Ayoub M M, Solis M M, Rogers J J, Dalton M L
Department of Surgery, Mercer University School of Medicine, Macon, Georgia 31208.
Am Surg. 1993 Sep;59(9):619-23.
Between 1983 and 1990, 32 consecutive patients had 35 thru-knee amputations for ischemia causing infection or gangrene of the lower leg. Twenty-seven patients were nonambulatory, five had limited mobility, and none were considered to be candidates for rehabilitation with a prosthesis after surgery. The average age was 73 years. Thirty-day hospital mortality was 3 per cent. The incidence of complications was low, and healing was achieved in 97 per cent of survivors. One patients required revision to an above-knee amputation. Average postoperative hospital stay was 8.7 days. It is concluded from this study that thru-knee amputation is the treatment of choice in patients with nonsalvageable ischemic legs and in whom ambulation is not planned after operation.
1983年至1990年间,32例连续患者接受了35次经膝关节截肢手术,原因是缺血导致小腿感染或坏疽。27例患者不能行走,5例行动能力有限,术后均不被认为是假肢康复的候选人。平均年龄为73岁。30天医院死亡率为3%。并发症发生率较低,97%的幸存者伤口愈合。1例患者需要翻修为大腿截肢。术后平均住院时间为8.7天。本研究得出结论,对于无法挽救的缺血性下肢且术后不打算行走的患者,经膝关节截肢是首选治疗方法。