Kwindawo yamayeza anamhlanje, amayeza okubulala iintsholongwane abonakalise ukuba yenye yezona nkqubela zibalulekileyo, ehlisa kakhulu izehlo kunye namazinga okufa anxulumene nosulelo lwe-microbial. Ukukwazi kwabo ukuguqula iziphumo zeklinikhi zosulelo lwebhaktheriya luye lwandisa ixesha lokuphila lezigulane ezingenakubalwa. Ii-antibiotics zibalulekile kwiinkqubo zonyango ezintsonkothileyo, kubandakanya utyando, ukufakwa kokufakelwa, ukutshintshwa, kunye nechemotherapy. Nangona kunjalo, ukuvela kwe-pathogens enganyangekiyo ngamachiza kuye kwaba yinkxalabo ekhulayo, inciphisa ukusebenza kwala machiza ngokuhamba kwexesha. Iimeko zokunganyangeki ngamayeza okubulala iintsholongwane ziye zabhalwa kuzo zonke iindidi zamayeza okubulala iintsholongwane njengoko uguquko lwemicrobial lwenzeka. Uxinzelelo lokukhetha olwenziwe ngamachiza e-antimicrobial lube negalelo ekunyukeni kweentlobo ezixhathisayo, ezibeka umngeni omkhulu kwimpilo yehlabathi.
Ukulwa nomba ocinezelayo wokunganyangeki kwe-antimicrobial, kubalulekile ukuphumeza imigaqo-nkqubo esebenzayo yokulawula usulelo enqanda ukusasazeka kwezifo ezixhathisayo, ecaleni kokunciphisa ukusetyenziswa kwamayeza okubulala iintsholongwane. Ngaphaya koko, kukho imfuneko engxamisekileyo yezinye iindlela zonyango. I-Hyperbaric Oxygen Therapy (HBOT) iye yavela njengendlela ethembisayo kulo mongo, ebandakanya ukuphefumla i-oksijini ye-100% kumanqanaba athile oxinzelelo lwexesha elithile. Ibekwe njengonyango olusisiseko okanye olongezelelweyo losulelo, i-HBOT inokunika ithemba elitsha ekunyangeni usulelo oluqatha olubangelwa ziintsholongwane ezingevayo ngamayeza okubulala iintsholongwane.
Olu nyango lusetyenziswa ngakumbi njengonyango oluphambili okanye olulolunye unyango kwiimeko ezahlukeneyo, kubandakanywa ukuvuvukala, i-carbon monoxide poisoning, amanxeba angapheliyo, izifo ze-ischemic, kunye nosulelo. Izicelo zeklinikhi ze-HBOT kunyango losulelo zinzulu, zibonelela ngeenzuzo ezixabisekileyo kwizigulane.
Izicelo zeklinikhi ze-Hyperbaric Oxygen Therapy kwi-Infection
Ubungqina bangoku buxhasa ngamandla ukusetyenziswa kwe-HBOT, zombini njengonyango oluzimeleyo kunye nonyango oluncedisayo, lubonisa izibonelelo ezibalulekileyo kwizigulana ezosulelekileyo. Ngexesha le-HBOT, uxinzelelo lwegazi lwe-oxygen lwe-arterial lunokunyuka ukuya kwi-2000 mmHg, kwaye umphumo ophezulu we-oksijeni-izicubu ze-gradient ye-gradient inokunyusa amanqanaba e-oksijeni ye-tissue kwi-500 mmHg. Iziphumo ezinjalo zibaluleke kakhulu ekukhuthazeni ukuphiliswa kweempendulo ezivuthayo kunye nokuphazamiseka kwe-microcirculatory okubonwa kwiindawo ze-ischemic, kunye nokulawula i-compartment syndrome.
I-HBOT inokuchaphazela iimeko ezixhomekeke kumajoni omzimba. Uphando lubonisa ukuba i-HBOT inokucinezela i-syndromes ye-autoimmune kunye ne-antigen-induced responses immune reactions, inceda ukugcina ukunyamezela kwe-graft ngokunciphisa ukujikeleza kwe-lymphocytes kunye ne-leukocytes ngelixa imodareyitha iimpendulo ze-immune. Ukongeza, HBOTixhasa ukuphiliswakwizilonda ezingapheliyo zesikhumba ngokuvuselela i-angiogenesis, inkqubo ebalulekileyo yokuphucula ukubuyiswa. Olu nyango lukwakhuthaza ukubunjwa kwe-collagen matrix, isigaba esibalulekileyo ekuphulukiseni isilonda.
