背景:高压氧治疗(HBOT)涉及患者在加压室中呼吸100%的氧气,1大气以上。许多中心现在正在推广使用HBOT进行嫩肤。然而,目前HBOT的适应症不包括美学应用。
目的:本循证综述的目的是评估现有的关于HBOT在医学美学和年轻化中的应用的文献,评估其有效性和安全性,并进行成本分析。
方法:PubMed接口,科克伦图书馆,谷歌学者,并进行了Embase搜索。使用了最佳赌注方法,并使用定量研究质量评估工具评估偏倚风险。
■本综述共包括17项人体研究,共有766名参与者。三项研究被归类为二级证据,三项研究是三级证据,11个是IV级证据.所有纳入的研究均被认为存在高偏倚风险。II级证据支持的最相关发现是HBOT降低了FUE头发移植后的脱落率(27.6±2.6%与69.1±2.4%),但这并不影响HBOT(96.9±0.5%)和对照组(93.8±0.6%)之间的最终结果。此外,三级证据表明,在HBOT之后,弹性纤维长度显着增加(p≤0.0001,效应尺寸=2.71),纤维碎片显着减少(p=0.012)。HBOT后胶原纤维密度也显著增加(p=0.0001,效应大小=1.10)。然而,抗氧化维生素A没有显著影响,C,E和HBOT.HBOT治疗7天后,炎症反应显著降低,IL-12p40、MIP-1β表达降低,和PDGF-BB和更高的IL-1Ra表达。此外,在腹部成形术之前预防性使用HBOT以降低并发症的风险。在这项研究中,并发症从32.6%(89例)下降到8.4%(7例),p<0.001,在多变量分析中,术前HBOT是术后并发症的独立保护因素(p<0.001)。
结论:关于HBOT的作用方法如何在美学上具有有益效果以及治疗是否合理,存在相互矛盾的证据。据我们所知,这是第一次全面审查,讨论了在许多美学临床场景中使用HBOT的现有证据,包括预防性的,medical,和手术设置。然而,需要具有更长随访时间和更好患者选择的随机临床试验,才能得出可靠的结论.
BACKGROUND: Hyperbaric oxygen therapy (HBOT) involves patients breathing 100% oxygen in a pressurized chamber, above 1 atmosphere. Many centers are now promoting the use of HBOT for skin rejuvenation. However, the current indications for HBOT do not encompass aesthetic applications.
OBJECTIVE: The aim of this evidence-based review was to assess the existing literature regarding the utilization of HBOT in medical aesthetics and rejuvenation, evaluate its effectiveness and safety, and conduct a cost analysis.
METHODS: PubMed Interface, Cochrane Library, Google Scholar, and Embase searches were carried out. The Best Bets methodology was used, and the risk of bias was appraised using the Quality Assessment Tool for Quantitative Studies.
UNASSIGNED: This review included a total of 17 human studies with a total of 766 participants. Three studies were classified as level II evidence, three studies were of level III evidence, and 11 were of level IV evidence. All the included studies were judged at high risk of bias. The most relevant findings supported by level II evidence were that HBOT decreased the shedding rate post-FUE hair transplant (27.6 ± 2.6% vs. 69.1 ± 2.4%) but this did not affect the final outcome between HBOT (96.9 ± 0.5%) and the control (93.8 ± 0.6%). Moreover, level III evidence demonstrated that following HBOT, there was a significant increase in elastic fiber length (p ≤ 0.0001, effect size = 2.71) and a significant decrease in fiber fragmentation (p = 0.012). There was also a significant increase in collagen fiber density following HBOT (p = 0.0001, effect size = 1.10). However, there was no significant effect of antioxidant vitamins A, C, and E with HBOT. The inflammatory response significantly decreased after 7 days of HBOT with a decreased expression of IL-12p40, MIP-1β, and PDGF-BB and a higher expression of IL-1Ra. Moreover, HBOT was used prophylactically prior to abdominoplasty to decrease the risk of complications. In this study, complications were decreased from 32.6% (89 patients) to 8.4% (7 patients) with a p < 0.001, and in a multivariate analysis, preoperative HBOT was an independent protective factor against postoperative complications (p < 0.001).
CONCLUSIONS: There is conflicting evidence on how the method of action of HBOT can have a beneficiary effect in aesthetic and whether the treatment is justifiable. To our knowledge, this is the first comprehensive review discussing the available evidence regarding the use of HBOT in many aesthetic clinical scenarios, including preventive, medical, and surgical settings. However, randomized clinical trials with longer follow-up and better patient selection are needed to be able to generate a reliable conclusion.