在主要的下肢截肢之后,血管患者的假肢转移和功能移动性的决定因素
Jeremy Fridling1, Brendan Gontarz1, Shane R Wurdeman2
1Department of Surgery, University of Connecticut Health, Farmington, CT; Heart and Vascular Institute, Hartford HealthCare, Hartford, CT.
Annals of vascular surgery
|July 2, 2025
概括
大型下肢截肢 (MLA) 后的功能性移动性因之前的冠状动脉旁路移植 (CABG) 和医疗保险等因素而得到改善. 出院到家或急性康复也提高了血管疾病患者的结果.
科学领域:
- 血管外科 血管外科
- 康复医学 康复医学 康复医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 由于糖尿病和外周动脉疾病,主要下肢截肢 (MLA) 的发生率正在上升.
- 了解影响MLA后功能性移动性的因素对于患者的康复至关重要.
- 这项研究调查了在接受MLA.的血管疾病患者中,假肢适配和功能移动性的决定因素.
研究的目的:
- 确定与MLA后成功安装假肢相关的因素.
- 使用PLUS-M评分来确定更大的功能移动性的预测因素.
- 分析并发症和出院安排对流动性结果的影响.
主要方法:
- 对350名接受血管疾病MLA治疗的患者的回顾性分析 (2016年6月 - 2022年11月).
- 患者按假肢装配完成分层;通过假肢使用者移动性调查 (PLUS-M) 评分评估功能移动性.
- 多变量逻辑回归用于识别与改善功能移动性相关的因素.
主要成果:
- 假肢安装在37.1%的病例中完成;92名患者在安装后走路.
- 41.5%的PLUS-M得分的患者实现了高于平均水平的移动性.
- 超出平均水平的流动性与较少的并发病,先前的CABG,医疗保险/私人保险以及家庭/急性康复出院有关.
结论:
- 前冠状动脉旁路移植 (CABG) 和私人/医疗保险与MLA后更好的功能性移动性有关.
- 出院或急性康复可以改善MLA患者的功能结果.
- 解决并发症和保险状况可以优化恢复轨迹.
相关概念视频
Peripheral Artery Disease V: Postoperative Nursing Management
28
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
28
Peripheral Artery Disease III: Interprofessional Care
33
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
33
Peripheral Artery Disease IV: Nursing Management
47
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
47
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
38
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
38


