Persson A V, Anderson L A, Padberg F T
Surg Clin North Am. 1985 Apr;65(2):393-403. doi: 10.1016/s0039-6109(16)43592-9.
We successfully predicted that patients presenting with critical ischemia of a limb and Doppler ratios greater than or equal to 0.3 would benefit from lumbar sympathectomy alone. However, we found that the procedure failed in 14 per cent of limbs whose ratios were greater than or equal to 0.3. In retrospect, all these patients were found to have deep infection. Had we known this fact prospectively, our predictions for success would have been close to 100 per cent. We were less than 50 per cent successful in predicting failure of the procedure, but the number of patients in this group is too small to draw reliable conclusions. We believe that patients with arm-ankle Doppler ratios greater than or equal to 0.3 whose manifestations of ischemia are limited to the skin will have a greater than 95 per cent chance of receiving a good result from lumbar sympathectomy alone and that this result will be maintained for many years.
我们成功预测出，出现肢体严重缺血且多普勒比值大于或等于0.3的患者，仅接受腰交感神经切除术就会受益。然而，我们发现，在那些比值大于或等于0.3的肢体中，该手术有14%失败了。回顾发现，所有这些患者都有深部感染。如果我们事先知道这一情况，我们对手术成功的预测准确率会接近100%。我们在预测手术失败方面的成功率不到50%，但这组患者数量太少，无法得出可靠结论。我们认为，臂踝多普勒比值大于或等于0.3且缺血表现仅限于皮肤的患者，仅接受腰交感神经切除术获得良好效果的几率将大于95%，而且这一效果将维持多年。
