四肢切断術を施行した透析患者の検討

DOI 被引用文献3件 参考文献10件

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  • A clinical study of amputation in hemodialysis patients.

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We performed a retrospective study to determine the prognosis of hemodialysis patients who suffered from gangrene and underwent amputations of the lower extremities or fingers. Between 1991 and 1997, 7 male patients and 5 female patients were operated upon. The average age was 71 years old. As causes of gangrene, arteriosclerotic obstruction (ASO) was suspected in 9 patients and diabetes in 10 patients. The site of amputation was above the knee in 4 patients, at the knee joint in 1, below the knee in 8, at the metatarsus in 2, the toe in 5 and the finger in 2. Echocardiography was perfomed on 10 patients and 7 patients had hypokinesis of the ventricular wall. These 7 patients were also found to have coronary heart disease by cardiac catheterization. The 1 and 2-year survival rates of all patients were 54 and 40% respectively. The 1 and 2-year survival rates of patients who did not have coronary heart disease (75 and 50%, respectively) were better than those of patients who had coronary heart disease (62 and 31%, respectively). Two patients who only had one toe amputated did not die but the prognosis of others who were amputated above the metatarsus was poor: The 1 and 2-year survival rates were 42 and 28% respectively. The serum urea nitrogen, creatinine and albumin levels of the amputated patients were statistically lower than those of the hemodialysis patients who did not suffer from gangrene.

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