muli o nā mea e like me ke kūlana pale ʻana i hoʻololi ʻia, nā maʻi kumu, a me nā ʻano virulence pathogen. Ke lilo nei ʻo HBOT i koho therapeutic hoihoi i nā maʻi fungal koʻikoʻi ma muli o kona palekana a me ke ʻano invasive ʻole. Hōʻike nā haʻawina e hiki i ka HBOT ke kūleʻa i nā pathogens fungal e like me Aspergillus a me Mycobacterium tuberculosis.
Hoʻolaha ʻo HBOT i nā hopena antifungal ma ke kāohi ʻana i ka hoʻokumu ʻana o ka biofilm o Aspergillus, me ka hoʻonui ʻia o ka pono i ʻike ʻia i loko o nā ʻano nele i nā genes superoxide dismutase (SOD). ʻO nā kūlana hypoxic i ka wā o nā maʻi fungal e hoʻopilikia i ka lawe ʻana i nā lāʻau antifungal, e hoʻolilo ana i ka hoʻonui ʻia o nā pae oxygen mai HBOT i mea hana pono, ʻoiai pono ka noiʻi hou aku.
Nā Waiwai Antimicrobial o HBOT
ʻO ke kaiapuni hyperoxic i hana ʻia e HBOT e hoʻomaka i nā loli physiological a me biochemical e hoʻoulu ai i nā waiwai antibacterial, e lilo ia i lāʻau lapaʻau adjunct kūpono no ka maʻi. Hōʻike ʻo HBOT i nā hopena kupaianaha e kūʻē i ka bacteria aerobic a me ka bacteria anaerobic ma o nā hana e like me ka hana bactericidal pololei, ka hoʻonui ʻana i nā pane pale, a me nā hopena synergistic me nā mea antimicrobial kikoʻī.
2.1 Nā hopena antibacterial pololei o HBOT
ʻO ka hopena antibacterial pololei o HBOT ua pili nui ʻia i ka hana ʻana o nā reactive oxygen species (ROS), ʻo ia hoʻi nā anions superoxide, hydrogen peroxide, hydroxyl radicals, a me nā hydroxyl ions—ʻo ia mau mea a pau e kū mai ana i ka wā o ka metabolism cellular.
He mea nui ka pilina ma waena o O₂ a me nā ʻāpana cellular i ka hoʻomaopopo ʻana i ke ʻano o ka hoʻokumu ʻana o ROS i loko o nā cell. Ma lalo o kekahi mau kūlana i kapa ʻia ʻo ke kaumaha oxidative, ua hoʻopilikia ʻia ke kaulike ma waena o ka hoʻokumu ʻana o ROS a me kona hōʻino ʻana, e alakaʻi ana i nā pae kiʻekiʻe o ROS i loko o nā cell. Hoʻoulu ʻia ka hana ʻana o ka superoxide (O₂⁻) e ka superoxide dismutase, ka mea e hoʻololi ai iā O₂⁻ i hydrogen peroxide (H₂O₂). Hoʻonui hou ʻia kēia hoʻololi ʻana e ka hopena Fenton, ka mea e oxidizes iā Fe²⁺ e hana i nā radical hydroxyl (·OH) a me Fe³⁺, no laila e hoʻomaka ana i kahi kaʻina redox maikaʻi ʻole o ka hoʻokumu ʻana o ROS a me ka hōʻino ʻana o ka cellular.
Hoʻopili nā hopena ʻawahia o ROS i nā ʻāpana cellular koʻikoʻi e like me DNA, RNA, nā protein, a me nā lipids. ʻO ka mea nui, ʻo DNA kahi pahuhopu mua o ka cytotoxicity i hoʻopili ʻia e H₂O₂, ʻoiai e hoʻopilikia ana i nā ʻano deoxyribose a hōʻino i nā haku mele kumu. ʻO ka pōʻino kino i hoʻokumu ʻia e ROS e hoʻonui i ka ʻano helix o ka DNA, hiki ke loaʻa mai ka lipid peroxidation i hoʻoulu ʻia e ROS. Hōʻike kēia i nā hopena maikaʻi ʻole o nā pae ROS kiʻekiʻe i loko o nā ʻōnaehana olaola.
