战斗导致双侧股骨截肢：对越战、阿富汗战争和伊拉克战争的比较。

Combat-incurred bilateral transfemoral limb loss: a comparison of the Vietnam War to the wars in Afghanistan and Iraq.

机构信息

Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA.

出版信息

J Trauma Acute Care Surg. 2012 Dec;73(6):1590-5. doi: 10.1097/TA.0b013e318265fe64.

DOI:10.1097/TA.0b013e318265fe64

PMID:23032809

Abstract

BACKGROUND

This study is a comparison of the self-reported health status, quality of life, function, and prosthetic use of veterans with bilateral transfemoral limb loss following combat injury in either the Vietnam War or the recent conflicts in Afghanistan and Iraq, to learn what improvements in surgery, prosthetics, and rehabilitation have occurred.

METHODS

Subjects were identified from Veteran's Administration and military databases. A cross-sectional survey was conducted of service members with bilateral transfemoral amputation who participated in a larger survey of service members with any type of amputation associated with a battlefield injury from the Vietnam War or Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF). The survey was conducted by mail, telephone, or Web site during 2007 to 2008.

RESULTS

There were 501 subjects in the Vietnam group and 541 in the OIF/OEF group with any type of limb loss. Bilateral transfemoral amputation was reported in 23 (7.7%) of 298 of the Vietnam group and 10 (3.5%) of 283 of the OIF/OEF group (χ test, p = 0.04). Self-reported health status was rated as good to excellent in 40% of the Vietnam group and 80% in the OIF/OEF group (p = 0.04). Quality of life was rated as good to excellent in 54.6% of the Vietnam group and 70% of the OIF/OEF group (not significant). Wheelchair use is reported by 22 of 23 subjects in the Vietnam group and all of the subjects of the OIF/OEF group. Of the Vietnam group, 8 (34.7%) of 23 currently use prostheses versus 7 (70%) of 10 of the OIF/OEF group (χ test, p = 0.13). The mean (SD) number of prostheses currently used is 1.0 (1.9) for the Vietnam group and 4.0 (5.2) for the OIF/OEF group (p = 0.022).

CONCLUSION

Participants who served in OIF/OEF and those who served in Vietnam report comparable quality of life. Prosthetic use continues to be a problem, especially as the service member ages.

LEVEL OF EVIDENCE

Epidemiologic study, level III.

摘要

背景

本研究比较了在越南战争或最近的阿富汗和伊拉克冲突中因战斗受伤而导致双侧股骨截肢的退伍军人的自我报告健康状况、生活质量、功能和假肢使用情况，以了解手术、假肢和康复方面的哪些改进。

方法

从退伍军人事务部和军事数据库中确定研究对象。对参加更大规模的服务成员任何类型的截肢相关的战场伤害的调查的双侧股骨截肢的服务成员进行了横断面调查，该调查来自于越南战争或伊拉克自由行动/持久自由行动（OIF/OEF）。该调查于 2007 年至 2008 年通过邮件、电话或网站进行。

结果

在越南组中有 501 名参与者，在 OIF/OEF 组中有 541 名参与者有任何类型的肢体丧失。在越南组的 298 名中，有 23 名（7.7%）报告双侧股骨截肢，在 OIF/OEF 组的 283 名中，有 10 名（3.5%）报告双侧股骨截肢（χ检验，p=0.04）。在越南组中，40%的自我报告健康状况被评为良好至优秀，而在 OIF/OEF 组中，80%的自我报告健康状况被评为良好至优秀（p=0.04）。在越南组中，54.6%的生活质量被评为良好至优秀，而在 OIF/OEF 组中，70%的生活质量被评为良好至优秀（无统计学意义）。在越南组的 23 名参与者中，有 22 名（95.7%）报告使用轮椅，而 OIF/OEF 组的所有参与者均报告使用轮椅。在越南组中，有 8 名（34.7%）的参与者目前使用假肢，而 OIF/OEF 组中有 10 名（100%）的参与者目前使用假肢（χ检验，p=0.13）。越南组目前使用的假肢平均（SD）数量为 1.0（1.9），而 OIF/OEF 组为 4.0（5.2）（p=0.022）。