難治な静脈性潰瘍に対する酸素療法 ―補助療法としての意義―

長期にわたり反復する静脈性潰瘍は，静脈圧亢進により拡張した毛細管の増加とその周辺に滲出したフィブリンの沈着により，血液からの酸素，及び栄養物の供給が妨げられている。医用質量分析装置による皮下組織ガス分圧の評価で経鼻的に100　％　の酸素吸入により潰瘍周辺への酸素供給が認められたので，重篤臨床例に対して静脈圧減圧処置に加えて酸素吸入を併用したところ，潰瘍の治癒傾向は著しく速くなり，補助療法としての意義を認めた。

Prolonged venous hypertension leads to increase the number of dilated capillaries and to fibrin deposition around them which may form a barrier to the diffusion of oxygen and other nutrients from the blood to the tissue, so that cell death and ulceration may occur. Following inhalation of 100 % -O(2), increased partial pressure of subcutaneous tissue oxygen (pO(2)) around the ulcer was confirmed by means of medical mass spectrometry, which was found comparable to or higher than the level of ulcer-free area (chest) on room air. Four patients suffering from chroriic ulcers were successfully treated by 100 % -O(2) inhalation, 4-5 ℓ/min, for one hour every day in addition to the simpie measures of reducing venous stasis. Suffice it to say that the inhalation of 100 % -O(2) may be applicative to an additional treatment modality in chronic venous ulceration, though inhalation of 100 % -O(2) for a long period of time may not be recommended.