高壓氧氣在敗血病治療之初探

敗血病（sepsis）以及敗血性休克（septic shock）是一種威脅生命的疾病。嚴重的敗血病會引起全身性心臟血管、血液、代謝及免疫功能之異常，甚至會造成死亡。臨床上的症狀包括有血壓下降、心臟功能抑制、呼吸衰竭、組織灌流減少等。傳統的治療方式如輸液、抗生素、升壓劑的給予等，對病情的控制以及降低死亡率的效果有限，故有關敗血病的治療方式一直都在積極的研究中。高壓氧氣治療（hyperbaric oxygen therapy）是用大於常壓的氧氣作為臨床治療方式，目前在臨床上已被廣泛地應用在許多疾病的輔助治療上。研究報告顯示，高壓氧氣治療可以改善由於不同菌種所引發之敗血病以及敗血性休克動物的死亡率，並且可以增加動物的存活空間。目前已知可能與其可以抑制在敗血病中過度活化的免疫系統以及過量的細胞素（cytokine）和誘導型一氧化氮（inducible nitric oxide）的釋放有密切關係，但詳細的作用機制仍不是很清楚。此綜合論述乃針對過去有關高壓氧氣應用在敗血病以及敗血性休克治療上的文獻做一初步報告，藉以增加對高壓氧氣治療機制的了解，並探討其未來在臨床上的可行性。

關鍵字

敗血病；敗血性休克；高壓氧氣治療

並列摘要

Sepsis is a life-threatening condition mediated by complex interaction of cells, cytokines and humoral pathways. The symptoms are characterized by hypotension, heart dysfunction, vascular hyporeactivity, respiratory failure, multiple tissue hypoperfusion and so on. Despite advances in antimicrobial therapy and other medical supports, sepsis (and septic shock) remains a major cause of morbidity and mortality among hospitalized patients. Although a vast array of treatment strategies in under investigation, no effective adjunctive therapy has yet been approved for clinical use. Hyperbaric oxygen therapy (HBO2) has been applied as an adjunctive treatment for a variety of clinical problems. Many evidences indicate that appropriate doses of oxygen tension may yield a beneficial biochemical, cellular and physiological action. Additionally, accumulated experiences have shown that HBO2 has a marked beneficial effect on experimental sepsis model, although the underlying mechanism is still unclear. Therefore, this review is focusing to understand the possible mechanisms and therapeutic potential for HBO2 in the treatment of sepsis.

並列關鍵字

sepsis ； septic shock ； hyperbaric oxygen therapy

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高壓氧氣在敗血病治療之初探

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