Schwilden E D
Klinik für Gefässchirurgie, Städtische Kliniken, Esslingen a.N.
Langenbecks Arch Chir Suppl Kongressbd. 1996;113:866-9.
In the course of demographic ageing with a growing number of handicapped and people in need of care the vascular surgeon will be confronted more and more with the question whether to perform a leg-saving vascular reconstruction or a primary amputation, when treating such patients. This question is discussed by analyzing the parameters benefit, risk and costs. On balance the conclusion is made, that considering nursing, medical and psychological aspects also the seriously handicapped will benefit from the leg-saving procedure. Also the risk of a vascular reconstruction is justifiable, when the procedure has a real chance of success. Concerning the costs the question is still unanswered, if in consideration of the dictated economical commulsions it is allowed to perform an expensive reconstructive procedure, when the primary amputation is the substantially "cheaper" solution.
在人口老龄化过程中，残疾人和需要护理的人数不断增加，血管外科医生在治疗这类患者时，将越来越多地面临这样一个问题：即进行保肢血管重建术还是一期截肢术。本文通过分析获益、风险和成本等参数来讨论这个问题。总体而言，得出的结论是，综合护理、医疗和心理等方面来看，重度残疾人也将从保肢手术中获益。此外，当血管重建手术有真正的成功机会时，其风险也是合理的。关于成本问题，如果考虑到既定的经济限制，在一期截肢术实质上“更便宜”的情况下，是否允许进行昂贵的重建手术，这个问题仍然没有答案。