Ingqwalasela eyodwa kufuneka inikwe kusulelo oluthile, ngakumbi usulelo olunzulu kwaye kunzima ukulunyanga olunje nge-necrotizing fasciitis, i-osteomyelitis, usulelo olungapheliyo lwezicubu ezithambileyo, kunye ne-endocarditis esosulelayo. Esinye sezona zicelo zekliniki eziqhelekileyo ze-HBOT zezosulelo lwe-skin-soft tissue kunye ne-osteomyelitis ehambelana namanqanaba e-oksijini aphantsi ahlala ebangelwa yi-anaerobic okanye iibhaktheriya ezixhathisayo.
1. Usulelo lweNyawo lwesifo seswekile
Unyawo lwesifo seswekileizilonda yingxaki exhaphakileyo phakathi kwabaguli abanesifo seswekile, echaphazela ukuya kutsho kuma-25% aba bantu. Usulelo luhlala luvela kwezi zilonda (izibalo ze-40% -80% yamatyala) kwaye zikhokelela ekwandeni kokugula kunye nokufa. Usulelo lwenyawo lwesifo seswekile (i-DFIs) luhlala lubandakanya usulelo lwe-polymicrobial kunye neentlobo ezahlukeneyo zentsholongwane ye-anaerobic echongiweyo. Izinto ezahlukeneyo, kubandakanya iziphene zomsebenzi we-fibroblast, imiba yokwakheka kwe-collagen, iindlela zokuzikhusela kwiselula, kunye nomsebenzi we-phagocyte, unokuthintela ukuphiliswa kwesilonda kwizigulana zeswekile. Uphononongo oluninzi luchonge ukukhutshwa kwe-oxygen eluswini njengowona mngcipheko mkhulu wokunqunyulwa kwezitho ezinxulumene nee-DFIs.
Njengenye yeenketho zangoku zonyango lweDFI, i-HBOT ixelwe ukuba ikhulise kakhulu izinga lokuphulukisa izilonda zeenyawo zesifo sikashukela, emva koko ukunciphisa imfuno yokunqunyulwa kunye nokungenelela okunzima kotyando. Ayinciphisi nje imfuneko yeenkqubo zoncedo olunzulu, ezifana noqhaqho lweflap kunye nokufakelwa kwesikhumba, kodwa ikwabonelela ngeendleko eziphantsi kunye neziphumo ebezingalindelekanga ezincinci xa kuthelekiswa nokhetho lotyando. Uphononongo olwenziwe nguChen et al. ibonise ukuba ngaphezu kweeseshoni ze-10 ze-HBOT zikhokelele ekuphuculweni kwe-78.3% kumazinga okuphilisa amanxeba kwizigulane ezinesifo seswekile.
2. I-Necrotizing Soft Tissue Infections
I-Necrotizing soft tissue infections (NSTIs) ihlala i-polymicrobial, edla ngokuvela kwindibaniselwano ye-aerobic kunye ne-anaerobic pathogens yebhaktiriya kwaye zihlala zinxulunyaniswa nokuveliswa kwegesi. Ngelixa ii-NSTIs zinqabile ngokwentelekiso, zibonisa izinga eliphezulu lokusweleka ngenxa yokuqhubela phambili kwazo ngokukhawuleza. Ukuxilongwa ngexesha kunye nokufanelekileyo kunye nonyango ngundoqo ekuphumezeni iziphumo ezithandekayo, kwaye i-HBOT iye yacetyiswa njengendlela yokudibanisa yokulawula i-NSTIs. Nangona kusekho ingxabano ejikeleze ukusetyenziswa kwe-HBOT kwi-NSTIs ngenxa yokunqongophala kwezifundo ezilawulwayo,ubungqina bubonisa ukuba inokunxulunyaniswa nokuphuculwa kwamazinga okuphila kunye nokugcinwa kwamalungu kwizigulana ze-NSTI.. Uphononongo lokubuyela emva lubonise ukuhla okubalulekileyo kumazinga okusweleka phakathi kwezigulane ze-NSTI ezifumana i-HBOT.
