Østlie Kristin, Lesjø Ingrid Marie, Franklin Rosemary Joy, Garfelt Beate, Skjeldal Ola Hunsbeth, Magnus Per
Innlandet Hospital Trust, Department of Physical Medicine and Rehabilitation, Ottestad, Norway.
Disabil Rehabil Assist Technol. 2012 Jul;7(4):294-303. doi: 10.3109/17483107.2011.635405. Epub 2011 Nov 23.
To estimate the rates of primary and secondary prosthesis rejection in acquired major upper-limb amputees (ULAs), to describe the most frequently reported reasons for rejection and to estimate the influence of background factors on the risk of rejection.
Cross-sectional study analysing population-based questionnaire data (n = 224). Effects were analysed by logistic regression analyses and Cox regression analyses.
Primary prosthesis rejection was found in 4.5% whereas 13.4% had discontinued prosthesis use. The main reasons reported for primary non-wear were a perceived lack of need and discrepancies between perceived need and the prostheses available. The main reasons reported for secondary prosthesis rejection were dissatisfaction with prosthetic comfort, function and control. Primary prosthesis rejection was more likely in ULAs amputated at high age and in ULAs with proximal amputations. Secondary prosthesis rejection was more likely in proximal ULAs and in women.
Clinicians should be aware of the increased risk of rejection in proximal ULAs, elderly ULAs and in women. Emphasising individual needs will probably facilitate successful prosthetic fitting. Improved prosthesis quality and individualised prosthetic training may increase long-term prosthesis use. Further studies of the effect of prosthetic training and of the reasons for rejection of different prosthetic types are suggested.
评估后天性上肢截肢者（ULA）初次和二次假体排斥的发生率，描述最常报告的排斥原因，并评估背景因素对排斥风险的影响。
横断面研究，分析基于人群的问卷调查数据（n = 224）。通过逻辑回归分析和Cox回归分析来分析影响因素。
初次假体排斥发生率为4.5%，而13.4%的患者已停止使用假体。报告的初次不佩戴假体的主要原因是感觉缺乏需求以及感觉需求与现有假体之间存在差异。报告的二次假体排斥的主要原因是对假体舒适度、功能和控制不满意。高龄截肢的ULA和近端截肢的ULA发生初次假体排斥的可能性更大。近端ULA和女性发生二次假体排斥的可能性更大。
临床医生应意识到近端ULA、老年ULA和女性中排斥风险增加。强调个体需求可能会促进假体成功适配。提高假体质量和个性化假体训练可能会增加假体的长期使用。建议进一步研究假体训练的效果以及不同类型假体排斥的原因。
