Singh Rajiv, Hunter John, Philip Alistair
Rehabilitation Medicine Unit, Astley Ainslie Hospital, Edinburgh, UK.
Arch Phys Med Rehabil. 2007 May;88(5):661-3. doi: 10.1016/j.apmr.2007.02.016.
To assess the incidence of fluid collections in postoperative amputee stumps and the impact on limb-fitting outcomes in patients with such collections.
Cohort study.
Inpatient rehabilitation ward.
Successive patients with amputation examined with ultrasound over 1 year.
Not applicable.
The presence of discrete fluid collections on admission and outcomes of successful limb fitting, length of inpatient stay, and presence of psychologic symptoms.
In 105 consecutive admissions, we detected discrete fluid collections in 28 (27%) of stumps with a median volume of 38.5 mL (range, 16-216 mL). All collections diminished and disappeared by discharge with 81% undetectable within 30 days since surgery. A transfemoral amputee was more likely to develop a collection than a transtibial amputee (P<.01). Patients with collections took 9.5 days longer to achieve limb fitting (P=.04) and had a 10-day longer inpatient stay (P=.02). However, the overall success of limb fitting was similar as was the incidence of psychologic distress.
Discrete fluid collections are common in postoperative amputation stumps but regress by discharge. Although limb fitting may be delayed, the ultimate success of limb fitting is not reduced and patients can be reassured.
评估截肢术后残肢积液的发生率以及此类积液对患者假肢适配结果的影响。
队列研究。
住院康复病房。
连续1年接受超声检查的截肢患者。
不适用。
入院时离散性积液的存在情况、假肢适配成功的结果、住院时间以及心理症状的存在情况。
在连续105例入院患者中，我们在28例（27%）残肢中检测到离散性积液，积液中位数体积为38.5 mL（范围为16 - 216 mL）。所有积液在出院时均减少并消失，81%在术后30天内检测不到。经股截肢患者比经胫截肢患者更易出现积液（P <.01）。有积液的患者实现假肢适配的时间要长9.5天（P =.04），住院时间长10天（P =.02）。然而，假肢适配的总体成功率以及心理困扰的发生率相似。
离散性积液在截肢术后残肢中很常见，但在出院时会消退。虽然假肢适配可能会延迟，但假肢适配的最终成功率并未降低，患者可放心。
