儿童下肢截肢及其功能康复的流行病学与临床特征

doi:10.3969/j.issn.1006-9771.2022.07.002

Abstract

Abstract:

Objective To analyze the epidemiological and clinical characteristics of children's lower extremity amputation and amputation rehabilitation, and to explain the causes of children's amputation and the complications after amputation.

Methods From January, 2016 to March, 2021, 51 amputation related children were retrospectively analyzed. The correlation between the cause of amputation and complications post amputation were analyzed.

Results Traumatic amputations accounted for 58.82%, and the main cause was traffic accidents (70%). Amputations caused by diseases accounted for 41.18%, and the main cause was congenital limb deformities (80.95%). Traumatic amputation was more likely to have stump complications than expected (P< 0.05). The possibility of stump complications after disease-specific amputation was lower than expected (P< 0.05).

Conclusion Traffic trauma is the main cause of amputation in children and is characterized clinically by a high incidence of unsatisfactory stumps, mainly due to soft tissue abnormalities, and most cases require stump revision to improve the poor residuals for prosthetic restoration of ambulation. Congenital pseudarthrosis of the tibia is the main cause of disease-specific amputation, and the outcome of amputation often cannot be definitely avoided even after long-term limb preservation treatment.

Key words: amputation, children, rehabilitation, epidemiology, unsatisfactory stumps

CLC Number:

R687.5

GU Rui,TIAN Gang,HUANG Qiuchen,LIU Kemin,MIN Hongwei,FENG Jianpu,WANG Anqing. Epidemiological and clinical characteristics of pediatric lower extremity amputation and functional rehabilitation[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(7): 753-758.

Figures/Tables 5

References 24

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项目	值	项目	值
性别/n		截肢部位/n
男	32	单侧下肢截肢	49
女	19	经前中足截肢	1
年龄/岁	1.8~17	经后足部截肢	7
截肢时年龄/岁	8.1±1.6	经小腿截肢	30
因先天性畸形截肢时年龄/岁	8.06±4.64	膝离断	3
单侧截肢/n	49	经大腿截肢	7
左侧	17	半骨盆截肢	1
右侧	32	双侧下肢截肢	2
双侧截肢/n	2	双大腿截肢	1
截肢原因/n		双侧髋部离断	1
创伤性截肢	30	截肢后并发症/n	33
交通相关因素	21	1种并发症	19
看护不当	9	2种并发症	12
疾病性截肢	21	3种及以上并发症	2
先天性肢体畸形	17	软组织并发症	16
血管性截肢	1	骨性并发症	12
肿瘤性截肢	1	残端神经瘤	7
脂肪异常增生	1	感染性并发症	5
后天性畸形并发感染	1	幻肢痛	1
平均住院时间/d	33.92±31.20	无法分类及其他复杂并发症	21
初次截肢时住院时间/d	34.00±24.95	平均住院费用/元	24 191.34±16 341.22
残端修整时住院时间/d	31.33±35.90	截肢时住院费用/元	25 119.48±18 685.43
残端修整时住院费用/元	18 993.48±17 081.53

原因	n	无	神经瘤	骨性	感染	软组织	幻肢痛	复杂并发症^a
创伤性	30	3	1	2	2	5	0	17
疾病性	21	15	1	0	1	0	1	3

Epidemiological and clinical characteristics of pediatric lower extremity amputation and functional rehabilitation

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截肢原因	n	无	1种	2种	3种及以上
创伤性	30	3	14	11	2
疾病性	21	15	5	1	0