Hana Antimicrobial o ROS
He kuleana koʻikoʻi ko ROS i ka pale ʻana i ka ulu ʻana o nā microbes, e like me ka mea i hōʻike ʻia ma o ka hanauna ROS i hoʻokomo ʻia e HBOT. Hoʻopili pololei nā hopena ʻawahia o ROS i nā ʻāpana cellular e like me ka DNA, nā protein, a me nā lipids. Hiki i nā nui kiʻekiʻe o nā ʻano oxygen hana ke hōʻino pololei i nā lipids, e alakaʻi ana i ka lipid peroxidation. Hoʻopilikia kēia kaʻina hana i ka pono o nā membrane cell a, no laila, ka hana o nā mea loaʻa a me nā protein e pili ana i ka membrane.
Eia kekahi, ʻo nā protein, ʻo ia hoʻi nā pahuhopu molekala koʻikoʻi o ROS, e hana i nā hoʻololi oxidative kikoʻī ma nā koena amino acid like ʻole e like me cysteine, methionine, tyrosine, phenylalanine, a me tryptophan. No ka laʻana, ua hōʻike ʻia ʻo HBOT e hoʻoulu i nā loli oxidative i loko o kekahi mau protein ma E. coli, me ka elongation factor G a me DnaK, no laila e hoʻopilikia ana i kā lākou hana cellular.
Ka Hoʻoikaika ʻana i ka Palekana ma o HBOT
Nā waiwai anti-inflammatory o HBOTua hoʻopaʻa ʻia, e hōʻoia ana he mea nui no ka hōʻoluʻolu ʻana i ka hōʻino ʻana o nā ʻiʻo a me ke kāohi ʻana i ka holomua o ka maʻi. Hoʻopilikia nui ka HBOT i ka hōʻike ʻana o nā cytokines a me nā mea hoʻoponopono mumū ʻē aʻe, e hoʻohuli ana i ka pane pale. Ua ʻike nā ʻōnaehana hoʻokolohua like ʻole i nā loli like ʻole i ka hōʻike ʻana o ka gene a me ka hanauna protein ma hope o ka HBOT, kahi e hoʻonui ai a hoʻohaʻahaʻa paha i nā mea ulu a me nā cytokines.
I ka wā o ke kaʻina hana HBOT, hoʻoulu ka piʻi ʻana o nā pae O₂ i nā ʻano pane cellular, e like me ke kāohi ʻana i ka hoʻokuʻu ʻia ʻana o nā mea hoʻopili pro-inflammatory a me ka hoʻolaha ʻana i ka lymphocyte a me ka neutrophil apoptosis. I ka hui pū ʻana, hoʻoikaika kēia mau hana i nā ʻano hana antimicrobial o ka ʻōnaehana pale, no laila e hoʻomaʻamaʻa ai i ka ho'ōla ʻana o nā maʻi.
Eia kekahi, hōʻike nā haʻawina e hiki i ka hoʻonui ʻia ʻana o nā pae O₂ i ka wā o HBOT ke hōʻemi i ka hōʻike ʻana o nā cytokines pro-inflammatory, me ka interferon-gamma (IFN-γ), interleukin-1 (IL-1), a me interleukin-6 (IL-6). Hoʻokomo pū kēia mau hoʻololi i ka hoʻohaʻahaʻa ʻana i ka lakio o nā pūnaewele CD4:CD8 T a me ka hoʻololi ʻana i nā mea loaʻa hiki ke hoʻoheheʻe ʻia, i ka hopena e hoʻokiʻekiʻe i nā pae interleukin-10 (IL-10), he mea nui ia no ka pale ʻana i ka mumū a me ka hoʻoulu ʻana i ka ho'ōla.
