Emkhakheni wezokwelapha wanamuhla, ama-antibiotic abonakale engenye yezindlela ezibaluleke kakhulu, ehlisa kakhulu izinga lokusabalala kanye nokufa okuhlobene nokutheleleka ngamagciwane. Amandla awo okushintsha imiphumela yezokwelapha yokutheleleka ngamagciwane andise isikhathi sokuphila seziguli eziningi. Ama-antibiotic abalulekile ezinqubweni zezokwelapha eziyinkimbinkimbi, okuhlanganisa ukuhlinzwa, ukufakwa kwezitho ezifakiwe, ukufakelwa izitho, kanye nokwelashwa ngamakhemikhali. Kodwa-ke, ukuvela kwamagciwane amelana namagciwane kube yinto ekhathazayo ekhulayo, kunciphisa ukusebenza kahle kwale mithi ngokuhamba kwesikhathi. Izimo zokumelana namagciwane zibhalwe kuzo zonke izigaba zama-antibiotic njengoba kwenzeka izinguquko zamagciwane. Ingcindezi yokukhetha ekhishwa yimithi yokulwa namagciwane inegalelo ekwandeni kwezinhlobo ezimelana namagciwane, okubeka inselele enkulu empilweni yomhlaba wonke.
Ukuze kulwiwe nenkinga ephuthumayo yokumelana namagciwane, kubalulekile ukusebenzisa izinqubomgomo zokulawula ukutheleleka ezisebenzayo ezinciphisa ukusabalala kwamagciwane amelana namagciwane, kanye nokunciphisa ukusetshenziswa kwama-antibiotic. Ngaphezu kwalokho, kunesidingo esiphuthumayo sezindlela zokwelapha ezihlukile. Ukwelashwa Nge-Oxygen Ene-Hyperbaric (HBOT) kuvele njengendlela ethembisayo kulo mongo, okubandakanya ukuhogela umoya-mpilo ongu-100% emazingeni athile okucindezela isikhathi esithile. Njengoba ibekwe njengokwelashwa okuyinhloko noma okuhambisanayo kokutheleleka, i-HBOT inganikeza ithemba elisha ekwelapheni ukutheleleka okunamandla okubangelwa amagciwane amelana namagciwane.
Lokhu kwelashwa kusetshenziswa kakhulu njengokwelashwa okuyinhloko noma okunye kwezimo ezahlukahlukene, okuhlanganisa ukuvuvukala, ubuthi be-carbon monoxide, amanxeba angapheli, izifo ze-ischemic, kanye nezifo. Ukusetshenziswa kwemitholampilo kwe-HBOT ekwelapheni ukutheleleka kukhulu kakhulu, kunikeza izinzuzo ezibalulekile ezigulini.
Izicelo Zemitholampilo Zokwelashwa Kwe-Hyperbaric Oxygen Ekuthelelekeni
Ubufakazi bamanje busekela ngokuqinile ukusetshenziswa kwe-HBOT, kokubili njengokwelashwa okuzimele kanye nokwengeziwe, okuletha izinzuzo ezibalulekile ezigulini ezinegciwane. Ngesikhathi se-HBOT, umfutho wegazi we-arterial oxygen ungakhuphuka ufike ku-2000 mmHg, futhi umfutho ophezulu we-oxygen-tissue gradient ophumelayo ungaphakamisa amazinga e-oxygen ezicubu abe ngu-500 mmHg. Imiphumela enjalo ibaluleke kakhulu ekukhuthazeni ukuphulukiswa kwezimpendulo zokuvuvukala kanye nokuphazamiseka kwe-microcirculatory okubonwa ezindaweni ezingasebenzi kahle, kanye nasekuphatheni i-compartment syndrome.
I-HBOT ingathinta nezimo ezincike ohlelweni lokuzivikela komzimba. Ucwaningo lubonisa ukuthi i-HBOT ingacindezela ama-autoimmune syndromes kanye nezimpendulo zokuzivikela komzimba ezibangelwa yi-antigen, isize ekugcineni ukubekezelelana kwe-graft ngokunciphisa ukujikeleza kwama-lymphocyte nama-leukocyte ngenkathi ilawula izimpendulo zokuzivikela komzimba. Ngaphezu kwalokho, i-HBOTisekela ukuphulukiswaezilonda zesikhumba ezingamahlalakhona ngokuvuselela i-angiogenesis, inqubo ebalulekile yokululama okuthuthukisiwe. Lokhu kwelashwa kukhuthaza nokwakheka kwe-collagen matrix, isigaba esibalulekile ekwelapheni amanxeba.