1.3 Usulelo lweNdawo yoCando
Ii-SSIs zinokuhlelwa ngokusekwe kwindawo ye-anatomical yosulelo kwaye zinokuvela kwiintsholongwane ezahlukeneyo, kubandakanya zombini iibhaktheriya ze-aerobic kunye ne-anaerobic. Ngaphandle kokuqhubela phambili kumanyathelo okulawula usulelo, njengeendlela zokuvala inzala, ukusetyenziswa kwe-antibiotics ye-prophylactic, kunye nokuphuculwa kweendlela zotyando, ii-SSI zihlala ziyingxaki eqhubekayo.
Olunye uphononongo olubalulekileyo luphande ukusebenza kwe-HBOT ekukhuseleni ii-SSI ezinzulu kwi-neuromuscular scoliosis operation. I-HBOT yangaphambi kokusebenza inokunciphisa kakhulu iziganeko ze-SSI kwaye iququzelele ukuphulukiswa kwesilonda. Olu nyango olungathinteliyo ludala indawo apho amanqanaba e-oksijini kwizicubu zenxeba aphakanyisiweyo, adibaniswa nesenzo sokubulala i-oxidative ngokuchasene ne-pathogens. Ukongeza, ijongana negazi elithotyiweyo kunye namanqanaba eoksijini afaka isandla kuphuhliso lweeSSIs. Ngaphaya kwamanye amaqhinga olawulo losulelo, i-HBOT iye yacetyiswa ngokukodwa kuqhaqho olungcolisekileyo olufana neenkqubo ze-colorectal.
1.4 Ukutshisa
Ukutshisa kukwenzakala okubangelwa bubushushu obugqithisileyo, umsinga wombane, imichiza, okanye ukusasazeka kwemitha kwaye kunokubangela ukugula okuphezulu kunye namazinga okufa. I-HBOT inenzuzo ekunyangeni ukutshisa ngokunyusa amanqanaba e-oksijini kwizicubu ezonakalisiweyo. Ngelixa izifundo zezilwanyana kunye neklinikhi zibonisa iziphumo ezixubeneyo malungaukusebenza kwe-HBOT kunyango lokutshisa, Uphononongo olubandakanya izigulane ze-125 ezitshisayo lubonise ukuba i-HBOT ayizange ibonise impembelelo ebalulekileyo kumazinga okufa okanye inani lotyando olwenziweyo kodwa liye lanciphisa ixesha lokuphulukisa eliqhelekileyo (iintsuku ze-19.7 xa kuthelekiswa neentsuku ze-43.8). Ukudibanisa i-HBOT kunye nolawulo olubanzi lokutshisa kunokulawula ngokufanelekileyo i-sepsis kwizigulane ezitshayo, okukhokelela kumaxesha amafutshane okuphilisa kunye nokunciphisa iimfuno zamanzi. Nangona kunjalo, uphando olungakumbi olulindelekileyo luyafuneka ukuze kuqinisekiswe indima ye-HBOT ekulawuleni ukutshisa okukhulu.
1.5 I-Osteomyelitis
I-Osteomyelitis lusulelo lwethambo okanye umongo wethambo odla ngokubangelwa ziintsholongwane zebhaktiriya. Ukunyanga i-osteomyelitis kunokuba ngumngeni ngenxa yokungaboneleli kakuhle kwegazi emathanjeni kunye nokungena okuncinci kwamayeza okubulala iintsholongwane kumongo. I-osteomyelitis engapheliyo ibonakaliswe yi-pathogens eqhubekayo, ukuvuvukala okuncinci, kunye nokwakheka kwethambo le-necrotic. I-osteomyelitis ye-Refractory ibhekisela kwizifo ezingapheliyo zethambo eziqhubekayo okanye eziphindaphindiweyo nangona unyango olufanelekileyo.
