Lee B Y, Trainor F S, Kavner D, Madden J L, McCann W J
Surg Gynecol Obstet. 1979 Mar;148(3):396-8.
One hundred patients, 111 limbs, with gangrene of the lower extremity were initially treated with lumbar sympathectomy. Lumbar sympathectomy appears to be most beneficial in the management of gangrene of the toe with a limb salvage rate of 75 per cent. The best results were seen when only one toe, not the big toe, was involved. Limb salvage dropped to 38 per cent for gangrene of the foot, and with gangrene of the leg, lumbar sympathectomy had no affect. The presence of diabetes had no affect on limb salvage for gangrene of the toe but did have an apparent affect on limb salvage for gangrene of the foot. Sympathectomy appeared to aid in stump healing, with 77 per cent of the amputations done not requiring revision to a higher level. Results of our experience appear to indicate that, for patients presenting with gangrene of the toes or forefoot who are not candidates for reconstructive arterial procedures, lumbar sympathectomy as an initial operative procedure should be given serious consideration.
100例（111条肢体）下肢坏疽患者最初接受了腰交感神经切除术治疗。腰交感神经切除术似乎对治疗足趾坏疽最为有益，肢体挽救率为75%。当仅累及一个足趾而非拇趾时，效果最佳。足部坏疽时肢体挽救率降至38%，而对于小腿坏疽，腰交感神经切除术无效。糖尿病的存在对足趾坏疽的肢体挽救无影响，但对足部坏疽的肢体挽救有明显影响。交感神经切除术似乎有助于残端愈合，77%的截肢手术无需向上一级别修正。我们的经验结果似乎表明，对于那些不适合进行重建性动脉手术的足趾或前足坏疽患者，应认真考虑将腰交感神经切除术作为初始手术方法。
