• 제목/요약/키워드: 심근경색증

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급성 심근경색에 합병된 심실중격 결손증의 수술적 치료: 1례 보고 (Surgical Management of Post-AMI VSD - A Case Report -)

  • 황석하
    • Journal of Chest Surgery
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    • 제25권4호
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    • pp.424-428
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    • 1992
  • Post-AMI VSD is an infrequent but often catastrophic complication of acute myocardial infarction In general, the mortality is associated with end organ failure due to low output syndrome. Therefore, a stable hemodynamic is necessary to prevent the end organ failure. If a supportive therapy does not accomplish it, surgical intervention should be considered. Recently, we have experinced a case of post-AMI VSD with cardiogenic shock. Early recognition and surgical repair of post-AMI VSD gave us a good result. Postoperative result was satisfactory and recovery was uneventful. We believe that early surgical repair can be lifesaving in the case of post-AMI VSD with cardiogenic shock.

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항동맥경화 활성 바이오소재 개발 연구 동향 및 활용 전망 (Current Status and Application Prospects of Anti-Atherosclerotic Active Biomaterials)

  • 김승희;이정호;유하영
    • Korean Chemical Engineering Research
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    • 제62권2호
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    • pp.133-141
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    • 2024
  • 전세계적으로 발병 및 사망률이 높은 동맥경화증은 뇌졸중, 심근경색 등 심혈관질환의 주요 병증의 원인인 만성 염증성 질환이다. 동맥경화증은 지질 침착으로 인해 죽종(atheroma)이 형성되고, 혈전증이 유발되면서 관련 증상이 발생한다. 동맥경화증의 합성 치료제의 부작용 우려로 인해 생물 유래 항동맥경화 소재 개발의 필요성이 강조되고 있다. 이에 따라 동맥경화증의 개선 및 치료를 위한 바이오소재의 발굴 및 기전 규명 등 관련 연구가 활발히 수행되고 있다. 주로 동맥경화증 발병 관련 인자들을 조절하여 증상을 억제하거나 지연시키는 바이오소재들이 연구되고 있으며, 대표적으로 다당류, 폴리페놀, 코엔자임 Q10이 해당된다. 우수한 활성을 가진 바이오소재의 경우에는 생체 내(동물 모델)에서의 항동맥경화증 활성이 확인되었다. 본고에서는 동맥경화증의 발병 기전을 살펴보고, 항동맥경화증 활성이 보고된 바이오소재의 연구 동향 및 활용 전망을 제시하고자 한다.

중장년 남성 급성심근경색증 환자의 심혈관위험인자 인식 및 치료추구 장애요인 (Perceptions of Barriers to Cardiovascular Risk Factors and Decision to Seek Treatment among Middle-aged Men with Acute Myocardial Infarction)

  • 황선영;권영란;김애리
    • 성인간호학회지
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    • 제22권5호
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    • pp.537-551
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    • 2010
  • Purpose: This study was designed to identify meaningful themes related to the recognition of lifestyle risk factors and barriers in seeking treatment following an acute event of first-time acute myocardial infarction. Methods: A methodological mixed method of thematic content analysis and a quantitative analysis was used. The sample consisted of 120 male patients < 65 years of age who agreed to be in the study were interviewed using a semistructured during 2008-2009. Data were analyzed according to the procedure of thematic content analysis and the meaningful themes were coded into SPSS data for quantitative analysis. Results: Pre-hospital delay greater than three hours reported by 58.3% (n=70) of the sample and similarly 63.3% had no recognition about their symptoms as cardiac in origin. The mean number of risk factors was $3.9{\pm}1.8$ out of 11 when lifestyle and psychosocial factors were included. From the interview data among the 70 patients delayed greater than three hours, thirty-five themes categorized into 12 main themes influenced the delayed decision which was identified according to personal-cognitive, socio-cultural, and contextual factors. Conclusion: Health care providers should consider these themes in designing individual interventions to make lifestyle changes and to facilitate more prompt decisions to seek care.

급성심근경색증 환자 중증도 보정 사망 모형 개발 (Development of Mortality Model of Severity-Adjustment Method of AMI Patients)