I-HBOT ibonakaliswe ukuba iphucule kakhulu amanqanaba e-oksijini kwiiscuphe zethambo ezisulelekileyo. Uthotho lwamatyala kunye nophononongo lweqela lubonisa ukuba i-HBOT yonyusa iziphumo zeklinikhi kwizigulana ze-osteomyelitis. Kubonakala kusebenza ngeendlela ezahlukeneyo, kubandakanya ukonyusa umsebenzi wemetabolism, ukucinezela iintsholongwane zebhaktheriya, ukuphucula iziphumo ze-antibiotics, ukunciphisa ukuvuvukala, kunye nokukhuthaza ukuphiliswa.iinkqubo. I-Post-HBOT, i-60% ukuya kwi-85% yezigulane ezine-osteomyelitis engapheliyo, i-refractory osteomyelitis ibonisa iimpawu zoxinzelelo losulelo.
1.6 Usulelo lomngundo
Ehlabathini jikelele, bangaphezulu kwezigidi ezithathu abantu abaphethwe sisifo sokungunda esingapheliyo okanye esihlaselayo, esikhokelela ekufeni kwabantu abangaphezu kwama-600,000 ngonyaka. Iziphumo zonyango losulelo lomngundo luhlala lusengozini ngenxa yezinto ezifana nokuguqulwa kwesimo somzimba sokuzikhusela, izifo ezisisiseko, kunye neempawu zentsholongwane ye-pathogen. I-HBOT isiba lukhetho olunomtsalane lonyango kusulelo lomngundo olunzima ngenxa yokhuseleko lwayo kunye nendalo engahlaseli. Uphononongo lubonisa ukuba i-HBOT inokusebenza ngokuchasene neentsholongwane zokungunda ezifana ne-Aspergillus kunye ne-Mycobacterium tuberculosis.
I-HBOT ikhuthaza imiphumo ye-antifungal ngokuvimbela ukubunjwa kwe-biofilm ye-Aspergillus, ngokunyuka kokusebenza kakuhle okuphawulwe kwiintlobo ezingenayo i-superoxide dismutase (SOD) genes. Iimeko ze-hypoxic ngexesha lokusuleleka kwefungal zenza imingeni ekuhanjisweni kweziyobisi ze-antifungal, okwenza ukunyuka kwamanqanaba e-oksijini ukusuka kwi-HBOT kungenelelo olunokuba luncedo, nangona uphando olongezelelweyo lufanelekile.
IiPropati ze-Antimicrobial ze-HBOT
Imekobume ye-hyperoxic eyenziwe yi-HBOT iqalisa utshintsho lwe-physiological and biochemical evuselela iipropathi ze-antibacterial, iyenza ibe yonyango olusebenzayo lonyango losulelo. I-HBOT ibonisa iziphumo eziphawulekayo ngokuchasene neebhaktheriya ze-aerobic kunye neebhaktheriya ezininzi ze-anaerobic ngokusebenzisa iindlela ezifana nomsebenzi othe ngqo we-bactericidal, ukuphuculwa kweempendulo ze-immune, kunye nemiphumo ye-synergistic kunye ne-antimicrobial agents ezithile.
2.1 Iimpembelelo ze-Antibacterial ezithe ngqo ze-HBOT
Umphumo othe ngqo we-antibacterial we-HBOT ubangelwa kakhulu kwisizukulwana se-oxygen esebenzayo (i-ROS), equka i-superoxide anions, i-hydrogen peroxide, i-hydroxyl radicals, kunye ne-hydroxyl ions-zonke ezivela ngexesha le-metabolism yeselula.
Ukusebenzisana phakathi kwe-O₂ kunye nezixhobo zeselula kubalulekile ekuqondeni indlela i-ROS eyenza ngayo ngaphakathi kweeseli. Ngaphantsi kweemeko ezithile ezibizwa ngokuba yi-oxidative stress, ibhalansi phakathi kokubunjwa kwe-ROS kunye nokuthotywa kwayo kuphazamiseka, okukhokelela kumazinga aphakamileyo e-ROS kwiiseli. Ukuveliswa kwe-superoxide (O₂⁻) i-catalyzed yi-superoxide dismutase, ethi emva koko iguqule i-O₂⁻ ibe yi-hydrogen peroxide (H₂O₂). Olu guqulelo lwandiswa ngakumbi yi-Fenton reaction, ethi ifake i-Fe²⁺ ukuvelisa i-hydroxyl radicals (·OH) kunye ne-Fe³⁺, ngaloo ndlela iqalisa ulandelelwano oluyingozi lwe-redox yokwakheka kwe-ROS kunye nomonakalo weselula.