Kumelwe kuqashelwe ngokukhethekile izifo ezithile, ikakhulukazi izifo ezijulile nezinzima ukwelapha ezifana ne-necrotizing fasciitis, i-osteomyelitis, izifo ezithambile ezingamahlalakhona, kanye ne-endocarditis ethelelanayo. Enye yezindlela ezivame kakhulu zokwelashwa ze-HBOT ukutheleleka kwezicubu ezithambile njengesikhumba kanye ne-osteomyelitis ehlotshaniswa namazinga aphansi e-oxygen avame ukubangelwa amagciwane angenawo umoya noma amelana nawo.
1. Ukutheleleka Kwezinyawo Zesifo Sikashukela
Unyawo olunesifo sikashukelaIzilonda ziyinkinga evamile phakathi kweziguli ezinesifo sikashukela, ezithinta abantu abafinyelela ku-25% baleli qembu labantu. Ukutheleleka kuvame ukuvela kulezi zilonda (okubangela u-40%-80% wamacala) futhi kuholela ekwandeni kokugula nokufa. Ukutheleleka kwezinyawo zesifo sikashukela (ama-DFI) ngokuvamile kuqukethe ukutheleleka kwe-polymicrobial okunezinhlobo ezahlukene zezifo ezibangelwa amagciwane angenawo umoya ezitholakele. Izici ezahlukahlukene, kufaka phakathi ukukhubazeka kokusebenza kwe-fibroblast, izinkinga zokwakheka kwe-collagen, izindlela zokuzivikela kwamangqamuzana, kanye nokusebenza kwe-phagocyte, kungavimbela ukuphulukiswa kwamanxeba ezigulini ezinesifo sikashukela. Izifundo eziningana zikhombe ukungasebenzi kahle kwe-oxygenation yesikhumba njengento enamandla eyingozi yokunqunywa kwezicubu okuhlobene nama-DFI.
Njengenye yezinketho zamanje zokwelapha i-DFI, i-HBOT ibikwe ukuthi ithuthukisa kakhulu amazinga okuphulukiswa kwezilonda zezinyawo ezinesifo sikashukela, kamuva inciphisa isidingo sokunqunywa kanye nokungenelela okuyinkimbinkimbi kokuhlinzwa. Ayinciphisi nje kuphela isidingo sezinqubo ezidinga izinsiza eziningi, njengokuhlinzwa kwe-flap kanye nokufakelwa kwesikhumba, kodwa futhi iveza izindleko eziphansi kanye nemiphumela emibi emincane uma kuqhathaniswa nezinketho zokuhlinzwa. Ucwaningo lukaChen et al. lubonise ukuthi izikhathi ezingaphezu kwe-10 ze-HBOT ziholele ekuthuthukisweni okungu-78.3% kwamazinga okuphulukiswa kwezilonda ezigulini ezinesifo sikashukela.
2. Ukutheleleka Kwezicubu Ezithambile Ezibulala Izicubu
Ukutheleleka kwezicubu ezithambile ezifayo (ama-NSTI) kuvame ukuba yi-polymicrobial, ngokuvamile okuvela ekuhlanganisweni kwamagciwane e-aerobic kanye ne-anaerobic futhi kuvame ukuhlotshaniswa nokukhiqizwa kwegesi. Nakuba ama-NSTI engavamile, abonisa izinga eliphezulu lokufa ngenxa yokuqhubeka kwawo okusheshayo. Ukuxilongwa kanye nokwelashwa ngesikhathi esifanele kubalulekile ekufinyeleleni imiphumela emihle, futhi i-HBOT iye yanconywa njengendlela eyengeziwe yokuphatha ama-NSTI. Nakuba kusekhona ukuphikisana ngokusetshenziswa kwe-HBOT kuma-NSTI ngenxa yokuntuleka kwezifundo ezilawulwayo ezingaba khona,ubufakazi bubonisa ukuthi kungase kuhlotshaniswe namazinga okusinda athuthukisiwe kanye nokugcinwa kwezitho zomzimba ezigulini ze-NSTIUcwaningo olubukezwa emuva lubonise ukwehla okukhulu kwamazinga okufa phakathi kweziguli ze-NSTI ezithola i-HBOT.
