Ellitsgaard N, Andersson A P, Fabrin J, Holstein P
University of Copenhagen, Department of Orthopedics M, Denmark.
Acta Orthop Scand. 1990 Apr;61(2):140-2. doi: 10.3109/17453679009006506.
Lower-extremity amputation for arterial insufficiency was performed in 282 cases ineligible for vascular surgery. In 203 cases (Group I), amputation was elective without previous vascular surgery. In 14 cases (Group II), amputation followed recent vascular reconstruction, and in 12 cases (Group III) amputation was performed after failed thromboembolectomy. In 53 cases (Group IV), amputation was done acutely, i.e., as a life-saving procedure because of septicemia. The results as regards both knee salvage and survival were much better in Groups I and II than in Groups III and IV. We conclude that knee salvage is poor and mortality high after acute amputations and after failed thrombembolectomy. These factors should be taken into account when comparing series from different centers.
对282例不适合进行血管手术的患者实施了因动脉供血不足导致的下肢截肢手术。在203例患者中(第一组),截肢为择期手术,此前未进行过血管手术。在14例患者中(第二组),截肢是在近期血管重建术后进行的,在12例患者中(第三组),截肢是在血栓栓塞切除术失败后进行的。在53例患者中(第四组),截肢是急症手术,即由于败血症而作为挽救生命的手术进行的。第一组和第二组在保膝和生存方面的结果比第三组和第四组好得多。我们得出结论,急症截肢术后和血栓栓塞切除术失败后的保膝效果差且死亡率高。在比较不同中心的系列病例时应考虑这些因素。