Hermodsson Y, Ekdahl C, Persson B M
Department of Orthopaedics, Helsingborg Hospital, Sweden.
Scand J Caring Sci. 1998;12(2):73-80.
All 112 patients (55 females and 57 males) with a primary unilateral trans-tibial amputation for vascular disease performed in one year at all five hospitals in Malmöhus county, Sweden were examined at 6 months according to the prosthetic function and prospectively followed-up 8 years after the amputation for survival, and prosthetic fitting. The prosthetic function was re-examined among the survivors 8 years postoperatively. At 6 months 50% were fitted with a prosthesis and later (up to 8 years) a further 13%, in total 32 females and 39 males. The mortality at 6 months was 33%, at 2 years 47% and at 8 years 92%. Age at amputation (p = 0.015), to be amputated on the left leg (p = 0.0004), to be able to walk alone outdoors before the amputation (p = 0.007) and not using a wheelchair (p = 0.02) were all found to be statistically significant predictors for receiving a prosthesis. Predictors for good function with the prosthesis 6 months postoperatively was male sex (23 of 57 vs 8 of 55 females) (p = 0.006) and greater ability to walk alone outdoors before the amputation (p = 0.01). There was no significant age difference in this comparison. The finding that it is more favourable to be amputated on the left leg merits further study.
瑞典斯科讷郡所有五家医院在一年内因血管疾病进行原发性单侧经胫骨截肢手术的112例患者（55例女性和57例男性），在术后6个月时根据假肢功能进行了检查，并在截肢后8年对生存情况和假肢适配情况进行了前瞻性随访。在术后8年对幸存者的假肢功能进行了复查。术后6个月时，50%的患者安装了假肢，之后（直至8年）又有13%的患者安装了假肢，总计32名女性和39名男性。术后6个月的死亡率为33%，2年时为47%，8年时为92%。截肢时的年龄（p = 0.015）、左腿截肢（p = 0.0004）、截肢前能够独自在户外行走（p = 0.007）以及不使用轮椅（p = 0.02）均被发现是接受假肢的统计学显著预测因素。术后6个月假肢功能良好的预测因素为男性（57名男性中有23名，55名女性中有8名）（p = 0.006）以及截肢前独自在户外行走的能力更强（p = 0.01）。在此比较中年龄无显著差异。左腿截肢更有利这一发现值得进一步研究。
