• 현장농수산연구지
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• 제10권1호
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• pp.91-99
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• 2008

무균돼지 생산을 위하여 임신 111일령에서 113일령 사이의 미니돼지 모돈 22두에 대하여 자궁적출술을 실시하였다. 모돈 14두에 대하여 Ketamine 50^®과 CO₂ 가스를 사용하였고 모돈 8두에 대하여는 slaughter pistol을 사용하여 고정 한 후 복부 정중선을 절개하여 자궁을 적출하고 적출된 자궁을 다시 절개하여 신생자돈을 생산하였다. 1. Ketamine 50^®을 0.09㎖/kg과 0.03㎖/kg 용량으로 주입하였을 경우 자궁적출까지 소요된 수술시간은 각각 146초와 283초로서 앞의 경우가 짧았지만, 생산된 신생자돈 1두가 완전히 소생되기까지는 427초와 64초가 소요되어 용량이 적을수록 자돈이 빠르게 활력을 회복하였다. 2. Ketamine 50^®과 slaughter pistol을 사용하여 자돈 작출완료 까지의 수술경과시간은 각각 470초와 155초로서 slaughter pistol을 사용한 경우가 매우 짧았다. 3. 자돈의 생존율에 있어서는, Ketamine 50^®을 사용한 경우에서 111두 중 93두(83.8%)를 소생시켰으나 slaughter pistol을 사용한 경우는 66두 중 64두(97%)를 소생시켜 훨씬 높아보였지만 통계처리 결과 유의성이 없는 것으로 나타났다. 4. 자궁적출술을 실시한 임신 111일령의 자돈의 폐사두수는 0.29두였고 임신 113일령의 자돈은 0.50두였으나 서로간의 유의성이 없었기 때문에 분만 3일전의 모돈도 자궁적출술을 이용한 무균돼지 생산에 아무런 문제없이 사용될 수 있을 것으로 판단되었다. 5. 자궁내 산자수가 많음에 따라 자돈작출에 시간이 더 소요되는 경향이 있었으나 자돈의 생존율과는 큰 관련이 없었다.

• 한국산학기술학회논문지
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• 제16권4호
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• pp.2639-2646
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• 2015

본 연구는 수술 전 수술실 간호사의 지지간호중재가 자궁적출술 환자의 불안에 미치는 효과를 검정하기 위한 유사실험 연구이다. 2013년 5월 1일부터 6월 20일까지 불안, 혈압, 맥박에 대한 자료를 수집하였고, 통계 검정은 SPSS 20.0을 이용하여 $x^2-test$, Fisher's exact test, t-test를 수행하였다. 대조군 25명은 기존의 간호중재를 받았고 실험군 25명은 지지간호중재를 받은 자궁적출술 환자이다. 불안(p=.002), 이완기혈압(p=.012), 수축기 혈압(p=.045)은 대조군에 비해 실험군이 유의하게 낮았고 맥박수는 대조군과 실험군에서 유의한 차이가 없었다. 결과적으로 수술 전 지지간호중재가 환자의 불안을 감소시키는데 효과적인 것으로 확인되었다.

• Radiation Oncology Journal
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• 제17권1호
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• pp.23-29
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• 1999

