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确定对称性外周坏疽截肢的时机和范围:来自韩国的三例报告

Determining the timing and extent of amputation in symmetrical peripheral gangrene: a report of three cases from Korea.

作者信息

Deslivia Maria Florencia, Lee Hyun-Joo, Jeon In-Ho, Kochhar Hemanshu, Kim Hyo-Jin, Kim Poong-Taek

机构信息

Department of Orthopaedic Surgery, St Carolus Hospital, Jakarta, Indonesia.

Department of Orthopaedic Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.

出版信息

Ewha Med J. 2025 Jan;48(1):e77. doi: 10.12771/emj.2024.e77. Epub 2025 Jan 31.

Abstract

Symmetrical peripheral gangrene is a severe condition marked by symmetric acral necrosis without obstruction of the major blood vessels. This case report examines the critical decisions involved in choosing between early and delayed amputation, as well as determining the extent of the necessary amputation. We present three cases: one involving antiphospholipid syndrome, another with disseminated intravascular coagulation, and a third associated with diabetes mellitus. All three cases ultimately required amputation due to symmetrical peripheral gangrene. In the first two cases, amputation was delayed, which is typically advantageous as it allows for the clear demarcation of necrotic tissue. However, in the third case, where infection was evident, immediate amputation was necessary despite the patient's overall poor health.

摘要

对称性周围坏疽是一种严重病症,其特征为对称性肢端坏死,且主要血管无阻塞。本病例报告探讨了在早期截肢和延迟截肢之间做出选择以及确定必要截肢范围时所涉及的关键决策。我们呈现三个病例:一个涉及抗磷脂综合征,另一个患有弥散性血管内凝血,第三个与糖尿病相关。所有三个病例最终均因对称性周围坏疽而需要截肢。在前两个病例中,截肢被延迟,这通常是有利的,因为它能使坏死组织清晰分界。然而,在第三个病例中,由于感染明显,尽管患者整体健康状况不佳,仍有必要立即进行截肢。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1533/12277902/286045704073/emj-48-1-20-g1.jpg

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