• Title/Summary/Keyword: 비만 수술

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Surgical Treatment of the Aortic Aneurysm (대동맥류의 외과적 치료)

  • 김학제;조원민;김태식;이송암;김욱진;손영상;최영호
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.13-19
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    • 1998
  • Aortic aneurysm has poor prognosis and high mortality, but the incidence of aortic aneurysm is in increasing state. From July, 1986 to July, 1996, we operated on 25 patients with aortic aneurysm and analysed the clinical results and relations between the duration from symptoms onset to operation(Sx-Op), the duration from admission to operation(Adm-Op), preoperative blood pressure, preoperative heart rate and postoperative mortality, retrospectively. The patients were classified as dissecting aneurysm(10 cases), abdominal aortic aneurysm(9 cases), Marfan's syndrome(3 cases), descending thoracic aortic aneurysm(3 cases). The operative technique were graft interposition in 17 cases, Bentall's operation in 4 cases, aneurysm bypass in 2 cases, and wrapping of aorta in 2 cases. Seven patients died of several causes, bleeding in 5 cases, acute renal failure in 1 case and respiratory failure in another one case. Before 1992, the early stage of operation, 6 mortality among 14 operated patients occurred, and after then 1 mortality among 11 operated patients occurred. Eighteen survivors were followed up from 1 to 118 months(mean 50.6 months), and total follow up was 911 patient-months. During the follow up period one patient died of melena 30 months after operation. The other patients did not complain chest pain or dyspnea. The surgical mortality was improved in the late period, and the major cause of death was intraoperative or postoperative bleeding. The Sx-Op duration, the Adm-Op duration, preoperative blood pressure and preoperative heart rate were proven to have no statistical relations with postoperative mortality.

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Stress among Hospital OR Nurses (수술실 간호사의 스트레스와 관련된 요인 분석)

  • 홍복화;김석범;강복수
    • Korean Journal of Health Education and Promotion
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    • v.13 no.1
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    • pp.52-71
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    • 1996
  • To measure the degree of work stress and identify factors influencing the stress among OR nurses, a study was implemented for 131 OR nurses working at four university hospitals in Taegu city through self administered questionnaires. Mean score of total work stress of nurses was 3.71, when maximum score was 5. Relatively high degrees of work stress was evident among OR nurses. When the related factors of the stress specified in the questionnaire were grouped into 11 categories, the respondents turned out to feel the highest stress when they were faced with the categories of non-peculiar duty and personal conflict with doctors. The most stressful events were nursing malpractice during surgical operations and damage to OR equipments. The nurses more susceptible to workstress were married with one child, less educated and worked at OR for 3 to 6 years.

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The Effect of Aroma Inhalation on the Preoperative Pain and Anxiety of the Elderly Preparing to Undergo Spine Surgery (척추 수술 전 노인환자에게 적용한 아로마 향흡입요법이 통증 및 불안에 미치는 효과)

  • Park, Sohwi;Kim, Bokyoung;Park, Kyungsook
    • Journal of Digital Convergence
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    • v.17 no.12
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    • pp.523-533
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    • 2019
  • This study's purpose is to determine the effects of aroma inhalation on preoperative pain and anxiety of the elderly preparing to undergo a spine surgery. A Quasi-experimental design, with non-equivalent control group non-synchronized design was used in this study. Blended essential oils with frankincense, marjoram and mandarin were inhaled twice in the experimental group (n=30). The control group (n=30) was treated with the standard preoperative care. Pain, state anxiety, and vital sign were measured twice (before and after). The results of this study showed that pain (t=-1.223, p=.226), systolic blood pressure (t=-0.211, p=.833), diastolic blood pressure (t=0.638, p=.526), and respiration rate (t=0.734, p=.466) were not statistically significant in the experimental and the control group. There were significant differences in state anxiety (t=-3.202, p=.002) and pulse rate (t=-0.213, p=.037) in the experimental group compared to the control group. According to the results, aroma inhalation is an effective nursing intervention for relieving anxiety in surgical patients.

