[The comparison of operative and non-operative treatment for acute embolism of upper extremity artery].

OBJECTIVE: To compare surgical and non-surgical therapy of the upper extremity after acute arterial occlusion. To analyze the relation between prognosis and relevant factors of different therapeutic methods. METHODS: Sixty patients with acute upper extremity arterial embolism treated between January 1990 and October 2007 were retrospectively studied in The First Hospital of China Medical University. RESULTS: There were 60 patients, 32 men and 28 women, with a mean age of 63 years (21 - 86 years). Among them, 31 underwent thrombembolectomies with the Fogarty catheter and 29 received anti-coagulation and thrombolytic therapy. Therapeutic effects were evaluated by Cooley's standard. Therapeutic efficacy was better in the surgical group than in the non-surgical group (P < 0.05). There was no relationship between post-operative ischemic recovery and pre-operative ischemia severity and the site of embolism in the surgical group, while there were significant relationships in the nonsurgical group. The result of Cox proportional hazard regression model showed that the age and Cooley's standard of the patient was correlated with survival time. CONCLUSIONS: A more active surgical approach is better for the treatment of acute arterial occlusion of the upper extremity.

[Clinico-epidemiological features of infrarenal abdominal aortic aneurysm and relevant prognostic factors].

OBJECTIVE: To investigate the clinico-epidemiology features of infrarenal abdominal aortic aneurysm (AAA) and relevant prognostic factors. METHODS: The clinical records of 375 infrarenal AAA patients, 282 males and 93 females, aged (62 +/- 15), hospitalized 1988 -2007 were analyzed. RESULTS: In recent ten years, the number of patients admitted because of AAA was 186.6% as high as that in the last 10 years. The rupture rate of the male AAA patients was 14.4%, significantly higher than that of the female AAA patients (6.5%, P < 0.05). The rupture rate of the AAA aged patients > or = 65 was 3.6%, significantly lower than that of the AAA patients < 65 (17.7%, P < 0.01). The aneurysm diameter of the patients with hyperextension was (6.1 +/- 3.3) cm, significantly lower than that of the patients without hypertension [(6.8 +/- 2.3) cm. P < 0.05]. The general 5-year survival rate was 70.1%. The 5-year survival rates of the female patients, patients > or = 65, without hypertension, and without coronary heart disease were, all significantly higher than those of the male patients, patients < 65, and patients with hypertension or coronary heart disease (all P < 0.05). Cox regression analysis showed that sex, smoking, and hypertension were all prognostic factors (all P < 0.05). CONCLUSION: The morbidity of AAA increases fiercely. The AAA patients being male, smoking, or with hypertension have poorer prognosis, and age and operation method are not related to prognoses.