Long Jeri, Hall Virginia
Lexington Medical Center, Southern Surgical Group, West Columbia, South Carolina.
Surgical Intensive Care Lexington Medical Center, West Columbia, South Carolina.
J Vasc Nurs. 2014 Mar;32(1):25-8. doi: 10.1016/j.jvn.2013.06.002.
Acute limb ischemia is a complication of severe peripheral arterial disease that can be a threatening limb as well as life. Multiple procedures exist today to help revascularize extremities; however, even with the latest technologies, surgical amputation of the limb may still be necessary. Cryoamputation, or physiologic amputation, is a method used to treat patients who are hemodynamically unstable for the operating room and who are in need of urgent amputation owing to arterial ischemia. This procedure is used in the rare instance where not only a persons' limb is threatened, but also their life. This is a case study regarding one patient who presented to the hospital with limb-threatening ischemia who became hemodynamically unstable owing to the rhabdomyolysis associated with the ischemia of his lower extremity. Cryoamputation was used to stabilize the patient and prevent further deterioration, so that he could safely undergo surgical amputation of the limb without an increase in mortality risk. Cryoamputation must be followed by formal surgical amputation when the patient is hemodynamically stabilized. It is not a limb salvaging, procedure but it is a life-saving procedure. This case study demonstrates the usefulness of the procedure and discusses the technique used for cryoamputation.
急性肢体缺血是严重外周动脉疾病的一种并发症，它可能会对肢体乃至生命构成威胁。如今有多种手术可帮助恢复肢体血运；然而，即便采用了最新技术，肢体的手术截肢可能仍有必要。冷冻截肢术，即生理性截肢，是一种用于治疗因血流动力学不稳定而无法进入手术室，且因动脉缺血而急需截肢的患者的方法。该手术用于不仅患者肢体受到威胁，而且其生命也受到威胁的罕见情况。这是一项关于一名因肢体威胁性缺血入院的患者的病例研究，该患者因下肢缺血相关的横纹肌溶解而出现血流动力学不稳定。冷冻截肢术用于稳定患者病情并防止进一步恶化，以便他能够在不增加死亡风险的情况下安全地接受肢体的手术截肢。当患者血流动力学稳定后，冷冻截肢术之后必须进行正式的手术截肢。它不是一种保肢手术，而是一种挽救生命的手术。本病例研究展示了该手术的实用性，并讨论了冷冻截肢术所使用的技术。