The Impact of Nurse Staffing Level on In-hospital Death and Infection in Cancer Patients Who Received Surgery (간호사 확보수준이 수술한 암환자의 원내 사망 및 감염에 미치는 영향)

  • Kim, Myo-Gyeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.4
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    • pp.408-417
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    • 2017
  • This study was conducted to examine the influence of the nurse staffing level on the level of in-hospital death and infection in cancer patients who received surgery. Secondary data were used and the subjects of this study were 24,510 patients who received surgery for six types of cancer with a high postoperative mortality rate in the first half of 2012 at 260 hospitals. Simple logistic and GEE multiple logistic regression analyses were used. After adjusting for the patient and hospital characteristics, a greater likelihood of dying was found in the nurse staffing level 2-3 group (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.00-2.11) and in the level 6-7 group (OR, 3.28; 95% CI, 1.87-5.74) compared to the level 0-1 group. The likelihood of in-hospital infection increased with each additional bed per nurse, being 6.63 times higher (95% CI, 3.00-14.62) in the level 2-3 group, 5.79 times higher (95% CI, 1.88-17.78) in the level 4-5 group, and 8.4 times higher (95% CI, 1.82-38.84) in the level 6-7 group, as compared to the level 0-1 group. A lower nurse staffing level was associated with higher in-hospital death and infection levels. This shows that an appropriate nurse staffing level is associated with superior postoperative cancer patient outcomes. Policies for providing adequate nurse staffing should be maintained for the sake of ensuring improved care quality and patient safety.

Long term prognosis of patients who had a Fontan operation (폰탄 수술을 받은 환아들의 장기적 예후)

  • Kim, Hyun-Jung;Bae, Eun-Jung;Noh, Jung-Il;Choi, Jung-Yun;Yun, Yong-Su;Kim, Wong-Hwan;Lee, Jung-Yeul;Kim, Yong-Jin
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.40-46
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    • 2007
  • Purpose : This study assessed the long term survival rate and long term complications of patients who had a modified Fontan operation for functionally univentricular cardiac anomaly. Methods : Between June 1986 and December 2000, 302 patients with a functional single ventricle underwent surgical interventions and were followed up until February 2006. The mean follow-up period was $8.3{\pm}5.3years$ (range 3.5-18 years). Their median age was 2.4 years at the Fontan operation. The survival rate, the incidence and the risk factor of late complications were evaluated retrospectively. Results : The verall survival rate was 91 percent at 5 years and 87 percent at 10 years. In multivariate analysis, early calendar year of operation and significant regurgitation were risk factors of death. The surviving patients showed NYHA functional class I in 82 percent, class II in 15 percent, and class III in 3 percent. Redo Fontan operations were necessary in 8.8 percent of patients at average $12.8{\pm}3.6years$ after initial Fontan operation. The most common cause of Fontan conversion was atrial arrhythmia. The incidence of thromboembolic events was 9.3% and these complications were associated with the occurrence of atrial tachyarrhythmia. Supraventricular tachycardia including atrial flutter or fibrillation were reported on the follow-up examination by 11.2 percent of survivors after $8.4{\pm}5.6years$. Atriopulmonary connection showed higher rates of late tachycardia than lateral tunnel operation. Conclusions : This study revealed that the recent survival rate of Fontan type operation was satisfactory, but the occurrence of late complications after a Fontan type operation increased with the longer survival. There is a need for strict follow up and early treatment of late complications in patients who had a Fontan operation.

Surgical Outcome of Patients with Ischemic Cardiomyopathy Selected by the Results of Myocardial Viability by Preoperative F-18 FDG PET (F-18 FDG 양전자단층촬영을 이용한 생존심근 평가 후 수술한 허혈성 심근병증 환자의 수술 결과)

  • Kim, Jae-Sung;Lee, Dong-Soo;Hong, Suk-Keun;Lee, Young-Tak;Kim, Yu-Kyeong;Kim, Youn-Jung;Moon, Keon-Sik;Won, Tae-Kyoung;Hwang, Hweung-Kon
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.4
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    • pp.276-284
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    • 2000
  • Purpose: We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. Materials and Methods: Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. Results: In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. Conclusion: F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.

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