Britton J P, Barrie W W
Ann R Coll Surg Engl. 1987 May;69(3):127-9.
Over a period of 10 years, 149 amputations were performed for lower limb ischaemia in 119 diabetic patients. Thirty patients required amputation of the second limb. Ninety per cent of the patients were over the age of 60 years. Sixty four ischaemic limbs were treated by primary local amputation or debridement--29 healed successfully, 30 proceeded to a higher amputation. The incidence of multiple local operations was high. A below knee amputation was performed in 56 limbs--7 failed to heal and required a more proximal amputation. Seventy five patients in the series have died; 58 of these survived less than 3 years from their first amputation. The hospital stay for all patients was long; for an unsuccessful local amputation the average stay was 109 days. Conservative management with the Scotchcast boot has been shown to be satisfactory. This must be compared with the significant costs to the patient of early operative intervention.
在10年期间，对119例糖尿病患者的下肢缺血进行了149次截肢手术。30例患者需要对第二只肢体进行截肢。90%的患者年龄超过60岁。64条缺血肢体接受了一期局部截肢或清创术——29例成功愈合，30例进行了更高位的截肢。多次局部手术的发生率很高。56条肢体进行了膝下截肢——7例未愈合，需要更靠近近端的截肢。该系列中有75例患者死亡；其中58例自首次截肢后存活不到3年。所有患者的住院时间都很长；局部截肢手术不成功的患者平均住院时间为109天。已证明使用苏格兰石膏靴进行保守治疗是令人满意的。这必须与早期手术干预给患者带来的巨大成本进行比较。
