Pell J P, Donnan P T, Fowkes F G, Ruckley C V
Wolfson Unit for the Prevention of Peripheral Vascular Diseases, Department of Public Health Sciences, University of Edinburgh, U.K.
Eur J Vasc Surg. 1993 Jul;7(4):448-51. doi: 10.1016/s0950-821x(05)80265-8.
Lower limb amputations for peripheral arterial disease are performed predominantly on an elderly population with poor social support and concomitant medical problems. The effect of amputations on the quality of life of this population has not been properly assessed. The quality of life of 149 amputees from one hospital was evaluated using the Nottingham Health Profile and compared to that of a control group matched for age and sex. One hundred and thirty (87%) amputees and 115 (77%) controls responded to the questionnaire. Amputees reported significantly more problems with mobility, social isolation, lethargy, pain, sleep and emotional disturbance than controls (p < 0.001). However, mobility was the only significant independent factor after matched logistic regression analysis (p < 0.001). The differences in social isolation and emotional distress lost their significance after adjustment for mobility. The overall quality of life following lower limb amputation for peripheral arterial disease is poor, but much of this is secondary to restricted mobility. Rehabilitation following amputation should therefore focus on attempts to improve mobility.
因外周动脉疾病而进行的下肢截肢手术主要针对的是社会支持差且伴有其他医疗问题的老年人群。截肢对该人群生活质量的影响尚未得到恰当评估。使用诺丁汉健康量表对一家医院的149名截肢者的生活质量进行了评估,并与年龄和性别匹配的对照组进行了比较。130名(87%)截肢者和115名(77%)对照组人员回复了问卷。与对照组相比,截肢者在行动能力、社交孤立、无精打采、疼痛、睡眠和情绪障碍方面报告的问题明显更多(p < 0.001)。然而,在匹配逻辑回归分析后,行动能力是唯一显著的独立因素(p < 0.001)。在对行动能力进行调整后,社交孤立和情绪困扰方面的差异不再显著。因外周动脉疾病进行下肢截肢后的总体生活质量较差,但这很大程度上是由于行动受限所致。因此,截肢后的康复应着重于改善行动能力。