末梢循環障害への人工炭酸浴の効果

末梢動脈の慢性閉塞性疾患に対する血行再建術の予後は不良で，虚血肢の治療には一定の見解が乏しく非常に難澁するものである。組織循環の概念にもとづいた評価法によると，医用質量分析装置を用いた虚血肢運動負荷後のPtCO(2)の脱飽和曲線の型により組織循環の良否が定まる。組織循環の良好な型では，自然予後は良好で，いかなる保存的治療にもよく反応する。一方，組織循環の不良な型の自然予後は不良であるので，人工炭酸泉浴によるPtO(2)の増加，および組織循環量の改善により予後は良好となる。人工炭酸泉浴は，組織循環の良好な症例には治癒促進的に作用し，組織循環の不良な症例にも有効に作用する。

Arteriography provides clear and useful information of ischemic leg anatomy. The method is limited, in that measurement of less than 100μ can not be made. The hemodynamics or functional consequences of the ischemic state should be evaluated by tissue circulation or perfusion methods that depend principally on systemic blood flow. Tissue perfusion is classified in two groups, insufficient and sufficient, depending on the type of clearance curve of PCO(2) in leg muscle following ankle exercise by means of medical mass spectrometry, Medspect Ⅱ, Chemetron, U.S.A. Either artificial CO(2) bathing or CO(2) vapour bath are efficacious for peripheral ischemic wound. Artificial CO(2) bathing is prepared with BUB-KAO 2tab., a 50g sodium hydrogen-carbonate and succinic acid tablet, Kao Co. Ltd. Japan, in 280-litre-tub at 40℃ for 20 minutes. CO(2) vapour bath is prepared with UKS CO(2) Trockengas Badkabine, Hansen Co., Ltd. West Germany, 20-litre-CO(2) per minutes at 40～42℃ for 20 minutes. In the case of insufficient tissue perfusion, ischemic wound is met promising outcome with CO(2) bathing even though no hope is expected with any medicine for peripheral circulation. Whereas, in the case of sufficient tissue perfusion, ischemic wound is expected much help of CO(2) bathing, as well as of all kinds of medicine, in healing process.