목적 : 종괴가 큰 병기 IB, IIA와 IIB 자궁경부암 환자에서 방사선치료와 근막외 자궁적출술(extrafascial hysterectomy)의 효과를 알아보기 위해 본 연구를 시행하였다. 재료 및 방법 : 1986년 4월부터 1997년 12월까지 계명대학교 동산의료원 치료방사선과에서 큰 종괴로 방사선치료를 받고 잔여종양(residual lesion)이 의심되어 근막외 자궁적출술을 받은 자궁경부암환자 24명을 대상으로 하였다. 환자의 분포는 병기 IB, IIA가 각각 7명, 9명, 병기 IIB가 8명 이었고 평균연령은 42세이었다. 병리조직학적으로 편평상피암이 16명, 선암이 8명이었고 종괴의 크기는 5cm미만이 7명, 5cm이상이 17명이었다. 방사선치료후 근막외 자궁적 출술까지의 평균 기간은 57일이었다. 방사선치료는 외부 방사선치료로 전골반강에 하루에 180cGy씩 평균 5000cGy를 조사하였으며 평균 4100cGy후 4${\times}$10cm 중간차폐를 하였고 A 지점에 전체 조사량이 평균 7500cGy(최대 8500cGy)가 되도록 고선량 강내조사를 시행하였다. 최장기 및 중앙 추적기간은 각각 107개월, 42개월이었다. 결과 : 전체 환자중 근막외 자궁적출술을 시행한 조직에서 잔여종양이 있는 환자는 41.7%(10/24)이었으며 5년 생존률과 5년 무병생존률은 각각 63.6% 62.5% 이었다. 병기별 5년 생존률은 IB, IIA, IIB에서 각각 71.4%, 71.4%,%이었다. 5년 생존률과 5년 무병생존률은 잔여종양의 유무에 따라 83.3% 대 40%(P=0.01), 83.3% 대 36%(P=0.01)로 통계적으로 유의한 차이를 보였다. 선암이 편평상피암보다 높은 5년생존률과 5년무병생존률[(85.7% 대 53.3%(P=0.1), 85.7% 대 50.9%(P=0.1)로 유의한 경향을 보였다. A지점 조사량에 따른(7500cGy이하, 7500cGy이상) 잔여종양의 유무와 생존률에 차이는 없었다. 잔여종양이 있는 경우에서 없는 경우보다 통계적으로 유의하게 국소재발(5/10, 0/l4, P=0.003)이 많았다. 치료에 의한 사망은 없었다. 결론 : 방사선치료후 잔여종양이 의심되는 종괴의 크기가 큰 자궁경부암에서는 방사선량을 증가 시킴에도 불구하고 잔여종양의 유무와 생존률에 차이가 없었다. 선암의 경우는 환자의 수는 적으나 방사선치료와 근막외 자궁적출술이 상당히 높은 생존률을 보이므로 더 많은 환자를 대상으로 연구하여 근막외 자궁적출술이 선암환자의 생존에 미치는 영향을 확인 할 필요가 있겠다.

• Radiation Oncology Journal
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• 제21권3호
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• pp.199-206
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• 2003

목적: 자궁경부암에서 수술 후 위험인자가 있는 환자에 방사선치료 후 생존율, 국소 제어율과 예후인자를 후향적으로 분석하여 수술 후 방사선치료의 효과를 알고자 한다. 대상 및 방법: 1986년 3월부터 1998년 12월까지 자궁경부암 FIGO 병기 IB-IIB로 자궁적출술 후 방사선치료를 받은 58명을 대상으로 국소 제어율, 5년 무병생존율과 생존율에 미치는 예후인자를 후향적으로 분석하였다. 수술 후 방사선치료의 적응증은 병리학적으로 림프절에 전이된 경우, 암이 수술절제연이나, 자궁주위조직 혹은 자궁체부에 침범하였거나, 림프혈관강에 침범된 경우, 자궁기질의 1/2 이상 깊이 침윤된 경우와 단순 자궁적출술 후 암으로 진단받은 환자로 하였다. 수술 후 방사선치료는 모든 환자에서 골반강에 외부조사를 시행하였으며 5명은 외부조사와 강내조사를 병용하였다. 외부조사는 6 MV x-선을 이용하여 매일 180 cGy를 4문으로 조사하였으며 총 방사선량은 $4400\~5040$ cGy (중앙값: 5040 cGy)이었다. 강내조사는 외부조사 후 2주에 Cs-137를 이용하여 저선량률로 질 표면에서 5 mm 깊이에 $4488\~4932$ cGy (중앙값: 4500 cGy)를 시행하였다. 추적기간은 15개월에서 108개월로 중앙값은 44개월 이었다. 결과: 전체환자의 5년 무병생존율은 $94\%$, 국소 제어율은 $98\%$,이었으며 원격 전이율은 $5\%$이었다. 병기에 따른 5년 무병생존율은 $IB\;97.1\%,\;IIA\;100\%,\;IIB\;68.9\%$(p=0.0145)이었다. 질 절제연에 암의 침범이 없는 경우 5년 무병생존율이 $97.8\%$, 있는 경우 $60\%$, (P=0.0002)이었으며, 자궁주위조직에 암이 침범이 없는 경우의 5년 무병 생존율은 $97.8\%$이었고, 있는 경우는 $33.3\%$이었다(p=0.0001). 다변량 분석에 의하면 자궁주위조직의 침범만이 통계학적으로 의의있는 예후인자이었다. 치료 후 만성합병증은 3명($5\%$,)에서 RTOG grade 2의 방광염, 1명에서 grade 2의 직장염과 1명에서 하지에 림프부종이 나타났다. 결론: 조기 자궁경부암 환자에 단순 자궁적출술을 시행하였거나, 근치적 자궁적출술 후 병리학적으로 재발 위험 인자가 있는 환자에 수술 후 방사선치료를 시행하여 심각한 부작용 없이 비교적 높은 국소 제어율과 생존율을 얻을 수 있었다. 생존율에 영향을 미치는 예후인자는 병리학적으로 암이 자궁주위조직에 침범된 것으로 예후가 불량하였다. 수술 후 방사선치료의 실패원인과 예후인자를 분석한 본 후향적 연구결과를 토대로 앞으로 방사선치료와 항암화학요법을 병용하여 보다 적극적이고 전향적인 연구를 시도하는데 이정표로 이용할 수 있다고 생각한다.

