在慢性肢体威胁性缺血症中,自由肢的挽救和的复发
Norifumi Matsuda1,2, Dongkyung Seo1,2, Riho Suzuki3,4
1Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
The international journal of lower extremity wounds
|September 27, 2024
概括
慢性四肢威胁性缺血症 (CLTI) 的自由重建可以延长存活时间,但的复发是令人担忧的. 高活动水平和后动脉使用增加了手术后两年内复发的风险.
科学领域:
- 血管外科 血管外科
- 重建性手术是一种重建性手术.
- 肢体的救援工作
背景情况:
- 自由移动是慢性肢体威胁性缺血症 (CLTI) 的标准治疗方法,可提供长时间的无截肢生存.
- 有限的数据存在于的复发率在自由重建后,特别是在CLTI患者,大多数研究集中在创伤病例.
研究的目的:
- 在患有CLTI的患者中,在自由脚重建后,回顾性分析的复发率和相关因素.
- 评估该患者队列的长期结果,包括活动水平和存活率.
主要方法:
- 一个17年的回顾性审查的CLTI患者接受自由脚重建.
- 纳入标准:成功的手术,完整的伤口愈合和≥1年的随访.
- 使用统计方法分析患者人口统计,的复发,活动水平和存活率.
主要成果:
- 包括42名患者 (平均年龄57.1岁,92.9%男性) 具有高并发症 (39%糖尿病,35.7%关键肢体缺血,35.7%ESRD/透析).
- 五年原发性的无复发生存率为48.7%.
- 高活动水平 (HR 3.59) 和后动脉作为接收器 (HR 9.81) 是复发的重要预测因素. 手术后2年内复发率达到顶峰.手术后2年内复发率达到顶峰.
结论:
- 在CLTI患者中,自由重建具有显著的复发率,特别是在前两年内.
- 虽然复发很常见,但患者经常保持手术前的活动水平.
- 仔细的患者选择和接受器动脉的选择可能对最小化复发风险至关重要.
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