Dowd G S
Ann R Coll Surg Engl. 1987 Jan;69(1):31-5.
In patients with peripheral vascular disease requiring amputation, a below-knee stump is likely to result in improved function compared to above-knee. Unfortunately, clinical assessment of skin circulation is inaccurate, making the decision of amputation level difficult. The transcutaneous oxygen monitor has been investigated as a method of assessing skin circulation. A prospective study using the monitor in 51 amputations based on clinical assessment has shown that a transcutaneous oxygen tension (tcPO2) greater than 40 mm Hg is associated with stump healing, while measurements below that level lead to an unpredictable outcome. Half of the patients undergoing above-knee amputation had a tcPO2 level greater than 40 mm Hg at the below-knee site, suggesting that a successful distal amputation might have been performed. A further prospective study of 50 patients requiring amputation for peripheral gangrene showed that when amputations were performed at the lowest level in the limb with a tcPO2 greater than 40 mm Hg there was a higher rate of below-knee amputations (72%) and a higher rate of successful stump healing. Review of the literature confirms the potential of the monitor as a non-invasive, simple and accurate method of predicting stump healing.
在需要截肢的外周血管疾病患者中，与膝上截肢相比，膝下残端可能会带来更好的功能。不幸的是，对皮肤循环的临床评估并不准确，这使得截肢平面的决策变得困难。经皮氧监测仪已被作为一种评估皮肤循环的方法进行研究。一项基于临床评估，在51例截肢手术中使用该监测仪的前瞻性研究表明，经皮氧分压（tcPO2）大于40 mmHg与残端愈合相关，而低于该水平的测量结果会导致不可预测的结果。接受膝上截肢的患者中有一半在膝下部位的tcPO2水平大于40 mmHg，这表明可能已经成功进行了低位截肢。另一项对50例因外周坏疽需要截肢的患者进行的前瞻性研究表明，当在tcPO2大于40 mmHg的肢体最低平面进行截肢时，膝下截肢率更高（72%），残端愈合成功率也更高。文献综述证实了该监测仪作为一种预测残端愈合的非侵入性、简单且准确方法的潜力。
