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오수명 한국의학사 1986 診斷과治療 Vol.6 No.3
당뇨와 비당뇨 환자의 서혜부 이하 동맥우회로술 후 개존율과 하지구제율의 비교 분석
오수명,안형준,박호철,윤충,고석환 대한혈관외과학회 2000 Vascular Specialist International Vol.16 No.1
Purpose: The purpose of this study is to compare and analyze the results of primary and secondary patency rates and limb salvage rates in DM (Diabetes Mellitus) and Non-DM patients with atherosclerosis in the lower extremity after arterial reconstruction. Methods: A retrospective study was done by reviewing admission notes and follow up records of 95 atherosclerotic limbs which had infrainguinal arterial reconstruction due to claudication induced severe impediment and limb threatening ischemia (teat pain, minor and major tissue loss). Kaplan-Meier survival analysis was used in the comparison of the primary, secondary patency rates and limb salvage rates, and statistical examination was handled by the Log-Rank significance test. Results: 1 and 3 year primary patency rates were 76.0% and 65.6% each in the DM group and 63.9% and 56.5% each in the Non-DM group. 1 and 3 year secondary patency rates were 80.0% and 69.7% in DM patients and 81.1%, 73.9% each in Non-DM patients. The 1 and 3 year limb salvage rates of DM patients were 83.8% and 72.6% while Non-DM patients revealed a 84.9% and 77.8%. Conclusion: Aggressive arterial reconstruction is recommended as well, in DM patients with atherosclerosis in the lower extremity, considering the insignificant differences in the risk of surgery as well as the primary, secondary patency rates and limb salvage rates.
오수명 한국의학사 1985 診斷과治療 Vol.5 No.8
오수명 한국의학사 1989 診斷과治療 Vol.9 No.10
오수명,박호철,신영도 대한혈관외과학회 1996 Vascular Specialist International Vol.12 No.2
Patients undergoing peripheral arterial procedures are at increased risk for postoperative cardiac complications and are difficult to assess preoperatively because of limitations on their activity. Preoperative identification of high-risk patients is important both for a proper assessment of the risk-benefit ratio for surgery and to allow more intense perioperative management of those at high risk to reduce complication rates. An inexpensive approach to stratification of patients admitted for arterial surgery into groups of high and low cardiac risk has been retrospectively evaluated in 43 patients over 50 years of age. Cardiac risk was calculated according to Goldmans index, Detskys index, or the criteria identified by Eagle(age) 70 years, diabetes, angina, Q wave on electrocardiogram, or ventricular arrhythmia). Of the 43 patients, 4(9.3%) patients had postoperative cardiac death. When Goldman's index was applied to the patients, the cardiac death ratios for each risk class were as follows: Class I(n=32), 3.1%; Class II(n=7), 0%', Class III(n=3), 66.6 %; and Class IV(n=l), 100%. When Detsky's index was applid to the patients, cardiac death ratios were 2.5% in the patients having Detsky's risk scores of 0 to 15 points(n=40) and 100% in the patients having 20 points or more(n=3). When the patients were classified into three groups according to Eagle's criteria, the cardiac risk ratios for each group were as follows.' Patients with none of Eagles criteria(n=22), 0%; patients with one or two of these criteria(n=19), 15.7%; and patients with three or more of these criteria(n=2), 50.0%. We conclude that patients with high scores on clinical cardiac risk indexes(Goldman index $gt;l2 or Detsky index $gt;15), or more than three of Eagles criteria are likely to be at higher risk for cardiac death after vascular surgery.