1.3 Ukutheleleka Kwendawo Yokuhlinzwa
Ama-SSI angahlukaniswa ngokusekelwe endaweni yokwakheka kokutheleleka futhi angavela ezifweni ezahlukahlukene, okuhlanganisa kokubili amagciwane e-aerobic kanye ne-anaerobic. Naphezu kwentuthuko ezindleleni zokulawula ukutheleleka, njengezindlela zokubulala inzalo, ukusetshenziswa kwama-antibiotic okuvimbela, kanye nokuthuthukiswa kwemikhuba yokuhlinzwa, ama-SSI ahlala eyinkinga eqhubekayo.
Okunye ukubuyekezwa okubalulekile kuhlole ukusebenza kahle kwe-HBOT ekuvimbeleni ama-SSI ajulile ekuhlinzeni kwe-neuromuscular scoliosis. I-HBOT yangaphambi kokuhlinzwa inganciphisa kakhulu ukwanda kwama-SSI futhi ikhuthaze ukuphulukiswa kwenxeba. Lokhu kwelashwa okungangenisi kudala indawo lapho amazinga omoya-mpilo ezicutshini zenxeba ephakama khona, okuye kwahlotshaniswa nesenzo sokubulala i-oxidative ngokumelene namagciwane. Ngaphezu kwalokho, ibhekana namazinga aphansi egazi kanye nomoya-mpilo afaka isandla ekuthuthukisweni kwama-SSI. Ngaphandle kwamanye amasu okulawula ukutheleleka, i-HBOT inconywe ikakhulukazi ekuhlinzeni okungcolile okuhlanzekile njengezinqubo zokugaya ukudla.
1.4 Ukusha
Ukusha kuyizingozi ezibangelwa ukushisa okukhulu, ugesi, amakhemikhali, noma imisebe futhi kungabanga amazinga aphezulu okugula nokufa. I-HBOT iwusizo ekwelapheni ukusha ngokwandisa amazinga omoya-mpilo ezicutshini ezonakele. Ngenkathi izifundo zezilwane kanye nezokwelapha ziveza imiphumela exubile mayelanaukusebenza kahle kwe-HBOT ekwelapheni ukusha, ucwaningo oluhilela iziguli ezishile ezingu-125 lubonise ukuthi i-HBOT ayizange ibonise umthelela omkhulu emazingeni okufa noma enanini lokuhlinzwa okwenziwe kodwa yehlisa isikhathi sokuphulukiswa esimaphakathi (izinsuku ezingu-19.7 uma kuqhathaniswa nezinsuku ezingu-43.8). Ukuhlanganisa i-HBOT nokuphathwa kokusha okuphelele kungalawula ngempumelelo i-sepsis ezigulini ezishile, okuholela ezikhathini zokuphulukiswa ezimfushane kanye nezidingo zoketshezi ezincishisiwe. Kodwa-ke, kudingeka ucwaningo olwengeziwe oluqhubekayo ukuqinisekisa indima ye-HBOT ekuphathweni kokusha okukhulu.
1.5 I-Osteomyelitis
I-Osteomyelitis ukutheleleka kwamathambo noma umnkantsha ovame ukubangelwa amagciwane abangela izifo. Ukwelapha i-osteomyelitis kungaba yinselele ngenxa yokungatholakali kahle kwegazi emathanjeni kanye nokungena okulinganiselwe kwama-antibiotic emnkantsha. I-osteomyelitis engapheli ibonakala ngamagciwane aqhubekayo, ukuvuvukala okuncane, kanye nokwakheka kwezicubu zamathambo ezifile. I-osteomyelitis engaphili ibhekisela ekuthelelekeni kwamathambo okungapheli okuqhubekayo noma okuphindeka naphezu kokwelashwa okufanele.
