DOI: https://doi.org/10.22263/2312-4156.2017.6.42
Famin A.V.1, Kontrovsky A.A.2
The risks of unfavorable outcomes and quality of life in purulent-necrotic lesions of lower extremities
1Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
2Orsha Central Polyclinic, Orsha, Republic of Belarus
Vestnik VGMU. 2017;16(6):42-50.
Abstract.
Objectives. To improve the efficiency of treatment and life quality of patients with vascular diseases of the lower extremities.
Material and methods. The analysis of the treatment results of 475 patients with obliterating atherosclerosis of lower extremities vessels (n=186), diabetic foot (n=149), with a combination of obliterating atherosclerosis of lower extremities vessels and diabetes mellitus (n=140) has been made at the general surgical hospital. The degree of patients’ psychological adaptation and their quality of life have been investigated.
Results. On the basis of the obtained data the clinical-psychological portrait of a patient, who underwent a high amputation was specified. These are men, aged 65 (Me=64) years, females, aged 80 years (Me=81), suffering from a combination of obliterating atherosclerosis of lower extremities vessels and diabetes mellitus during 12,1 years or even longer, having concomitant diseases of the cardiovascular system (88%), arterial hypertension (80%), overweight (55%), smoking during 20 or more years (84%) from 3 to 6 cigarettes a day (76%). These patients, as a rule have no higher education (84%), haven’t got any treatment before (72%), more frequently rural residents (56%).
Patients with high amputation demonstrated a significant reduction in life quality (their integrated rate made up 36%), including reduced physical mobility (30%), emotional state (28%), social adaptation (39%), sharply reduced economic status (19%). The biggest difference in terms of life quality between patients who managed to avoid amputation and those who underwent high amputation was in their emotional state (24%), economic situation (21%), physical mobility (20%) and social adaptation (18%). Sexual function was significantly reduced in both groups of patients, but in patients with high amputation it was by 10% weaker.
Conclusions. The rise in the level of persons’ care of their health, early clinical examination of people consistent with the clinical-psychological portrait of a patient with high amputation can contribute to the improvement of treatment results of patients with purulent-necrotic lesions of the lower extremities. The criterion of the efficiency of patients’ treatment results may be the evaluation of their life quality and the degree of their psychological adjustment.
Key words: vascular diseases of the lower extremities, necrosis, diabetic foot, quality of life, prophylactic medical examination.
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Information about authors:
Famin A.V. – Doctor of Medical Sciences, professor of the Chair of Faculty Surgery, Vitebsk State Order of Peoples’ Friendship Medical University;
Kontrovsky A.A. – surgeon, Orsha Central Polyclinic.
Correspondence address: Republic of Belarus, 210023, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Faculty Surgery. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Anatol V. Famin.
