Eskelinen E, Lepäntalo M, Hietala E-M, Sell H, Kauppila L, Mäenpää I, Pitkänen J, Salminen-Peltola P, Leutola S, Eskelinen A, Kivioja A, Tukiainen E, Lukinmaa A, Brasken P, Railo M
Department of Vascular Surgery, Helsinki University Central Hospital, Finland.
Eur J Vasc Endovasc Surg. 2004 Feb;27(2):193-200. doi: 10.1016/j.ejvs.2003.10.011.
To assess the current incidence of major lower limb amputations in Southern Finland and epidemiological trends during the last 17 years.
In a retrospective survey for the year 2000 patient data was gathered from hospital records in the eight surgical hospitals in the area studied. Follow-up was 1 year. Amputation data for years 1984-1995 was gathered from reports done before at the same area and amputation figures for years 1990-2001 also from the National Research and Development Centre for Welfare and Health.
In year 2000, the incidence of major amputations was 154/million inhabitants. The reason for major amputation was chronic critical lower limb ischaemia in 71.8% and acute ischaemia in 16.5% of the cases. The below-knee (BK)/above-knee (AK) ratio was 0.76. After 1 year only 48% of the patients were alive. From 1984 to 2000 amputation incidence showed a decrease of 41%. The decline in age-adjusted amputation incidence from 1990 to 2000 was 30% and by 2001 as much as 40%. There was a significant inverse correlation both between incidence of infrainguinal bypass and amputation (r=-0.682, p=0.021) and between infrapopliteal bypass and amputation (r=-0.682, p=0.021).
There was a reduction in the number of amputations in Southern Finland during the past 17 years. This occurred synchronously with the increase in vascular reconstructions. Our data suggests that vascular surgery saves patients from BK-amputations and therefore relative amount of AK-amputations inevitably rises.
评估芬兰南部主要下肢截肢的当前发病率以及过去17年的流行病学趋势。
在一项针对2000年的回顾性调查中，从研究区域内八家外科医院的医院记录中收集患者数据。随访时间为1年。1984 - 1995年的截肢数据来自之前在同一区域所做的报告，1990 - 2001年的截肢数据也来自国家福利与健康研究发展中心。
2000年，主要截肢的发病率为每百万居民154例。主要截肢的原因在71.8%的病例中是慢性严重下肢缺血，16.5%是急性缺血。膝下（BK）/膝上（AK）比例为0.76。1年后只有48%的患者存活。从1984年到2000年，截肢发病率下降了41%。1990年至2000年年龄调整后的截肢发病率下降了30%，到2001年高达40%。腹股沟下搭桥手术的发病率与截肢之间以及腘动脉以下搭桥手术与截肢之间均存在显著的负相关（r = -0.682，p = 0.021）。
在过去17年中，芬兰南部的截肢数量有所减少。这与血管重建手术的增加同步发生。我们的数据表明，血管外科手术使患者免于膝下截肢，因此膝上截肢的相对数量不可避免地上升。
