Johnson B F, Evans L, Drury R, Datta D, Morris-Jones W, Beard J D
Department of Vascular Surgery Royal Hallamshire Hospital, Sheffield, U.K.
Eur J Vasc Endovasc Surg. 1995 Feb;9(2):181-8. doi: 10.1016/s1078-5884(05)80088-7.
To study the quality of life of patients following surgery for critical limb is ischaemia.
Part retrospective, part prospective open study.
Vascular unit of a University Hospital.
Seventy-nine consecutive patients, medium age 75 years (range 44 to 94), who presented with leg threatening ischaemia and who underwent successful revascularisation or a major amputation were studied.
Six separate quality of life measures were recorded at 6 months: pain, mobility, anxiety, depression, activities of daily living (Barthel) and lifestyle (Frenchay).
The mortality of this group of patients after six months was 24%. Forty-seven patients were available for quality of life assessment six months after initial intervention. Overall, amputation was more costly than successful revascularisation and limb salvage. Limb salvage resulted in greater mobility (p < 0.001) and better performance in self-care (p < 0.001) and lifestyle (p = 0.006), but produced more anxiety and depression (p = 0.04) than major amputation. A subgroup of patients who had major amputation after a failed limb salvage operation consumed a disproportionate amount of resources and, although their mobility was typical of amputees, their self-care and lifestyle scores were similar to those who had successful limb salvage. OBSTRUCTIONS: Limb salvage is attempted in up to 22% of patients for whom primary amputation may provide more expeditious rehabilitation with minimal impairment of their lifestyle performance.
研究严重肢体缺血患者术后的生活质量。
部分回顾性、部分前瞻性开放研究。
一所大学医院的血管科。
研究了79例连续患者，中位年龄75岁（范围44至94岁），这些患者出现威胁肢体的缺血，并且接受了成功的血运重建或大截肢手术。
在6个月时记录6项独立的生活质量指标：疼痛、活动能力、焦虑、抑郁、日常生活活动能力（巴氏指数）和生活方式（弗伦奇ay指数）。
该组患者6个月后的死亡率为24%。47例患者在初次干预6个月后可进行生活质量评估。总体而言，截肢比成功的血运重建和肢体挽救成本更高。肢体挽救导致更大的活动能力（p<0.001）、更好的自我护理表现（p<0.001）和生活方式（p = 0.006），但比大截肢产生更多的焦虑和抑郁（p = 0.04）。一组在肢体挽救手术失败后进行大截肢的患者消耗了不成比例的资源，尽管他们的活动能力是截肢患者的典型情况，但他们的自我护理和生活方式得分与成功进行肢体挽救的患者相似。障碍：对于高达22%的患者尝试进行肢体挽救，而初次截肢可能会以对其生活方式表现的最小损害提供更迅速的康复。
