Andrews Karen L
Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota 55905, USA.
J Vasc Nurs. 2011 Sep;29(3):120-3. doi: 10.1016/j.jvn.2011.07.004.
The best predicator of amputation is a history of previous amputation. A history of lower extremity ulceration or amputation increases the risk for further ulceration, infection, and subsequent amputation. Early diagnosis, control of risk factors, medical management, and timely revascularization may aid in avoiding limb loss. Treatment combines patient education, orthoses, footwear, and off-loading. Patients at risk should understand the implications of loss of protective sensation, the importance of carefully monitoring their feet, proper care of the foot, and always wearing protective footwear. It is important to control risk factors, protect the limb, recognize early signs of inflammation, and optimize wound care. Lower extremity amputation is a common outcome for patients with an at-risk foot. Amputation may be the best option to optimize function.
截肢的最佳预测指标是既往截肢史。下肢溃疡或截肢史会增加进一步溃疡、感染及后续截肢的风险。早期诊断、控制危险因素、药物治疗及及时血运重建有助于避免肢体缺失。治疗包括患者教育、矫形器、鞋具及减压。有风险的患者应了解保护性感觉丧失的影响、仔细监测足部的重要性、足部的正确护理以及始终穿着保护性鞋具。控制危险因素、保护肢体、识别早期炎症迹象及优化伤口护理很重要。对于足部有风险的患者，下肢截肢是常见结局。截肢可能是优化功能的最佳选择。
