• 제목/요약/키워드: 심부정맥 혈전증

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하지 심부정맥혈전증을 가진 중환자의 특성 및 발생 영향 요인 (Risk Factors and Features of Critically Ill Patients with Deep Vein Thrombosis in Lower Extremities)

  • 김화순;조옥민;조효임;김주연
    • 대한간호학회지
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    • 제42권3호
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    • pp.396-404
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    • 2012
  • Purpose: The purpose of this study was to identify the features, risk scores and risk factors for deep vein thrombosis in critically ill patients who developed deep vein thrombosis in their lower extremities. Methods: The participants in this prospective descriptive study were 175 adult patients who did not receive any prophylactic medication or mechanical therapy during their admission in the intensive care unit. Results: The mean age was 62.24 (${\pm}17.28$) years. Men made up 54.9% of the participating patients. There were significant differences in age, body mass index, and leg swelling between patients who developed deep vein thrombosis and those who did not have deep vein thrombosis. The mean risk score was 6.71(${\pm}2.94$) and they had on average 4.01(${\pm}1.35$) risk factors. In the multiple logistic regression, body mass index (odds ratio=1.14) and leg swelling (odds ratio=6.05) were significant predictors of deep vein thrombosis. Conclusion: Most critically ill patients are in the potentially high risk group for deep vein thrombosis. However, patients who are elderly, obese or have leg edema should be closely assessed and more than one type of active prophylactic intervention should be provided.

일 지역 병원간호사의 심부정맥혈전증에 관한 지식과 간호수행 (Nurses' Knowledge and Compliance on Deep Vein Thrombosis)

  • 최동옥;민혜숙
    • 중환자간호학회지
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    • 제4권1호
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    • pp.75-87
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    • 2011
  • Purpose: This study was done to investigate the DVT-related knowledge and compliance of hospital nurses. Methods: A survey questionnaire was administrated to a convenience sample of 367 nurses working at 3 university hospitals and 4 general hospitals located in Busan. Results: The mean score of DVT-related knowledge was $16.86{\pm}$3.40$ points out of 26, with a percentage of correct answers of 64.8%. The mean score of DVT-related compliance was $21.40{\pm}6.42$ points out of 32. There was a significant correlation between hospital nurses' DVTrelated knowledge and compliance (r=.309, p=.000). The factors for predicting hospital nurses' DVT-related compliance included knowledge of treatment and care areas, the subcategories of DVT knowledge (${\beta}$=.214), knowledge of the area of risk factors (${\beta}$=.105), whether to perform DVT prevention and treatment based on protocols (${\beta}$=.193), the existence of DVT protocols (${\beta}$=.168) and the degree of interest in DVT (${\beta}$=.102) and the total explanatory power of these was 21.3%. Conclusion: To improve compliance on preventing DVT effectively, it is necessary to improve nurses' DVT-related knowledge and interest in DVT through appropriate education. And, it is necessary to develop standardized protocols and guidelines.

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전이성 위암환자의 심부정맥혈전증에 대한 저분자량 헤파린 투여 사례 (A Case of Advanced Gastric Cancer with Deep Vein Thrombosis Treated with Low Molecular Weighted Heparin)

  • 허수진;박찬혁;이상길
    • Journal of Digestive Cancer Research
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    • 제1권2호
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    • pp.108-110
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    • 2013
  • 전체 정맥혈색전증 환자의 20% 이상이 암과 관련이 있고, 암 환자에 있어 혈색전증은 두 번째 사망 원인으로 작용하고 있어 이에 대한 효과적인 예방과 치료가 사망률을 감소시킬 수 있는 것으로 알려져 있다. 혈색전증 진단에 있어 혈액검사로 D-dimer 측정 및 영상검사로 도플러 초음파, 전산화단층혈관 촬영술을 사용한다. 치료 약제로 경구 비타민 K 길항제가 사용되었으나, 최근에는 정기적인 모니터링이 필요하지 않은 약제들이 새롭게 사용되고 있다. 저자들은 진행성 위암환자에서 발생한 하지 심부정맥 혈전증 및 폐동맥 혈색전증에 있어 저분자량 헤파린을 투여하며, 호전된 사례를 문헌고찰과 함께 보고하는 바이다.