• 여성건강간호학회지
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• 제8권3호
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• pp.380-388
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• 2002

The purpose of this Quasi-experimental design was to assess the effects of a hysterectomy on women's emotional response and ultimately, to develop a nursing protocol recommending nursing education for women undergoing a hysterectomy. The subjects at D university hospital receiving a hysterectomy,(for benign gynecological disease) were invited to participate in the study. Subjects who agreed to participate were allocated into control or experimental groups. Each group consisted of 30 women. The subjects emotional adaptation was surveyed through mood questionnaires. The data were analyzed using SAS program. The findings of the study are as follows: In the post test, the "experimental group" reported higher emotional adaptation than the "control group". Between pre and post testing, the "experimental group" showed significant improvement in emotional response; the "control group" did not. In conclusion, allocating nursing information to women both before and after undergoing a hysterectomy was confirmed as an effective nursing intervention for promoting women's emotional adaptation. Therefore, we propose a nursing protocol should be adapted recommending nursing education for women undergoing a hysterectomy.

• 여성건강간호학회지
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• 제16권1호
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• pp.60-68
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• 2010

Purpose: This study determined the effect of head and neck massage on anxiety, pain, and discomfort for hysterectomy patients. Methods: Subjects consisted of 48 hysterectomy patients at K hospital. Experimental group (n=23) received head and neck massage at 8 minutes per massage for five times: (at admission, before sleeping on preoperative day, at 4 hours after operation, before sleeping on operation day, before sleeping on the first postoperative day). Control group (n=25) received conventional treatment. As an effectiveness of this intervention, state of anxiety and BP was measured before sleeping on preoperative day. Pain and discomfort were measured before sleeping on the day of surgery and then on the first postoperative day. Data was analyzed descriptive statistics using $x^2$ test, Fisher's exact test, paired t-test, unpaired t-test, repeated measures ANOVA and Bonferroni multiple comparison. Results: 1. State of anxiety score and BP at post-treatment decreased significantly in the experimental group. 2. Pain score in experimental group was lower than that in control group, with no significant difference; whereas, 3. Discomfort level decreased significantly in the experimental group. Conclusion: Results indicate that head and neck massage could be an effective intervention for reducing preoperative anxiety and postoperative discomfort in hysterectomy patients.

• 여성건강간호학회지
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• 제16권4호
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• pp.409-418
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• 2010

Purpose: The purpose of this study was to identify the effects of a pre-operation video assisted education program on residual urine, gas passing and state anxiety in women undergoing hysterectomy. Methods: Nonequivalent control group non-synchronized design was used for the study. In the research, video assisted education program was applied to the experimental group while a similar conventional education was done to the control group. The pre-operation state anxiety and post-operation residual urine and gas discharge of both the groups were measured. The data were analyzed using SPSS. Results: The experimental group was significantly higher than control group on gas passing (t=3.04, p=.00). However the residual urine (t=0.34, p=.73) and state anxiety (t=0.81, p=.82) did not make significant differences. Conclusion: This study is very meaningful in that it developed and provided a nursing intervention can positively affect hysterectomy patients. The pre-operation video assisted education program may be an effective nursing intervention that is clinically practical and useful to reduce time of the gas passing of hysterectomy patients after the operation.

• 여성건강간호학회지
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• 제23권1호
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• pp.42-51
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• 2017

Purpose: This study was conducted to compare postoperative complications, hospitalization days and treatment expenses to postoperative prophylactic antibiotics administrated to hysterectomy or not. Methods: A retrospective survey study was performed with 128 cases in which elective hysterectomy had undergone. They were divided into two groups by identifying whether postoperative prophylactic antibiotics was administered for hysterectomy: a) one group who received postoperative prophylactic antibiotics and; b) those who did not. Data were collected using the electric medical record at a hospital and analyzed by SPSS 23.0 for $x^2$ test, t-test and ANCOVA. Results:Postoperative complications including wound infection (p=1.000), pneumonia (p=.496), hematoma (p=.530), and pneumoperitoneum (p=.496) showed no significant differences between two groups. Hospitalization days for the prophylactic antibioticsadministrated group were significantly longer than the non-administered for prophylactic antibiotics (p=.004). The treatment expenses of the prophylactic antibiotics-administrated group were significantly higher than those of the non-administered prophylactic antibiotics (F=4.31, p=.040). Conclusion: These results can be provided for the evidence of administrating postoperative prophylactic antibiotics to hysterectomy. Additionally, it can contribute to decreasing the medication errors caused by infrequently administrating postoperative prophylactic antibiotics as well as to lessening likelihood of infection of intravenous injection site.