I-HBOT iboniswe ukuthi ithuthukisa kakhulu amazinga omoya-mpilo ezicutshini zamathambo ezinegciwane. Uchungechunge lwamacala amaningi kanye nezifundo zamaqembu ahlukene zibonisa ukuthi i-HBOT ithuthukisa imiphumela yezokwelapha yeziguli ze-osteomyelitis. Kubonakala sengathi isebenza ngezindlela ezahlukene, okuhlanganisa ukukhulisa umsebenzi we-metabolic, ukucindezela amagciwane abangela izifo, ukuthuthukisa imiphumela yama-antibiotic, ukunciphisa ukuvuvukala, kanye nokukhuthaza ukuphulukiswa.izinqubo. Ngemva kwe-HBOT, ama-60% kuya ku-85% eziguli ezine-osteomyelitis engapheli, engaphikisi abonisa izimpawu zokucindezelwa kokutheleleka.
1.6 Ukutheleleka Kwesikhunta
Emhlabeni jikelele, abantu abangaphezu kwezigidi ezintathu bahlushwa izifo zesikhunta ezingamahlalakhona noma ezihlaselayo, okuholela ekufeni kwabantu abangaphezu kuka-600,000 minyaka yonke. Imiphumela yokwelashwa kwezifo zesikhunta ivame ukubekeka engcupheni ngenxa yezici ezifana nokushintsha kwesimo somzimba sokuzivikela, izifo eziyisisekelo, kanye nezici zokutheleleka kwezifo. I-HBOT isiba yindlela yokwelapha ekhangayo ezifweni zesikhunta ezinzima ngenxa yokuphepha kwayo kanye nokungabi yingozi. Izifundo zibonisa ukuthi i-HBOT ingaba ngempumelelo ekulweni namagciwane esikhunta njenge-Aspergillus kanye nesifo sofuba i-Mycobacterium.
I-HBOT ikhuthaza imiphumela yokubola ngokuvimbela ukwakheka kwe-biofilm ye-Aspergillus, kanye nokusebenza kahle okwandisiwe okuphawulwe ezinhlotsheni ezingenazo izakhi zofuzo ze-superoxide dismutase (SOD). Izimo ze-hypoxia ngesikhathi sokutheleleka kwesikhunta zibeka inselele ekulethweni kwemithi yokubola, okwenza amazinga e-oxygen akhuphukile avela ku-HBOT abe ukungenelela okunenzuzo, yize ucwaningo olwengeziwe luyadingeka.
Izakhiwo Zokulwa Namagciwane ze-HBOT
Indawo engcolile kakhulu edalwe yi-HBOT iqala izinguquko zomzimba kanye nezamakhemikhali ezivuselela izakhiwo zokulwa namagciwane, okwenza kube ukwelashwa okusebenzayo kokwenezela kokutheleleka. I-HBOT ikhombisa imiphumela emangalisayo ngokumelene namagciwane e-aerobic kanye namagciwane angenawo umoya ngokusebenzisa izindlela ezifana nomsebenzi oqondile wokubulala amagciwane, ukuthuthukiswa kwezimpendulo zomzimba, kanye nemiphumela yokusebenzisana nama-antimicrobial agents athile.
2.1 Imiphumela Eqondile Yokulwa Namagciwane ye-HBOT
Umphumela oqondile wokulwa namagciwane we-HBOT ubangelwa kakhulu ukukhiqizwa kwezinhlobo ze-oxygen ezisabelayo (i-ROS), ezifaka phakathi ama-anion e-superoxide, i-hydrogen peroxide, ama-radical e-hydroxyl, nama-ion e-hydroxyl—konke okuvela ngesikhathi sokusebenza kweseli.
Ukusebenzisana phakathi kwe-O₂ kanye nezingxenye zamaseli kubalulekile ekuqondeni ukuthi i-ROS yakheka kanjani ngaphakathi kwamaseli. Ngaphansi kwezimo ezithile ezibizwa ngokuthi ukucindezeleka kwe-oxidative, ibhalansi phakathi kokwakheka kwe-ROS kanye nokuwohloka kwayo iyaphazamiseka, okuholela emazingeni aphezulu e-ROS kumaseli. Ukukhiqizwa kwe-superoxide (O₂⁻) kuqhutshwa yi-superoxide dismutase, eguqula i-O₂⁻ ibe yi-hydrogen peroxide (H₂O₂). Lokhu kuguqulwa kukhuliswa kakhulu yi-Fenton reaction, ehlanganisa i-Fe²⁺ ukuze ikhiqize ama-hydroxyl radicals (·OH) kanye ne-Fe³⁺, ngaleyo ndlela kuqale ukulandelana kwe-redox okulimazayo kokwakheka kwe-ROS kanye nomonakalo wamaseli.