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과호모시스턴혈증에서 발생된 다발성 혈전증 1예 (A Case of Multiple Thromboembolisms in Hyperhomocysteinemia)

  • 박재선;배원기;이상준;정내인;진성림;이혁표;김주인;최수전;염호기
    • Tuberculosis and Respiratory Diseases
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    • 제47권2호
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    • pp.239-246
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    • 1999
  • 저자등은 우하지 동통 및 객혈을 주소로 내원하여 우하지 심부정맥혈전증, 폐색전증 및 뇌정맥혈전증으로 환자에서 과호모시틴혈증이 다발성 혈전증의 원인이었던 1예를 경험 하였기에 문헌고찰과 함께 보고하는 바이다.

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인공 슬관절 전치환술 후 발생한 May-Thurner 증후군 (May-Thurner Syndrome after Total Knee Arthroplasty)

  • 심창헌;박진우;왕립
    • 대한정형외과학회지
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    • 제56권3호
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    • pp.277-281
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    • 2021
  • 장골정맥 눌림 증후군으로 알려져 있는 May-Thurner 증후군은 May와 Thurner에 의해 1957년 처음으로 기술되었다. 좌측 하지에서 침습적인 처치 없이 심부 정맥 혈전증의 증상이 나타날 때 May-Thurner 증후군을 의심할 수 있다. 저자들은 우측 인공 슬관절 전치환술 후 좌측 하지의 급작스러운 통증, 부종 및 피부색 변화를 보여 컴퓨터 단층촬영 정맥 조영술 시행 후 May-Thurner 증후군을 진단 받은 중년 여성 환자의 흥미로운 증례를 경험하였다. 본 증례를 통해서 우측 인공 슬관절 전치환술 후 간과할 수 있는 좌측 하지 May-Thurner 증후군을 조기에 진단하여 합병증을 예방하는 데 임상적 의의가 있다고 본다. 이에 문헌 고찰과 함께 증례를 보고하고자 한다.

복부구획증후군 환자에서 발생한 심부정맥혈전증 (The Occurence of Deep Vein Thrombosis in Abdominal Compartment Patient)

  • 김성엽;진성찬
    • Journal of Trauma and Injury
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    • 제26권4호
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    • pp.312-315
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    • 2013
  • Abdominal compartment syndrome is one cause of deep vein thrombosis of lower extremity. Although prophylactic dose of anticoagulation agent is safely started after 24~48 hours without the evidence of active bleeding, there may be bleeding complication related to invasive procedure which trauma victims undergo. Inferior vena cava filter should be considered in the treatment plan of this complex situation.

심방중격결손을 통해 좌심방으로 유입되어 있는 혈전을 동반한 급성 폐동맥 혈전색전증의 치험 (Treatment of Acute Pulmonary Thromboembolism with Left Atrial Thrombus via Atrial Septal Defect - A case report-)

  • 김시욱;최재성;유재현;임승평;이영;나명훈
    • Journal of Chest Surgery
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    • 제37권12호
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    • pp.1010-1014
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    • 2004
  • 급성 폐동맥 혈전색전증은 대부분 혈전용해제나 항응고제 등을 이용하여 내과적으로 치료하나, 폐동맥 혈전색전증에 의한 급성 우심실 부전이 발생하는 경우에는 신속히 수술을 하지 않으면, 단시간 내에 치명적인 결과를 가져올 수 있으며, 우심혈전이 동반되어 있는 경우 그 사망률은 훨씬 높아지고, 개방형 난원공을 통한 역리성 색전증(paradoxical embolism)이 보고되고 있다. 그러나 본 증례에서와 같이 우심방의 혈전이 심방중격결손을 통해 좌심방으로 유입되는 것이 관찰되는 예는 극히 드물다. 직장암으로 저위전방절제술을 받은 63세 남자 환자에서 수술 직후 심부정맥혈전증에 의해 생긴 우심실부전을 동반한 급성 페동맥 혈전색전증을 응급개심술을 통해 좋은 결과를 얻었기에 보고하는 바이다.

