以高壓氧治療作為對難治的柏格氏症（Buerger's disease）的救援治療：一病例報告

Hyperbaric Oxygen Therapy as a Salvage Therapy for the Treatment of Refractory Buerger's Disease (Thromboangitis Obliterans): A Case Report

阻塞性栓塞血管炎（柏格氏症）是一種非血管硬化性的、發炎性的、原因未明的周邊血管疾病。之前的研究顯示它和長時間抽煙有關係，戒煙則可以改善病情。目前研究認為致病機轉和自體免疫反應有關。本篇報告提出一位四十四歲的男性於2003年九月被診斷為柏格氏症。最初的表現為手指壞疽，儘管在停止抽煙、使用前列腺素、免疫抑制劑及抗凝血劑的情況下，仍然持續惡化，最後右手食指截肢。而在高壓氧治療後，剩餘手指壞疽改善。並且在血管攝影下發現原本已狹窄的血管恢復通暢。既然目前對於治療反應不佳的柏格氏症的治療方法並無共識，高壓氧治療或許能做為主要治療方式。

Thromboangitis obliteran (Buerger's disease) is a non-atherosclerotic, inflammatory peripheral vascular disease of unknown cause. By the previous studies, this disease was noted to be related to long-term smoking and could be improved after cessation of smoking. Recently, autoimmune associated pathogenesis was proposed and there was still no effective medication for this disease. We reported a case of 44 y/o man with Buerger's disease, diagnosed in September 2003 with manifestation of digital gangrene of fingers. Digital gangrene progressed with right index finger amputated in spite of cessation of smoking, parenteral prostaglandin, immunosuppressive, and anticoagulant therapy. After hyperbaric oxygen therapy was given, digital gangrene improved. Angiography was performed before and after hyperbaric oxygen therapy and showed significant improvement of vascular patency. Since there is no consensus for the treatment of refractory Buerger's disease, hyperbaric oxygen therapy may be used as a primary treatment for refractory Buerger's disease.