Особенности ампутаций у сосудистых больных

Abstract

Retrospectively studied 53 patients with a history of high leg amputation at the age of 30-92 years (mean age — 63,61 ± 6,31 years). The main group — 43 patients with a history of high amputation of the lower limbs on the critical lower limb ischemia. The control group — 10 patients with histories of high amputation of the lower limbs on the disease of the lower extremities non-vascular origin. Exclusion criterion was absence of hemodynamically significant stenosis in the segment of femoral/popliteal artery. The average age of the patients operated on for atherosclerosis of the arteries of the lower extremities significantly higher age profile and trauma patients was 72,12 ± 12,34 years, but in spite of that in the study group, 9.3 % of patients, persons of working age; Of all operated patients about atherosclerosis of the arteries of the lower extremities in 20.9% of cases had previously been performed on a high amputation of the contralateral limb. High amputation in patients with OASNK is a forced measure, since hemodynamically significant stenosis in 100% is located in the femoral artery in patients traumatological high level of amputation due to localization of the foci in the femur/tibia bones. 51% of patients with atherosclerosis of the arteries of the lower extremities after high amputation needs to stay in the RAO, which suggests that these patients are at high operational and anesthetic risk. The main group of postoperative complications occur in 32.5% of cases, while in the comparison group — 20%. The number of amputations in patients vascular profile is growing steadily and has a tendency to decrease in the presence of effective conservative methods of slowing the progression of the disease, indicating that the imperfection of medical care.

Цель исследования. Обосновать необходимость оптимизации организации медицинской помощи пациентам с ОАСНК на этапах консервативного лечения и органосохраняющих оперативных вмешательств.