Imiphumela enobuthi ye-ROS ihlasela izingxenye ezibalulekile zamaseli njenge-DNA, i-RNA, amaprotheni, kanye nama-lipid. Okuphawulekayo ukuthi i-DNA iyisisulu esiyinhloko se-cytotoxicity ebangelwa yi-H₂O₂, njengoba iphazamisa izakhiwo ze-deoxyribose futhi yonakalise ukwakheka kwesisekelo. Umonakalo ongokoqobo obangelwa yi-ROS udlulela esakhiweni se-helix se-DNA, okungenzeka ukuthi ubangelwa yi-lipid peroxidation ebangelwa yi-ROS. Lokhu kugcizelela imiphumela emibi yamazinga aphezulu e-ROS ngaphakathi kwezinhlelo zebhayoloji.
Isenzo se-ROS sokulwa namagciwane
I-ROS idlala indima ebalulekile ekuvimbeleni ukukhula kwamagciwane, njengoba kuboniswe ngokukhiqizwa kwe-ROS okubangelwa yi-HBOT. Imiphumela enobuthi ye-ROS ihlasela ngqo izakhi zamaseli njenge-DNA, amaprotheni, kanye nama-lipid. Ukugxila okuphezulu kwezinhlobo ze-oxygen ezisebenzayo kungalimaza ngqo ama-lipid, okuholela ekufakweni kwe-lipid. Le nqubo ibeka engcupheni ubuqotho be-membrane yamaseli, futhi ngenxa yalokho, ukusebenza kwama-receptor namaprotheni ahlobene ne-membrane.
Ngaphezu kwalokho, amaprotheni, nawo ayizinhloso ezibalulekile zama-molecule e-ROS, abhekana nokuguqulwa okuthile kwe-oxidative kuma-residues ahlukahlukene e-amino acid njenge-cysteine, i-methionine, i-tyrosine, i-phenylalanine, ne-tryptophan. Isibonelo, i-HBOT iboniswe ukuthi ibangela izinguquko ze-oxidative kumaprotheni amaningana ku-E. coli, okuhlanganisa i-elongation factor G kanye ne-DnaK, ngaleyo ndlela ithinta imisebenzi yawo yamaseli.
Ukuthuthukisa Ukungavikeleki Nge-HBOT
Izakhiwo zokulwa nokuvuvukala ze-HBOTkuye kwabhalwa phansi, okubonakala kubalulekile ekunciphiseni umonakalo wezicubu nokucindezela ukuqhubeka kokutheleleka. I-HBOT ithinta kakhulu ukuvezwa kwama-cytokine kanye nezinye izilawuli zokuvuvukala, ithonya impendulo yomzimba. Izinhlelo ezahlukene zokuhlola zibone izinguquko ezihlukile ekuvezweni kwezakhi zofuzo kanye nokukhiqizwa kwamaprotheni ngemva kwe-HBOT, okwandisa noma kunciphisa izici zokukhula kanye nama-cytokine.
Ngesikhathi senqubo ye-HBOT, amazinga e-O₂ akhuphukile aqala izimpendulo ezahlukahlukene zamaseli, njengokucindezela ukukhululwa kwama-mediator abangela ukuvuvukala kanye nokukhuthaza i-lymphocyte kanye ne-neutrophil apoptosis. Ngokubambisana, lezi zenzo zithuthukisa izindlela zokulwa namagciwane zesistimu yomzimba, ngaleyo ndlela zenze kube lula ukuphulukiswa kwezifo.
Ngaphezu kwalokho, izifundo ziphakamisa ukuthi amazinga e-O₂ akhuphukile ngesikhathi se-HBOT anganciphisa ukuvezwa kwama-cytokine abangela ukuvuvukala, okuhlanganisa i-interferon-gamma (IFN-γ), i-interleukin-1 (IL-1), kanye ne-interleukin-6 (IL-6). Lezi zinguquko zifaka phakathi nokunciphisa isilinganiso samaseli e-CD4:CD8 T kanye nokuguqula amanye ama-receptor ancibilikayo, ekugcineni kukhuliswe amazinga e-interleukin-10 (IL-10), okubalulekile ekulweni nokuvuvukala nokukhuthaza ukuphulukiswa.
