Moreno Palacios J A, Moreno Martínez I, Casallo Cerezo M, Maitín Noguera V, Cid Bassaletti C, Vidal Millet C
Servicio de Rehabilitación, Hospital General Universitario Gregorio Marañón, Madrid, España.
Centro de Atención Primaria María Auxiliadora, Área 6, Madrid, España.
Rehabilitacion (Madr). 2022 Jul-Sep;56(3):188-194. doi: 10.1016/j.rh.2021.11.005. Epub 2022 May 6.
Restoring the ambulation ability with prostheses in lower limb amputeesis essential to improve their functional independence. The aim of this study was to determine the factors involved in achieving prosthesis fitting in vascular amputees.
Observational longitudinal study of patients with major lower limb amputation of vascular etiology performed from April 1st 2017 to April 1st 2020. The following variables were compared between the group of patients who were prosthetized and those who were not: age, gender, body-mass index, comorbidity (Charlson index), independence in the activities of daily living (Barthel index) and ambulation ability (FAC test) before and a year after the amputation. The prosthetic use after a year was measured with the Houghton scale.
A total of 80 patients were amputated with a mean age of 70.5 years old, 78.8% were male. The amputation level was supracondilealin 42 patients and infracondilealin 38 patients. The number of prosthetized patients was 35. The variables related to the possibility of prosthesis fitting were: younger age (P=0.020), less comorbidity (P=0.000), infracondileal amputation (P=0.024) and greater functional independence and ambulation ability prior to amputation (P=0.000). After a year 22 patients had died, only one of those who had been prosthetized.
Although there are no clear recommendations to determine which amputees should be prosthetic fitting, in our patients the presence of fewer comorbidities and a good previous functional situation, younger age and infracondileal amputation, are related to greater success in achieving this objective.
恢复下肢截肢患者使用假肢的行走能力对于提高其功能独立性至关重要。本研究的目的是确定影响血管性截肢患者成功安装假肢的因素。
对2017年4月1日至2020年4月1日期间因血管病因导致下肢大截肢的患者进行观察性纵向研究。比较安装假肢的患者组和未安装假肢的患者组在以下变量上的差异：年龄、性别、体重指数、合并症（Charlson指数）、截肢前和截肢后一年的日常生活活动独立性（Barthel指数）以及行走能力（FAC测试）。一年后的假肢使用情况用Houghton量表进行测量。
共有80例患者接受了截肢手术，平均年龄70.5岁，78.8%为男性。截肢平面为髁上42例，髁下38例。安装假肢的患者有35例。与成功安装假肢可能性相关的变量包括：年龄较小（P = 0.020）、合并症较少（P = 0.000）、髁下截肢（P = 0.024）以及截肢前功能独立性和行走能力较强（P = 0.000）。一年后有22例患者死亡，其中只有1例是安装了假肢的患者。
虽然对于确定哪些截肢患者适合安装假肢尚无明确建议，但在我们的患者中，合并症较少、既往功能状况良好、年龄较小以及髁下截肢与实现这一目标的更高成功率相关。