  • 임지혜;남문희
    • 한국산학기술학회논문지
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    • 제13권6호
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    • pp.2672-2679
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    • 2012
  • 본 연구는 급성심근경색증 환자의 사망률 측정을 위한 중증도 보정 모형을 개발하여 의료의 질 평가에 필요한 기초자료를 제공하고자 수행되었다. 이를 위해서 질병관리본부의 2005-2008년 퇴원손상환자 699,701건의 자료를 분석하였다. Charlson Comorbidity Index 보정 방법을 이용한 경우와 새롭게 개발된 중증도 보정 모형의 예측력 및 적합도를 비교하기 위해 로지스틱 회귀분석을 실시하였다. 새롭게 개발된 모형에는 연령, 성, 입원경로, PCI 유무, CABG 유무, 동반질환 12가지 변수가 포함되었다. 분석결과 CCI를 이용한 중증도 보정 모형보다 새롭게 개발된 중증도 보정 사망 모형의 C 통계량 값이 0.796(95%CI=0.771-0.821)으로 더 높아 모형의 예측력이 더 우수한 것으로 나타났다. 본 연구를 통하여 중증도 보정 방법에 따라 사망률, 유병률, 예측력에도 차이가 있음을 확인하였다. 향후에 이모형은 의료의 질 평가에 이용하고, 질환별로 임상적 의미와 특성, 모형의 통계적 적합성 등을 고려한 중증도 보정모형이 계속해서 개발되어야 할 것이다.

강화교육 프로그램이 심근 경색증 환자의 질병관련 지식에 미치는 효과 (Effects of Intensive Teaching Program on Knowledge Level of Patients with a Myocardial Infarction(MI))

  • 정혜선
    • 기본간호학회지
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    • 제8권2호
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    • pp.259-269
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    • 2001
  • Purpose: The purpose of this study was to investigate the effects of an intensive teaching program on the knowledge level of MI in patients with a myocardial infarction. Method: The subjects were 47 patients with a myocardial infarction. Of the subjects 23 were assigned to the experimental group and 24 to the control group. The data were collected through a questionnaire (Lee, 1992; Nam, 1998) survey of knowledge level. The data collection was done about MI between September 15, 1999 and December 31, 2000 after hospital discharge. Data were analyzed using the SAS program and the results are as follows. Results: 1. There were no significant difference in knowledge level of the MI (P=0.621) between the two groups before the teaching program was given. 2. After 4 weeks the knowledge level about MI was significantly higher in the experimental group compared to the control group (P = 0.000). 3. After 12 weeks the knowledge level about MI was significantly higher in the experimental group compared to the control group (P= 0.000). 4. After 4 weeks the experimental group was at a higher scores of knowledge category about MI for nature of disease (P=0.000). risk factors, (P=0.000), diet (P=0.000), medication (P=0.000) exercise and daily activities (P=0.000) as compared to the control group. 5. After 12 weeks the experimental group was at a higher scores of knowledge category about MI for nature of disease (P=0.000). risk factors (P=0.001). diet (P=0.000), medication (P=0.000) exercise and daily activities (P=0.000) as compared to the control group. Conclusion: The above findings indicate that the intensive teaching program used for the experimental group in this study was effective in increasing the knowledge level about MI of the patients with a myocardial infarction.

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급성심근경색증 환자의 성별에 따른 치료추구지연과 관련 경험의 비교 (Gender Differences in Delay Seeking Treatment and Related Experiences in Patients with Acute Myocardial Infarction)

  • 원미숙;신나미;김은숙
    • 성인간호학회지
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    • 제28권4호
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    • pp.459-469
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    • 2016
  • Purpose: This comparative descriptive study was to identify gender differences in delay seeking treatment and related experiences in patients with acute myocardial infarction (AMI). Methods: Ninety-seven participants were recruited from a tertiary hospital. Results: Mean age of 47 women was $71.5{\pm}13.3$ while that of men was $55.0{\pm}10.9$ (p<.001). More women lived alone and were jobless, less educated, and poorer than men. Men were likely to be 'current smokers' and drink alcohol, however viewed themselves healthier than women (p=.030). Women's hospital stay was $9.23{\pm}21.04$ days while men's was $4.86{\pm}2.72$ days (p=.014). More women had been diagnosed with hypertension (p=.040). Women appeared to report significantly less pain ($6.46{\pm}3.1$) than men ($8.44{\pm}1.8$). More men described their pain as sudden onset (p=.015) and chest pain as major symptom (p=.034) than women. More women were found alone upon onset of symptoms (p=.023) and had important reasons for delay seeking treatment (p=.021) than men. Median time from onset of symptoms to seeking medical service was 1.5 hours for men and 5.1 hours for women (p=.003). Median time taken from onset of symptoms to hospital for therapy was 3.5 hours for men and 9.1 hours for women (p=.019). Conclusion: This study findings that women reported less pain and delayed in seeking treatment, suggest needs for strategies targeting women at risk of AMI.