Imisebenzi ye-HBOT yokulwa namagciwane ixhumene nezinqubo eziyinkimbinkimbi zezinto eziphilayo. Kokubili i-superoxide kanye nokucindezela okuphezulu kubikwe ukuthi kukhuthaza ngokungaguquki umsebenzi wokulwa namagciwane obangelwa yi-HBOT kanye nokwehla kwe-neutrophil. Ngemva kwe-HBOT, ukuphakama okuphawulekayo kwamazinga omoya-mpilo kuthuthukisa amandla okubulala amagciwane ama-neutrophil, okuyingxenye ebalulekile yempendulo yomzimba. Ngaphezu kwalokho, i-HBOT icindezela ukunamathela kwe-neutrophil, okuhambisana nokusebenzisana kwama-β-integrins kuma-neutrophil nama-molecule okunamathelana kwamaseli (ICAM) kumaseli e-endothelial. I-HBOT ivimbela umsebenzi we-neutrophil β-2 integrin (Mac-1, CD11b/CD18) ngenqubo eqondiswa yi-nitric oxide (NO), efaka isandla ekufudukeni kwama-neutrophil endaweni yokutheleleka.
Ukuhlelwa kabusha okunembile kwe-cytoskeleton kuyadingeka kuma-neutrophils ukuze kuqedwe ngempumelelo izifo ezibangelwa amagciwane. I-S-nitrosylation ye-actin iboniswe ukuthi ikhuthaza i-actin polymerization, okungenzeka ukuthi ikhuthaze umsebenzi we-phagocytic wama-neutrophils ngemva kokwelashwa kwe-HBOT. Ngaphezu kwalokho, i-HBOT ikhuthaza i-apoptosis emigqeni yamaseli e-T omuntu ngokusebenzisa izindlela ze-mitochondrial, kanye nokufa okusheshayo kwe-lymphocyte ngemuva kwe-HBOT okubikiwe. Ukuvimba i-caspase-9—ngaphandle kokuthinta i-caspase-8—kuye kwabonisa imiphumela ye-HBOT yokulawula amasosha omzimba.
Imiphumela Yokubambisana Ye-HBOT Nama-Antimicrobial Agents
Ekusetshenzisweni kwemitholampilo, i-HBOT ivame ukusetshenziswa kanye nama-antibiotic ukulwa nokutheleleka ngempumelelo. Isimo se-hyperoxic esifinyelelwa ngesikhathi se-HBOT singathonya ukusebenza kahle kwama-antibiotic athile. Ucwaningo luphakamisa ukuthi imithi ethile ebulala amagciwane, njenge-β-lactams, i-fluoroquinolones, kanye ne-aminoglycosides, ayisebenzi nje kuphela ngezindlela ezingokwemvelo kodwa futhi incike kancane ekusetshenzisweni kwe-aerobic kwamagciwane. Ngakho-ke, ukuba khona komoya-mpilo kanye nezici ze-metabolic zamagciwane kubalulekile lapho kuhlolwa imiphumela yokwelapha yama-antibiotic.
Ubufakazi obubalulekile bubonise ukuthi amazinga aphansi e-oxygen angakhuphula ukumelana kwe-Pseudomonas aeruginosa ne-piperacillin/tazobactam nokuthi indawo ephansi ye-oxygen nayo inegalelo ekwandeni kokumelana kwe-Enterobacter cloacae ne-azithromycin. Ngokuphambene nalokho, izimo ezithile ze-hypoxia zingase zithuthukise ukuzwela kwamagciwane kuma-antibiotic e-tetracycline. I-HBOT isebenza njengendlela yokwelapha esebenzayo ngokukhuthaza i-metabolism ye-aerobic kanye nokuvuselela izicubu ezine-hypoxia, bese kukhulisa ukuzwela kwamagciwane kuma-antibiotic.