Iziphumo eziyityhefu zeROS zijolise kumacandelo abalulekileyo eselula anjengeDNA, iRNA, iiproteni, kunye nelipids. Ngokucacileyo, i-DNA yeyona nto iphambili ekujoliswe kuyo ye-H₂O₂-mediated cytotoxicity, njengoko iphazamisa izakhiwo ze-deoxyribose kwaye yonakalise ukuqanjwa kwesiseko. Umonakalo womzimba owenziwe yi-ROS udlulela kwisakhiwo se-helix ye-DNA, enokuthi ibangelwa yi-lipid peroxidation eyenziwa yi-ROS. Oku kugxininisa iziphumo ezibi zamanqanaba aphezulu e-ROS ngaphakathi kweenkqubo zebhayoloji.
Isenzo se-Antimicrobial ye-ROS
I-ROS idlala indima ebalulekileyo ekuthinteleni ukukhula kwe-microbial, njengoko kubonisiwe nge-ROS ye-HBOT-induced generation. Iziphumo eziyityhefu zeROS zijolise ngokuthe ngqo kumalungu eselula njengeDNA, iiproteni, kunye nelipids. Uxinzelelo oluphezulu lweentlobo ze-oksijeni ezisebenzayo zingonakalisa ngokuthe ngqo i-lipids, ekhokelela kwi-lipid peroxidation. Le nkqubo iphazamisa ingqibelelo yeembrane zeseli kwaye, ngenxa yoko, ukusebenza kwe-membrane ehambelana ne-receptors kunye neeprotheni.
Ngaphaya koko, iiproteni, ezikwalujoliso olubalulekileyo lweemolekyuli ze-ROS, zifumana uhlengahlengiso oluthile lwe-oxidative kwiintsalela ezahlukeneyo ze-amino acid ezifana ne-cysteine, i-methionine, i-tyrosine, i-phenylalanine, kunye ne-tryptophan. Ngokomzekelo, i-HBOT ibonakaliswe ukuba ibangele utshintsho lwe-oxidative kwiiprotheni ezininzi kwi-E. coli, kubandakanywa i-elongation factor G kunye ne-DnaK, ngaloo ndlela ichaphazela imisebenzi yabo yeselula.
Ukwandiswa koKhuseleko nge-HBOT
Iimpawu ezichasayo ze-HBOTzibhaliwe, zibonakala zibalulekile ekudambiseni umonakalo wezicubu kunye nokucinezela ukuqhubeka kosulelo. I-HBOT ichaphazela kakhulu ukubonakaliswa kwe-cytokines kunye nezinye izilawuli ezivuthayo, ezichaphazela impendulo yokuzivikela komzimba. Iinkqubo ezahlukeneyo zovavanyo ziye zabona utshintsho olwahlukileyo kwimbonakalo yemfuza kunye neproteni yokuvelisa emva kwe-HBOT, enokuthi ilawule okanye ithobe izinto zokukhula kunye neecytokines.
Ngexesha lenkqubo ye-HBOT, ukunyuka kwamanqanaba e-O₂ kubangela uluhlu lweempendulo zeselula, ezinjengokucinezela ukukhululwa kwabalamli be-pro-inflammatory kunye nokukhuthaza i-lymphocyte kunye neutrophil apoptosis. Ngokudibeneyo, ezi zenzo zongeza iindlela zokulwa ne-immune system, ngaloo ndlela ziququzelela ukuphiliswa kosulelo.
Ngaphezu koko, uphando lubonisa ukuba ukunyuka kwamanqanaba e-O₂ ngexesha le-HBOT kunokunciphisa ukubonakaliswa kwe-cytokines e-pro-inflammatory, kuquka i-interferon-gamma (IFN-γ), i-interleukin-1 (IL-1), kunye ne-interleukin-6 (IL-6). Olu tshintsho lukwabandakanya ukunciphisa umlinganiselo we-CD4: iiseli ze-CD8 T kunye nokumodareyitha ezinye ii-receptors ezinyibilikayo, ekugqibeleni ziphakamisa amanqanaba e-interleukin-10 (IL-10), eyona nto ibalulekileyo ekulweni nokudumba kunye nokukhuthaza ukuphiliswa.