• 대한간호학회지
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• 제20권3호
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• pp.357-367
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• 1990

This descriptive study was done to identify factors influencing sexual satisfaction in women who had had a hysterectomy and to compare these with women who had not had a hysterectomy. The purpose was to contribute theoretical understanding on which to base nursing care planning. One group of subjects were 156 women who had had a hysterectomy, between one and 18 months post surgery, living with their spouse, having no complications, and menstruating before surgery. The other group of subjects were 282 healthy women who were living with their husbands and menstruating. The study tool consisted of 108 items including item concerning personal characteristics, characteristics related to the hysterectomy, husband's support, body image, emotions, attitude toward the sexual relationship, knowledge of sexuality, sexual behavior, and sexual satisfaction. Sexual satisfaction was measured by a tool based on Derogatis Sexual Function Inventory. The range of the internal level of the study tool was from. 5208 to .9462. Data collection was done during the period from June 20 to Aug.20, 1989. The same questionnaire was used of data collection for both groups, but a mail survey method was used for the women who had had a hysterectomy, and an interview method was used for the women who had not had a hysterectomy. Data analysis was done using frequency, ratio, mean and S.D. for the characterstics of the subjects and level of sexual satisfaction. t - test or ANOVA was used for the differences between the groups with regard to the general and hysterectomy related characteristics. The relationship between the score for sex life related factors and the level of sexual satisfaction was analyzed using the Pearson Correlation, and the influencing factors on sexual satisfaction were analyzed by stepwise multiple regression. The results of this study were as follows ; 1. Mean age and income level were the only general characteristics for the two groups that were significantly different. The mean age, and income level of the group who had had a hysterectomy were 45years, and 1,150,000 won respectively, and for those who had not had a hysterectomy, 41 years and 999,000 won. 2. There was no statistical difference of the sexual satisfaction score between the two groups. 3. There was differences in the factors influencing sexual satisfaction between the two groups. Factors influencing sexual satisfaction for the group who had had a hysterectomy were husband's support (R＝.5793, P＝.000) and the women's Knowledge of sexuality(R＝.6670, P＝.000) (total variance : 33.56). On the other hand, emotional status(R＝.4294, P＝.000), sexual behavior(R＝.4294, P＝.000), husband's support(R＝.5274, P＝.000) and attitude towards sexual relations (R＝.5412, P＝.000) (total variance : 54.12) were the factors influencing sexual satisfaction in the group who had not had a hysterectomy. Since husband's support and sexuality knowledge were identified as factors influencing sexual satisfaction of women who have had a hysterectomy, it can be concluded that, before a woman who has had a hysterectomy is discharged from hospital, nurses should include strategies in the nursing care plan that will promote husband's support and the women's knowledge of sexuality.

• 여성건강간호학회지
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• 제8권2호
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• pp.177-189
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• 2002

Sexual health education for the patients is an independent function as well as a professional responsibility of nurses. Education should be based on the needs of patients in order to be successful and effective. Therefore nurses must identify sexual health education needs of their patients. A sexual health education protocol for hysterectomy patients was developed by the researcher for this study and included physiosexual and psychosexual topics as well as the topic of sexual interaction. The subject pool was composed of 108 post op total hysterectomy patients who had undergone doing a hysterectomy 5 to 10 days previously at 5 hospitals located in the Seoul and Kyunggi-do area from July 23 to September 30, 2001. The questionnaire was composed of 60 items on sexual health education and used a Likert-type 4-point scale. Internal consistency of this questionnaire in this study was cronbach's $\alpha$=.9495 for sexual health educational needs. For data analysis, the study executed a t-test, ANOVA, and Duncan's Test, in accordance with the purpose of the study using SPSS/PC Win 10.0. The results were as follows: The need for education was highest in the psychosexual area (3.38 point) with education related to sexual interaction the lowest (3.20 point). Osteoporosis (3.75 point) was ranked overall as the highest area of educational need. The degree of educational need varied in correlation with other characteristics of the patients including age, status of marriage, duration of marriage, religion, academic career, monthly income, occupation, the number of children age of menarche, menstruation, other diseases except gynecological disease, previous genital organ operation experience, disease discovery method, pre-explanation for the hysterectomy, average sexual intercourse frequency, how to acquire sexual health information and previous sexual health education (p<.05). In conclusion, the degree of sexual health education needs of hysterectomy patients was very high. Therefore, sexual health educational programs planned according to characteristics of the participating women is necessary.