Efeitos benéficos tardios da oxigenoterapia hiperbárica nas úlceras crónicas dos membros inferiores dos diabéticos que não cicatrizaram com este tratamento
Palavras-chave:
hiperbárico, oxigénio, diabetes, úlcerasResumo
Objectivos: Análise retrospectiva, observacional, controlada, da
evolução das úlceras crónicas dos diabéticos que não cicatrizaram com oxigenoterapia hiperbárica (OTHB) e das que não
beneficiaram de OTHB.
Material e métodos: 66 doentes diabéticos, com úlceras
crónicas, graus 2 a 4 de Wagner, repartidos por 2 grupos: não
submetido a OTHB- 32 doentes; submetido a OTHB- 34 doentes;
este último dividido em 2 subgrupos: melhorado com OTHB- 19
doentes; não melhorado com OTHB- 15 doentes.
OTHB: inalação diária de oxigénio puro a 2.5 atmosferas absolutas, durante 90 minutos consecutivos; média de 54 sessões/doente.
“Follow-up” de 55 meses (média) para o grupo não tratado, e de
45 meses para o grupo tratado e respectivos subgrupos.
Resultados: Decréscimo das taxas de amputação (global) e
aumento das taxas de cicatrização das lesões, estatisticamente
significativos, no grupo submetido a OTHB (44.1% e 41.2%) e
subgrupo melhorado com OTHB (31.6% e 57.9%), em comparação com as do grupo não submetido a OTHB (84.4% e 3.1%).
Decréscimo, não significativo, das taxas de amputação “major”,
no grupo submetido a OTHB (23.5%) e subgrupos, melhorado
(21.1%) e não melhorado (26.7%), em comparação com a do
grupo não submetido a OTHB (53.1%).
Aumento, não significativo, da taxa de cicatrização das lesões,
no subgrupo não melhorado com OTHB (20%), comparada com
a do grupo não submetido a OTHB (3.1%).
Conclusões: Constatou-se melhoria significativa do perfil evolutivo das úlceras que não cicatrizaram com OTHB (especialmente
das que melhoraram), comparado com o das não sujeitas a OTHB,
durante um “follow-up” médio de 4 anos.
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