格里蒂-斯托克斯截肢术与经膝截肢术愈合情况的前瞻性随机对照研究。
A prospective randomized comparison of healing in Gritti-Stokes and through-knee amputations.
作者信息
Campbell W B, Morris P J
出版信息
Ann R Coll Surg Engl. 1987 Jan;69(1):1-4.
Twenty-two patients with a median age of 79 years had 24 amputations about knee joint level. The patients were randomised to undergo either Gritti-Stokes or through-knee amputations. In two-thirds of limbs transcutaneous oxygen was less than 4.65 KPa (35 mmHg) or there were no audible Doppler signals at the ankle, indicating that a below-knee amputation would have been at risk of failing to heal, and in the remainder an amputation at the knee joint was considered the preferable site for a variety of reasons. Nine of 12 (75%) Gritti-Stokes amputations underwent uncomplicated primary healing compared with only 2 of 12 (17%) through-knee procedures (P = 0.04). Two through-knee amputations required revision to above the knee (17%) while all Gritti-Stokes amputations healed. Three patients in each group became mobile on a prosthesis, the remainder being bilateral amputees or unable to manage an artificial limb.
22名患者，中位年龄79岁，共进行了24次膝关节水平截肢手术。患者被随机分为接受格里蒂 - 斯托克斯截肢术或经膝关节截肢术两组。三分之二的肢体经皮氧分压低于4.65千帕（35毫米汞柱），或在脚踝处未检测到可闻及的多普勒信号，这表明进行膝下截肢有愈合失败的风险，其余患者因各种原因，膝关节截肢被认为是更合适的部位。12例格里蒂 - 斯托克斯截肢术中9例（75%）实现了无并发症的一期愈合，而12例经膝关节截肢术中只有2例（17%）如此（P = 0.04）。2例经膝关节截肢需要修正为大腿截肢（17%），而所有格里蒂 - 斯托克斯截肢均愈合。每组有3名患者能够使用假肢活动，其余患者为双侧截肢者或无法使用假肢。
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