Imisebenzi ye-antimicrobial ye-HBOT idibene kunye neendlela eziyinkimbinkimbi zebhayoloji. Zombini i-superoxide kunye noxinzelelo oluphezulu luye lwabikwa ngokungahambelani nokukhuthaza umsebenzi we-antibacterial we-HBOT kunye ne-neutrophil apoptosis. Ukulandela i-HBOT, ukunyuswa okuphawulweyo kumanqanaba eoksijini kuphucula amandla e-bactericidal ye-neutrophils, icandelo elibalulekileyo lokuphendula komzimba. Ngaphezu koko, i-HBOT icinezela i-neutrophil adhesion, ehambelana nokusebenzisana kwe-β-integrins kwi-neutrophils kunye ne-intercellular adhesion molecules (ICAM) kwiiseli ze-endothelial. I-HBOT inqanda umsebenzi we-neutrophil β-2 integrin (Mac-1, CD11b / CD18) ngokusebenzisa inkqubo ye-nitric oxide (NO)-mediated, igalelo ekufudukeni kwe-neutrophils kwindawo yokusuleleka.
Uhlengahlengiso oluchanekileyo lwe-cytoskeleton luyimfuneko ukuze i-neutrophils isebenze ngokufanelekileyo i-phagocytize pathogens. I-S-nitrosylation ye-actin ibonakaliswe ukuvuselela i-actin polymerization, enokuthi iququzelele umsebenzi we-phagocytic we-neutrophils emva kwe-HBOT yonyango lwangaphambili. Ngaphezu koko, i-HBOT ikhuthaza i-apoptosis kwimigca yeseli ye-T yomntu ngokusebenzisa iindlela ze-mitochondrial, kunye ne-lymphocyte ekhawulezayo yokufa emva kwe-HBOT. Ukuthintela i-caspase-9-ngaphandle kwempembelelo ye-caspase-8-ibonise imiphumo ye-immunomodulatory ye-HBOT.
Iimpembelelo ze-Synergistic ze-HBOT ezine-Antimicrobial Agents
Kwizicelo zeklinikhi, i-HBOT isetyenziswa rhoqo kunye ne-antibiotics ukulwa nosulelo ngokufanelekileyo. Isimo se-hyperoxic esiphunyeziweyo ngexesha le-HBOT sinokuchaphazela ukusebenza kwee-antibiotics ezithile. Uphando lucebisa ukuba amayeza athile e-bactericidal, anje nge-β-lactam, i-fluoroquinolones, kunye ne-aminoglycosides, awasebenzi nje kuphela ngeendlela zendalo kodwa axhomekeke ngokuyinxenye kwimetabolism ye-aerobic yeebhaktheriya. Ke ngoko, ubukho beoksijini kunye neempawu zemetabolism ye-pathogens zibalulekile xa kuvavanywa iziphumo zonyango lwe-antibiotics.
Ubungqina obucacileyo bubonise ukuba amanqanaba aphantsi e-oksijeni anokunyusa ukuchasana kwe-Pseudomonas aeruginosa kwi-piperacillin / tazobactam kwaye indawo ephantsi ye-oksijini nayo inegalelo ekwandeni kokuchasana kwe-Enterobacter cloacae kwi-azithromycin. Ngakolunye uhlangothi, iimeko ezithile ze-hypoxic zinokwandisa uvakalelo lwebhaktheriya kwi-tetracycline antibiotics. I-HBOT isebenza njengendlela yonyango esebenzayo ngokubangela i-aerobic metabolism kunye ne-reoxygenating izicubu ezosulelekileyo ze-hypoxic, emva koko ikhulise uvakalelo lwe-pathogens kwi-antibiotics.