수술환자의 심부정맥혈전증 예방 지침 수용개작 (Development of the Prevention Guideline of Deep Vein Thrombosis in Patients with Surgery according to the Guideline Adaptation Process)

  • 윤지현;이인선;이경윤;장미자;이정민;남민선;박지현;황지원;송현주;조용애;권인각;김미영
    • 임상간호연구
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    • 제20권3호
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    • pp.337-347
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    • 2014
  • Purpose: Deep Vein Thrombosis (DVT) is the cause of fatal diseases such as pulmonary embolism, due to a prolonged immobility, surgery, paralysis, and injuries. This study aimed to develop an evidence-based practice guideline for DVT prevention and apply it to patients with surgery in diverse nursing sites in South Korea. Methods: A 24-staged processes of adaptation was carried out on the basis of "adaptation of nursing practical guidelines" developed by Gu et al., in 2012. Results: Developed nursing guidelines of DVT prevention are composed of 79 recommendations in 8 domains. The extent and ratings of each recommendation with its evidence were addressed along with the background information. Conclusion: The developed DVT prevention guideline is necessary to be added to the evidence-based practice guidelines for the fundamentals of nursing practice. The developed guideline is needed to be disseminated to diverse nursing clinical settings in order to prevent DVT and enhance the quality nursing care.

하지압박요법이 중증 뇌손상 환자의 대퇴 정맥 혈류 속도변화에 미치는 영향 (Effects on Changes in Femoral Vein Blood Flow Velocity with the Use of Lower Extremity Compression for Critical Patients with Brain injury)

  • 김정숙;김혜정;우연희;임지영;이철형
    • 대한간호학회지
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    • 제39권2호
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    • pp.288-297
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    • 2009
  • Purpose: This study was done to evaluate the mean venous velocity (MVV) response with knee and thigh length compression stockings (CS) versus intermittent pneumatic compression (IPC) devices in immobile patients with brain injuries. Methods: We carried out a randomized controlled study. We analyzed both legs of a randomly chosen sample of 43 patients assigned to one of 4 groups (86 legs). The patients were sequentially hospitalized in the intensive care unit (ICU) in "S hospital" from November 2005 to December 2006. The base line and augmented venous velocity was measured at the level of the common femoral vein. We applied leg compression 42 times over 7 days (for 2 hours at a time at 2 hour intervals). Results: There was a statistical difference among the 4 groups. The difference for the "IPC" group was more significant than the "CS" group. Conclusion: These results indicate that the application of IPC can be considered as an effective method to prevent deep vein thrombosis for immobile patients with brain injury.

하대정맥 필터 삽입 후 합병증으로 발생한 Phlegmasia Cerulea Dolens 1예 (A Case of Phlegmasia Cerulea Dolens as a Complication Caused by Placement of Inferior Vena Cava Filter)

  • 조영신;김종화;이호성;최재성;나주옥;서기현;김용훈
    • Tuberculosis and Respiratory Diseases
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    • 제65권3호
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    • pp.225-229
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    • 2008
  • 저자들은 폐색전증과 심부정맥 혈전증을 이전에 진단받았던 말기 전립선암환자에서 외상성 뇌출혈로 인해 항응고제 치료를 시행하지 못하여 하대정맥 필터를 삽입 후 하지 부종, 하지 맥압 소실, 급성 신부전 및 DIC 등으로 사망한 phlegmasia cerulea dolens 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.