疎血性肢のリハビリテーション : Preventive rehabilitationへの血管外科の役割

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概要

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• Claudication is very nuisance to the patient who has a ischemic limb. Claudication itself does not mean immediaste amputation of the limb, since the inconvenience of the patient depends more or less on the activity. Things are different in patient who has a severely ischemic limb. It often causes peripheral ulcers, gangrene and amputation. These are life threatening potentially, especially in the elderly; after amputation of a lower extremity, unexpected falls may cause severe injury and stressfull life of post-amputation rehabilitation can possibly lead to cardiopulmonary distress. The advanteges of living limb over the artificial is so great that it is reasonable to try more active forms of arterial reconstruction for severely ischemic limb than would be suitable for claudication alone in the broad sense of preventive rehabilitation. We have a demonstrable case of a 30-year-old man who has successfully been recovered with arterial re-reconstruction from severely ischemic leg, suffering from Thromboangiitis Obliterans over the period of 3 years. He had his right lower extremity bypassed previously wity a Wesolowski-Weavenit, 6-mm in internal diameter, over the segmental stenosis of right popliteral artery for claudication, and right lumbar sympathetic ganglionecctomy simultaneously. Claudication and ulcers with severe ischemic pain developed in right foot following short period of success. We successfully saved his right foot by arterial reconstruction of autovein bypass over occluded arterial tree, supplying enough blood to improve claudication and also to cure longstanding-ischemic ulcers, though he eagerly his leg amputated because of severe pain. We strongly emphasize the role of arterial reconstruction surgery to get rid of ischemic conditions in the field of rehabilitation for ischemic limb. It does work on salvaging living limb, even in a short period of success.

• 社団法人日本リハビリテーション医学会の論文
• 1972-07-18

著者

• 勝村 達喜

  岡山大学第2外科

• 勝村 達喜

  岡山大学第二外科

• 古元 嘉昭

  岡山大学温泉研究所

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