摘要
目的调查分析澳门仁伯爵综合医院近5年截肢患者的临床特点、预后及危险因素。方法回顾性分析2011年1月至2016年12月澳门仁伯爵综合医院截肢患者,记录截肢患者的人口学资料、截肢原因、截肢危险因素、截肢平面以及伴随疾病等进行分析。多因素logistic回归分析疾病危险因素对截肢平面的影响。采用Kaplan-Meier法对截肢后患者生存时间做生存分析。结果共有175例住院患者进行了208次截肢手术,年龄(70.3±14.1)岁。其中膝上截肢71例,膝下截肢51例,足部截肢或截趾86例。130例因糖尿病足截肢,41例因糖尿病足合并下肢血管病变截肢,19例因下肢血管病变截肢,18例因其他原因截肢。多因素logistic回归分析结果表明高血压和下肢血管病患者更易发生膝上截肢(RR值分别为2.012,1.914,P值分别为0·215,0.107),糖尿病患者更易发生足部截肢(RR=0.315,=0.019)。Kaplan-Meier生存分析结果表明截肢平面对于患者生存期有一定影响,膝上截肢患者术后生存期最短。结论澳门仁伯爵综合医院截肢患者最常见的原因是糖尿病足,其次为下肢血管病变,其他原因包括创伤、肿瘤等。截肢平面与患者的心血管病危险因素与伴随疾病有关。截肢患者术后生存期较短,截肢平面是影响术后生存期的一个因素。
Objective To investigate the clinical characteristics,prognosis and risk factors of amputation patients in recent 5 years in Macao Hospital Conde S. Januario. Methods The inpatient amputation patients in our hospital between January 2011 and December 2016 were enrolled in this study. The clinical data, including demography, amputation causes, risk factors, amputation level and concomitant diseases were recorded. SPSS statistics 21.0 was used to perform the statistical analysis. Multivariate logistic regression analysis was employed to determine the effects of risk factors on amputation level. Kaplan-Meier survival analysis was used to analyze the survival time after amputation.Results There were 175 consecutive patients（70.3±14.1 years old） with 208 amputation procedures recruited in this study. They were 71 cases of above knee amputation,51 cases of below knee amputation,and 86 cases of foot or toe amputation. The causes of amputation were diabetic foot in 130 patients,diabetic foot and peripheral arterial disease in 41 patients,simple peripheral arterial disease in 19 patients, and other causes in 18 patients. Multivariate logistic regression analysis indicated that above knee amputation was associated with hypertension and peripheral artery disease（RR=2.012, P=0.215;RR=1.914,P=0.107）,and foot or toe amputation was more prevalent in diabetes mellitus （RR=0.315, P=0.019）. Kaplan-Meier survival analysis showed postoperative survival time was effected by amputation level,and survival time was shorter in those with above knee amputation. Conclusion The most common amputation cause in our hospital is diabetic foot,followed by vascular disease of lower extremity and other causes,such as trauma, tumor, and so on. Amputation level is associated with cardiovascular risk factors and concomitant diseases. The amputation patients have comparatively shorter survival time after operation,and amputation level is one of factors influencing the survival time.
出处
《中华老年多器官疾病杂志》
2017年第10期721-724,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
基金
澳门特别行政区科学技术发展基金(110/2015/A)
首都医科大学基础--临床科研合作基金(16JL54)~~
关键词
截肢术
糖尿病足
危险因素
预后
周围血管病
amputation
diabetic foot
risk factors
prognosis
peripheral artery disease
