Hacking H G, Lo-a-Njoe B A, Visser-Meily J M
Revalidatiecentrum de Hoogstraat, Utrecht.
Ned Tijdschr Geneeskd. 1999 May 22;143(21):1073-7.
Three patients had several major amputations because of disseminated intravascular coagulation accompanying purpura fulminans. A 31-year-old woman underwent a transfemoral amputation after a septic shock caused by haemolytic streptococcus A, which led to gangrene. A 57-year-old woman had a bilateral transtibial amputation after pneumococcaemia, and the third patient, a 37-year-old woman, underwent a quadruple amputation following a meningococcal septic shock. The amputations were accompanied by contractures and skin damage due to ischaemic tissue changes. Additionally, cerebral and peripheral nerve dysfunction occurred. An intensive rehabilitation programme led to completely independent functioning with the use of orthotics and prosthetics. By starting a multidisciplinary approach as early as possible impairments can be treated properly and future disabilities minimized.
三名患者因暴发性紫癜伴发弥散性血管内凝血而接受了多次大截肢手术。一名31岁女性在由A组溶血性链球菌引起的感染性休克导致坏疽后接受了经股截肢手术。一名57岁女性在肺炎球菌血症后进行了双侧经胫骨截肢手术，第三名患者是一名37岁女性，在脑膜炎球菌感染性休克后接受了四肢截肢手术。截肢手术伴有因缺血性组织改变导致的挛缩和皮肤损伤。此外，还出现了脑和周围神经功能障碍。强化康复计划使患者通过使用矫形器和假肢实现了完全独立的功能。通过尽早开始多学科治疗方法，可以妥善治疗损伤并将未来的残疾降至最低。
