Jamieson C W, Hill D
Br J Surg. 1976 Sep;63(9):683-90. doi: 10.1002/bjs.1800630904.
Amputation for peripheral ischaemia still has a depressingly high early and late mortality, and morbidity and the end result are usually less than satisfactory. Individual surgeons probably see too few amputees to treat them with maximal efficiency, and these patients create a large burden on beds and resources. There is room for improvement in all aspects of our management of amputees. Primary healing rates might be better with less heroic attempts to obtain a distal amputation. Sepsis is lessened by the use of prophylactic antibiotics. Tight bandaging and the intra-operative fitting of prostheses are undesirable. Simple tests of skin blood pressure may aid prediction of the degree of ischaemia at the proposed level of limb section and the chances of healing. The late mortality is high and merits study of methods designed to reduce it such as long term anticoagulation.
因外周缺血进行截肢手术的患者，其早期和晚期死亡率仍然高得令人沮丧，发病率也很高，最终结果通常不尽人意。个体外科医生可能接触到的截肢患者太少，无法以最高效率进行治疗，而这些患者给床位和资源带来了巨大负担。我们对截肢患者的管理在各个方面都有改进的空间。减少为实现远端截肢而进行的大胆尝试，一期愈合率可能会更高。使用预防性抗生素可减少脓毒症。不建议进行紧包扎和术中安装假肢。简单的皮肤血压测试可能有助于预测拟截肢部位的缺血程度和愈合几率。晚期死亡率很高，值得研究旨在降低死亡率的方法，如长期抗凝治疗。