Ua pili pū nā hana antimicrobial o HBOT me nā ʻano hana olaola paʻakikī. Ua hōʻike ʻia ʻo superoxide a me ke kaomi kiʻekiʻe e hoʻolaha mau ana i ka hana antibacterial i hoʻokomo ʻia e HBOT a me ka apoptosis neutrophil. Ma hope o HBOT, ʻo ka piʻi nui ʻana o nā pae oxygen e hoʻonui i nā hiki bactericidal o nā neutrophils, kahi ʻāpana koʻikoʻi o ka pane pale. Eia kekahi, hoʻopau ʻo HBOT i ka hoʻopili ʻana o ka neutrophil, kahi i hoʻopili ʻia e ka launa pū ʻana o β-integrins ma nā neutrophils me nā mole adhesion intercellular (ICAM) ma nā cell endothelial. Hoʻopaʻa ʻo HBOT i ka hana o ka neutrophil β-2 integrin (Mac-1, CD11b/CD18) ma o kahi kaʻina hana nitric oxide (NO), e kōkua ana i ka neʻe ʻana o nā neutrophils i kahi o ka maʻi.
Pono ka hoʻonohonoho hou ʻana o ka cytoskeleton no nā neutrophils e phagocytize i nā pathogens. Ua hōʻike ʻia ka S-nitrosylation o ka actin e hoʻoulu i ka polymerization actin, e hiki ai ke hoʻomaʻamaʻa i ka hana phagocytic o nā neutrophils ma hope o ka mālama mua ʻana o HBOT. Eia kekahi, hoʻolaha ʻo HBOT i ka apoptosis i nā laina cell T kanaka ma o nā ala mitochondrial, me ka wikiwiki o ka make ʻana o ka lymphocyte ma hope o HBOT i hōʻike ʻia. ʻO ka pale ʻana i ka caspase-9—me ka ʻole o ka hoʻopilikia ʻana i ka caspase-8—ua hōʻike i nā hopena immunomodulatory o HBOT.
Nā hopena Synergistic o HBOT me nā mea hana antimicrobial
I nā noi lapaʻau, hoʻohana pinepine ʻia ʻo HBOT me nā antibiotics e hakakā pono i nā maʻi. Hiki i ke kūlana hyperoxic i loaʻa i ka wā o HBOT ke hoʻololi i ka pono o kekahi mau mea antibiotic. Hōʻike ka noiʻi ʻaʻole hana wale nā lāʻau bactericidal kikoʻī, e like me β-lactams, fluoroquinolones, a me aminoglycosides, ma o nā ʻano hana kūlohelohe akā hilinaʻi pū kekahi i ka metabolism aerobic o ka bacteria. No laila, ʻo ke alo o ka oxygen a me nā ʻano metabolic o nā pathogens he mea nui i ka loiloi ʻana i nā hopena therapeutic o nā antibiotics.
Ua hōʻike ʻia nā hōʻike koʻikoʻi e hiki i nā pae oxygen haʻahaʻa ke hoʻonui i ke kū'ē ʻana o Pseudomonas aeruginosa i ka piperacillin/tazobactam a ʻo kahi kaiapuni oxygen haʻahaʻa e kōkua pū i ka hoʻonui ʻia o ke kū'ē ʻana o Enterobacter cloacae i ka azithromycin. I ka ʻaoʻao ʻē aʻe, hiki i kekahi mau kūlana hypoxic ke hoʻonui i ka ʻike bacteria i nā antibiotics tetracycline. Hana ʻo HBOT ma ke ʻano he ʻano lapaʻau adjunctive kūpono ma ka hoʻoulu ʻana i ka metabolism aerobic a me ka reoxygenating i nā ʻiʻo i loaʻa i ka maʻi hypoxic, a laila e hoʻonui ana i ka ʻike o nā pathogens i nā antibiotics.
Ma nā haʻawina preclinical, ʻo ka hui pū ʻana o HBOT—i lawelawe ʻia i ʻelua manawa i ka lā no 8 mau hola ma 280 kPa—me ka tobramycin (20 mg/kg/lā) ua hōʻemi nui i nā ukana bacteria ma Staphylococcus aureus infectious endocarditis. Hōʻike kēia i ka hiki o HBOT ma ke ʻano he lāʻau kōkua. Ua hōʻike ʻia nā noiʻi hou aʻe ma lalo o 37°C a me 3 ATA kaomi no 5 mau hola, ua hoʻonui nui ʻo HBOT i nā hopena o ka imipenem e kūʻē i ka macrophage-infected Pseudomonas aeruginosa. Eia kekahi, ua ʻike ʻia ke ʻano hui pū ʻana o HBOT me cephazolin he ʻoi aku ka maikaʻi i ka mālama ʻana iā Staphylococcus aureus osteomyelitis i nā hiʻohiʻona holoholona i hoʻohālikelike ʻia me cephazolin wale nō.