Ezifundweni zangaphambi kokwelashwa, inhlanganisela ye-HBOT—enikezwa kabili ngosuku amahora angu-8 ku-280 kPa—kanye ne-tobramycin (20 mg/kg/ngosuku) yehlise kakhulu umthwalo wamagciwane ku-Staphylococcus aureus infectious endocarditis. Lokhu kubonisa amandla e-HBOT njengokwelashwa okusizayo. Ucwaningo olwengeziwe luveze ukuthi ngaphansi kokucindezela okungu-37°C kanye no-3 ATA amahora ama-5, i-HBOT ithuthukise kakhulu imiphumela ye-imipenem ngokumelene ne-Pseudomonas aeruginosa etheleleke nge-macrophage. Ngaphezu kwalokho, indlela ehlanganisiwe ye-HBOT ne-cephazolin itholakale isebenza kangcono ekwelapheni i-Staphylococcus aureus osteomyelitis kumamodeli ezilwane uma kuqhathaniswa ne-cephazolin yodwa.
I-HBOT iphinde ikhulise kakhulu isenzo sokubulala amagciwane se-ciprofloxacin ngokumelene ne-Pseudomonas aeruginosa biofilms, ikakhulukazi ngemva kwemizuzu engama-90 yokuchayeka. Lokhu kuthuthukiswa kubangelwa ukwakheka kwezinhlobo ze-oxygen reactive oxygen (ROS) ezingokwemvelo futhi kubonisa ukuzwela okuphezulu kuma-mutant ane-peroxidase defective.
Kumamodeli e-pleuritis ebangelwa yi-Staphylococcus aureus (MRSA) engamelana ne-methicillin, umphumela wokubambisana we-vancomycin, i-teicoplanin, kanye ne-linezolid ene-HBOT ubonise ukusebenza kahle okukhulu ngokumelene ne-MRSA. I-Metronidazole, i-antibiotic esetshenziswa kakhulu ekwelapheni ukutheleleka okunamandla kwe-anaerobic kanye ne-polymicrobial njengokutheleleka kwezinyawo zesifo sikashukela (i-DFIs) kanye nokutheleleka kwendawo yokuhlinzwa (i-SSIs), ibonise ukusebenza okuphezulu kwe-antimicrobial ngaphansi kwezimo ze-anaerobic. Izifundo zesikhathi esizayo ziyafaneleka ukuhlola imiphumela ye-synergistic antibacterial ye-HBOT ehlanganiswe ne-metronidazole kokubili kuzilungiselelo ze-in vivo kanye ne-in vitro.
Ukusebenza kahle kwe-HBOT kwe-Antimicrobial kuma-bacteria amelana ne-Resistance
Ngokuthuthuka nokusabalala kwezinhlobo ezimelana nokutheleleka, ama-antibiotic endabuko avame ukulahlekelwa amandla awo ngokuhamba kwesikhathi. Ngaphezu kwalokho, i-HBOT ingaba yinto ebalulekile ekwelapheni nasekuvimbeleni izifo ezibangelwa amagciwane amelana nemithi eminingi, isebenza njengesu elibalulekile lapho ukwelashwa ngama-antibiotic kwehluleka. Izifundo eziningi zibike imiphumela ebalulekile yokubulala amagciwane ye-HBOT kumagciwane amelana nokutheleleka ahlobene nomtholampilo. Isibonelo, iseshini ye-HBOT yemizuzu engama-90 ku-2 ATM inciphise kakhulu ukukhula kwe-MRSA. Ngaphezu kwalokho, kumamodeli wesilinganiso, i-HBOT ithuthukise imiphumela yokulwa namagciwane yama-antibiotic ahlukahlukene ngokumelene nokutheleleka kwe-MRSA. Imibiko iqinisekisile ukuthi i-HBOT iyasebenza ekwelapheni i-osteomyelitis ebangelwa yi-Klebsiella pneumoniae ekhiqiza i-OXA-48 ngaphandle kokudinga noma yimaphi ama-antibiotic angeziwe.
Ngamafuphi, ukwelashwa nge-hyperbaric oxygen kumelela indlela enezici eziningi yokulawula ukutheleleka, okuthuthukisa impendulo yomzimba ngenkathi kukhulisa ukusebenza kahle kwama-antimicrobial agents akhona. Ngocwaningo oluphelele kanye nentuthuko, kunamandla okunciphisa imiphumela yokumelana nama-antibiotic, okunikeza ithemba empini eqhubekayo yokulwa nokutheleleka ngamagciwane.
Isikhathi sokuthunyelwe: Feb-28-2025