Objective:To reduce the amputation rate by analysis of risk factors of amputation in patients with popliteal artery injury.Methods: The data of patients with popliteal artery injury were collected and analyzed from January 2005 to January 2014.The detailed information should included basic information, injury mechanism, hemodynamic characteristics, physical activity, associated injuries, surgical methods and the amputation rate.Results: Two hundred and twelve patients with popliteal artery injuries were identified.Penetrating and blunt trauma accounted for 20 and 192 injuries, respectively.Associated injuries included fractures in 132 patients, kneed islocations in 22 and popliteal vein injuries in 118.Forty patients presented with a compartment syndrome.Arterial injuries were treated with reversed vein grafting in 110 patients, primary anastomosis in 80 cases, and primary amputationin 10 cases, who had extent of soft tissue damage.Forty patients underwent delayed amputation, giving an overall amputation rate of 23.6%.Three of 40 delayed amputations were performed due to uncontrolled infection complicated by haemorrhage or thrombosis.The presence of a compartment syndrome (OR=15.518, p<0.001) and associated with fractures (OR=19.029, p<0.001) were significantly associated with an increased amputation rate.Conclusions: The most significant risk factors associated with the high amputation rate of23.6% were the mechanism of injury, an ischaemic time longer than 6 hours, the presence of a compartment syndrome and associated with fractures around the knee joint.%目的:分析总结导致腘动脉损伤患者截肢的危险因素,降低截肢率.方法:回顾性分析2005年1月至2014年1月收治的腘动脉损伤患者,采集患者详细信息,包括患者基本信息、受伤机制、血液动力学特征、肢体活性、合并伤、手术方法以及截肢率.结果:共纳入212例腘动脉损伤患者,其中锐性伤20例,钝性伤192例;合并骨折132例,膝关节脱位23例,腘静脉损伤118例;小腿骨筋膜室综合症8例;110例行大隐静脉移植修复,80例端端吻合,22例行其他静脉移植修复术.10例患者因大面积软组织受损,初期行截肢术,40例患者手术后截肢,总截肢率为23.6%,6例患者由于发生不可控感染并发出血或血栓形成而截肢.采用logistic回归分析进行统计分析,发现截肢与是否发生骨筋膜室综合症(OR=15.518,P<0.001)、是否合并膝关节周围骨折相关(OR=19.029,P<0.001).结论:发生骨筋膜室综合症、合并膝关节周围骨折是造成腘动脉损伤高截肢率的显著因素.
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