Hoʻonui nui hoʻi ka HBOT i ka hana bactericidal o ka ciprofloxacin e kūʻē i nā biofilms Pseudomonas aeruginosa, ʻoi aku hoʻi ma hope o 90 mau minuke o ka hōʻike ʻana. Hoʻopili ʻia kēia hoʻonui ʻana i ka hoʻokumu ʻia ʻana o nā ʻano oxygen reactive endogenous (ROS) a hōʻike i ka ʻike kiʻekiʻe i nā mutants peroxidase-defective.
I loko o nā hiʻohiʻona o ka pleuritis i hoʻokumu ʻia e ka methicillin-resistant Staphylococcus aureus (MRSA), ua hōʻike ka hopena hui pū ʻana o vancomycin, teicoplanin, a me linezolid me HBOT i ka hoʻonui nui ʻana i ka pono kūʻē iā MRSA. ʻO Metronidazole, kahi antibiotic i hoʻohana nui ʻia i ka mālama ʻana i nā maʻi anaerobic koʻikoʻi a me nā polymicrobial e like me nā maʻi wāwae diabetic (DFIs) a me nā maʻi ʻoki kino (SSIs), ua hōʻike i ka hopena antimicrobial kiʻekiʻe ma lalo o nā kūlana anaerobic. Pono nā haʻawina e hiki mai ana e ʻimi i nā hopena antibacterial synergistic o HBOT i hui pū ʻia me metronidazole ma nā hoʻonohonoho in vivo a me in vitro.
ʻO ka hopena antimicrobial o HBOT ma nā bacteria kūpaʻa
Me ka ulu ʻana a me ka laha ʻana o nā ʻano kūʻē, nalowale pinepine ka ikaika o nā antibiotics kuʻuna i ka hala ʻana o ka manawa. Eia kekahi, hiki i ka HBOT ke hōʻoia i ka mea nui i ka mālama ʻana a me ka pale ʻana i nā maʻi i hoʻokumu ʻia e nā pathogens multidrug-resistant, e lawelawe ana ma ke ʻano he hoʻolālā koʻikoʻi ke hāʻule nā lāʻau antibiotic. Ua hōʻike ʻia nā haʻawina he nui i nā hopena bactericidal koʻikoʻi o HBOT i nā bacteria kūʻē pili i ka lāʻau. No ka laʻana, ua hōʻemi nui kahi hālāwai HBOT 90-minuke ma 2 ATM i ka ulu ʻana o MRSA. Eia kekahi, i nā hiʻohiʻona ratio, ua hoʻonui ʻo HBOT i nā hopena antibacterial o nā antibiotics like ʻole e kūʻē i nā maʻi MRSA. Ua hōʻoia nā hōʻike he pono ka HBOT i ka mālama ʻana i ka osteomyelitis i hoʻokumu ʻia e OXA-48-producing Klebsiella pneumoniae me ka ʻole o ka pono o nā antibiotics adjunct.
I ka hōʻuluʻulu manaʻo, hōʻike ka lāʻau lapaʻau oxygen hyperbaric i kahi ala multifaceted i ka kaohi ʻana i ka maʻi, e hoʻoikaika ana i ka pane ʻana o ka pale ʻana me ka hoʻonui ʻana i ka pono o nā mea antimicrobial e kū nei. Me ka noiʻi piha a me ka hoʻomohala ʻana, loaʻa iā ia ka hiki ke hōʻemi i nā hopena o ke kū'ē ʻana i ka antibiotic, e hāʻawi ana i ka manaʻolana i ke kaua e hoʻomau nei i nā maʻi bacteria.
Ka manawa hoʻouna: Pepeluali-28-2025