摘要
为探讨下肢动脉硬化闭塞症截肢术后常见并发症的防治 ,对 1996年 1月至 1998年 12月为严重下肢动脉硬化闭塞症患者 14例 (15条肢体 )所施行的 18次截肢术进行了回顾性分析。患者平均年龄 72岁 ,术前并发症率为冠心病 78.6 %、高血压 6 9.9%、糖尿病 78.6 %、血管重建术史 43.4%。其中膝上截肢 6次 ,膝下截肢 7次 ,半足截肢 1次 ,截趾术 4次。术后并发心梗 2例 ,残端坏死 3例 ,创面感染 1例 ,总并发症率 33%。死亡 2例。提示下肢截肢手术虽操作并不复杂 ,但临床上需行截肢术的下肢动脉硬化闭塞症患者多为高龄 ,且多合并症 ,常伴有肢体坏疽和脓毒症 ,手术耐受力极差 ;术前应积极治疗并存病 ,准确判断截肢平面 ,术后注意心、脑功能维护 ,以及适当的心理指导是减少后并发症 。
To investigate the prevention and management of postoperative complications of lower extremity amputation for arterial occlusive diseases, a retrospective analysis was made in 18 lower extremity amputations which were performed on 14 patients from Jan 1996 to Dec 1999. The mean age of the patients was 72. Before opeoation,78 6% of the patients were complicated with coronary artery disease, 69.9% with high blood pressure and 78.6% with diabetes mellitus, 43.4% with vascular reconstruction history. 6 above the knee amputations, 7 below the knee amputations, 1 hemiterpene amputation and 4 amputations of the toes were performed. Postoperative myocardial infarction occarred in 2 cases, gangrene of the stump in 3 cases and infection in 1 case, the total incidence rate of complication was 33%. The results showed that lower extremity amputation is not a complex operation, but preoperative estimation of the level of amputation and postoperative intensive care can reduce the postoperative rate of complication.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2001年第9期670-671,共2页
Medical Journal of Chinese People's Liberation Army
关键词
下肢动脉硬化闭塞症
截肢
手术后并发症
arteriosclerosis obliterans
amputation
postoperative complications