Kwizifundo zangaphambili, ukudibanisa kwe-HBOT-ilawulwa kabini imihla ngemihla kwiiyure ze-8 kwi-280 kPa-kunye ne-tobramycin (20 mg / kg / ngosuku) iyancipha kakhulu imithwalo yebhaktheriya kwi-Staphylococcus aureus endocarditis echaphazelekayo. Oku kubonisa amandla e-HBOT njengonyango oluncedisayo. Uphando olongezelelweyo lubonise ukuba phantsi kwe-37 ° C kunye ne-3 ye-ATA yoxinzelelo lweeyure ze-5, i-HBOT iphucule ngokuphawulekayo iziphumo ze-imipenem ngokuchasene ne-macrophage-infected Pseudomonas aeruginosa. Ukongezelela, i-modality edibeneyo ye-HBOT kunye ne-cephalolin ifunyenwe isebenze ngakumbi ekuphatheni i-Staphylococcus aureus osteomyelitis kwiimodeli zezilwanyana xa kuthelekiswa ne-cephalolin yodwa.
I-HBOT ikwanyusa kakhulu isenzo se-bactericidal ye-ciprofloxacin ngokuchasene ne-Pseudomonas aeruginosa biofilms, ngakumbi emva kwemizuzu engama-90 yokuba sesichengeni. Esi songezo sibalelwa kukwenziwa kweentlobo zeoksijini esebenzayo (i-ROS) kwaye ibonakalisa ubuntununtunu obuphezulu kwi-peroxidase-defective mutants.
Kwimizekelo ye-pleuritis ebangelwa yi-methicillin-resistant Staphylococcus aureus (MRSA), isiphumo sokusebenzisana se-vancomycin, i-teicoplanin, kunye ne-linezolid kunye ne-HBOT ibonise ukwandisa kakhulu ukusebenza kwe-MRSA. I-Metronidazole, isithinteli-ntsholongwane esisetyenziswa kakhulu ekunyangeni usulelo oluqatha lwe-anaerobic kunye ne-polymicrobial olufana nosulelo lweenyawo zesifo seswekile (i-DFIs) kunye nosulelo lwendawo yotyando (SSIs), lubonise ukusebenza okuphezulu kwe-antimicrobial phantsi kweemeko ze-anaerobic. Izifundo zexesha elizayo zifanelekile ukuba zihlolisise iziphumo ze-antibacterial synergistic ze-HBOT ezidityaniswe ne-metronidazole kuzo zombini kwi-vivo kunye ne-in vitro setting.
I-Antimicrobial Efficacy ye-HBOT kwi-Resistant Bacteria
Ngokuziphendukela kwemvelo kunye nokusasazeka kweentlobo ezixhathisayo, ii-antibiotics zendabuko zihlala zilahlekelwa amandla abo ekuhambeni kwexesha. Ngaphaya koko, i-HBOT inokuqinisekisa ukuba ibalulekile ekunyangeni nasekuthinteleni usulelo olubangelwa zizifo ezininzi ezinganyangekiyo ngamachiza, isebenza njengesicwangciso esibalulekileyo xa unyango lokubulala iintsholongwane lungasebenzi. Izifundo ezininzi zichaze iziphumo ezibalulekileyo ze-bactericidal ze-HBOT kwiibhaktheriya ezixhathisayo ngokwasekliniki. Ngokomzekelo, iseshoni ye-HBOT yemizuzu engama-90 kwi-ATM ye-2 yanciphisa kakhulu ukukhula kwe-MRSA. Ukongeza, kwiimodeli zomlinganiso, i-HBOT yongeze iziphumo zokulwa ne-antibacterial ye-antibiotics ngokuchasene nosulelo lwe-MRSA. Iingxelo ziqinisekisile ukuba i-HBOT iyasebenza ekunyangeni i-osteomyelitis ebangelwa yi-OXA-48-producing Klebsiella pneumoniae ngaphandle kokufuna nayiphi na i-antibiotics eyongezelelweyo.
Isishwankathelo, unyango lwe-oksijini ye-hyperbaric imele indlela ebanzi yokulawula usulelo, ukunyusa impendulo yokuzivikela komzimba ngelixa ukhulisa ukusebenza kakuhle kwee-antimicrobial agents ezikhoyo. Ngophando olubanzi kunye nophuhliso, ibambe amandla okunciphisa iziphumo zokunganyangeki ngamayeza okubulala iintsholongwane, inika ithemba kumlo oqhubekayo wokulwa nosulelo lwebhaktheriya.
Ixesha lokuposa: Feb-28-2025