관상동맥 우회로술시 심근보호법에 따른 수술결과의 임상분석 (Clinical Analysis of Coronary Artery Bypass Graft Surgery According to Cardiac Protection)

  • 이서원;이계선
    • Journal of Chest Surgery
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    • 제30권10호
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    • pp.961-965
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    • 1997
  • 대전을지병원 흉부외과에서는 1991년 10월 부터 1996년 4월까지 27명의 관상동맥우회로술을 시행하였으며 심정지액을 사용한 A그룹과 사용하지않은 B그룹으로 구분하여 조사하였다. 남자는 17명, 여자는 10명 이었 으며 연령은 45세에서 76세까지 분포하였으며 평균연령은 65세였다. 술전 임상소견으로는 안전성 협심증 11 례,불안전성 협심증 13례, 심근경색후 협심증이 3례였다. 동반질환으로 고혈압 7례, 당뇨병 5례 및 기타질환 이 3례있었다. 환자당 평균 혈관문합수는 A군에서 2.0개소, B군에서는 2.83개소의 원위문합을 하였다. 대동 맥 차단시간은 A군에서 54.7분, B군에서는 18.5분이었다. 술중 혹은 술후 발생한 심근경색증은 A군에서 2례, B군에서 3례 였으며, 전체파망율은 4례론 14.8%이며 B군의 사망율은 8.3%였다.

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심혈관질환자의 활동 제한이 정신건강과 삶의 질에 미치는 영향 (Effect of Activity Restriction on Mental health and the Quality of Life among patients with Cardiovascular Disease)

  • 김현수
    • 융합정보논문지
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    • 제11권3호
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    • pp.87-94
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    • 2021
  • 본 연구는 2016년~2018년도에 수집된 국민건강영양조사 7기 자료의 2차 분석을 통해 심혈관질환자의 활동 제한 여부에 의한 정신 건강과 삶의 질을 확인하였다. 연구대상자는 자료대상자 총 24,269명 중 협심증이나 심근경색 진단 병력이 있는 530명의 성인에서 변수의 누락이 없는 521명이다. SAS 9.4 version으로 활동 제한 유무에 따른 정신 건강과 삶의 질 차이를 Chi-square방법, 활동 제한에 의한 정신 건강과 삶의 질 영향을 Logistic regression 통계 방법으로 분석하였다. 분석 결과 활동 제한이 있을 때 스트레스 정도, 최근 2주간 우울감과 자살 생각 정도가 높아 정신 건강에 유의한 영향이 있었다. 활동 제한이 있을 때 운동능력, 자기관리, 일상활동에 더욱 지장이 있다고 느꼈고, 통증/불편감과 불안/우울감이 증가하여 삶의 질 역시 유의한 영향이 있었다. 따라서 심혈관질환자의 정신 건강 및 삶의 질 증진을 위해 활동 제한을 최소화할 수 있는 효과적인 신체 활동 증진프로그램의 개발 및 운영이 필요함을 제언한다.

ST분절 상승 심근경색증에서 혈전용해술 후 발생한 후복강 출혈 1예 (Retroperitoneal Hemorrhage after Thrombolysis in ST Elevation Myocardial Infarction)

  • 문민영;이종영;원성현;김정석;남광우;김창래;이진서;지원준
    • Journal of Yeungnam Medical Science
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    • 제29권2호
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    • pp.125-128
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    • 2012
  • Bleeding is the most common and serious complication of thrombolysis in ST elevation myocardial infarction. Most bleeding cases are associated with an intervention or operation, but spontaneous bleeding such as gastro-intestinal bleeding or intracranial hemorrhage can happen. This is a report on the case of a 76-year-old female patient with retroperitoneal hemorrhage due to spontaneous right colic artery branch bleeding after thrombolysis in ST elevation myocardial infarction.

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초발 급성 심근경색증 환자의 불확실성과 자가간호 역량 및 생리적 지표 (Uncertainty, Self-care Agency and Physiological Index in Acute Myocardial Infarction Patients who Underwent Primary Percutaneous Coronary Intervention)

  • 조숙희;전경숙
    • 보건의료산업학회지
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    • 제9권4호
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    • pp.105-117
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    • 2015
  • Objectives : The aim of this study was to investigate the relationship among uncertainty, self-care agency and physiological index in acute myocardial infarction (AMI) patients who underwent primary percutaneous coronary intervention. Methods : A total of 196 patients who were admitted C National University Hospital from Oct 2014 to Jun 2015 participated in the study. Data were collected with a questionnaire, and the blood pressure, HgA1C, and lipid profile levels of the patients were acquired. Results : The mean age was 69.2 (${\pm}13.0$) years, and 74 % of the patients were men. The mean score for uncertainty in illness was 48.7 (${\pm}8.8$). The mean score for self-care agency was 73.3 (${\pm}13.4$). Self-care agency showed a negative correlation with uncertainty (r=-.579, p<.001), age (r=-.732, p<.001), systolic blood pressure (r=-.265, p=.001) and HgA1C (r=-.293, p<.001). Conclusions : The results of this study can be used to develop a nursing program that prevents AMI and to improve the clinical prognosis of AMI patients.