• Title/Summary/Keyword: 화상환자

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The Correlation Between Defense Mechanism and Posttraumatic Stress Disorder in Burn Patients (화상 환자의 방어기제와 외상후 스트레스 장애와의 관련성)

  • Lee, Dowon;Choi, Yanghwan;Kim, Jong Dae;Son, Kyung-Lak;Im, Woo Young;Jun, Jin Yong
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.191-198
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    • 2021
  • Objectives : This study was designed to investigate the correlation between defense mechanism and posttraumatic stress disorder in burn patients. Methods : We recruit 40 burn patients and we evaluate sociodemographic characteristics, characteristics related to burn, korean version of Impact of Event Scale-Revised (IES-R), Korean Version of Center for epidemiologic studies depression scale (CES-D) and Ewha Defense Mechanisms Test (EDMT). Multiple regression analysis was performed to evaluate the correlation between EDMT score and IES-R score. Results : Factor 2 of EDMT which consists of Ego-expansion subjects was significantly correlate with IER-S score. In factor 2, Controlling (β=-0.299, p<0.05), Sublimation (β=-0.276, p<0.05) is significantly correlate with IER-S score. Conclusions : Some subjects of defense mechanism was significantly correlate with IES-R score. it might be helpful to understand defense mechanism for the posttraumatic stress disorder in burn patients.

The Early Prognosis of Burn Patients with Elevated Initial Arterial Carboxyhemoglobin Level (초기 동맥혈 Carboxyhemoglobin 농도가 높았던 화상 환자들의 예후지표에 관한 연구)

  • Choi, Chang Soon;Kim, Cheal Hong;Kim, Keun Sook;Lee, Tae-Yu;Chung, Youn Son;Eom, Kwang Seok;Park, Young Bum;Jang, Seung Hun;Kim, Dong Gyu;Park, Myung Jae;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck;Kim, Jong Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.2
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    • pp.188-197
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    • 2003
  • Background : Smoke inhalation injury is an important determinant of mortality in burn patients. The early detection of inhalation injury in burn patients is important because the incidence of respiratory failure after inhalation injury was known to be high, with hypoxemia, pneumonia, and prolonged ventilatory support being commonplace. Acute carbon monoxide poisoning was one feature of smoke inhalation. The purpose of our study were to investigate the clinical characteristics of burn patients whose initial arterial carboxyhemoglobin (COHb) level had been elevated, to assess the clinical impact of COHb for smoke inhalation injury. Methods : Among 1,416 burn patients had been admitted at our institution from August 1, 2001 to July 31, 2002, 39 patients whose initial arterial COHb level have been more than 5% were included. We compared clinical scoring system for inhalation injury, percent total body surface area (%TBSA) burn, initial chest X-ray findings, APACHE II scores and SAPS II scores between survivors (n=27) and non-survivors (n=12) retrospectively. Results : COHb level were 9.7(5.71% and 10.3(8.81% in survivors and in non-survivors (p>0.05). Mean %TBSA burn of survivors and non-survivors were $16.6{\pm}17.8%$ and $60.7{\pm}28.8%$ (p<0.001). We did not find any difference in clinical scoring system, initial chest X-ray findings in survivors and in non-survivors. But %TBSA burn, APACHE II and SAPS II scores were high in non-survivors than in survivors significantly. Important factors associated with death were %TBSA burn, APACHE II scores, SAPS II scores, and the most important factor in predicting mortality was %TBSA burn. Conclusion : Burn patients with elevated initial arterial COHb level showed poor prognosis, but further study may be performed to know that the effect of COHb on prognosis in burn patients accompanying smoke inhalation.

Use of Hypnosis in the Management of Patients with Burn Pain (최면을 이용한 화상 환자의 동통 조절)

  • Park, Hee-Gwan
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.2
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    • pp.218-222
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    • 1997
  • Before the dressing and debridement of the wounds, patients received hypnosis and were taught self-hypnosis. They were instructed to let the burn areas being worked on "become relaxed and numb" in the trance. The author encouraged them to imagine wound-healing. Result of this hypnoanalgesia as an adjunct treatment for burn pain proved it most effective and facilitative. Theoretical and practical implications and future research directions were discussed.

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A Case of Cavitary Lung Lesion as a Consequence of Smoke Inhalation Injury (흡입화상 치료과정에서 생긴 공동성 폐 병변)

  • Shin, Hyun Won;Kim, Cheol Hong;Eom, Kwang Seok;Park, Yong Bum;Jang, Seung Hun;Kim, Dong Gyu;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck;Lee, Eil Seong
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.564-570
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    • 2006
  • Toxic gases and soot deposition as a consequence of smoke inhalation can cause direct injury to the upper and lower airways and even to the lung parenchyma. A delay in proper and prompt therapy can be detrimental to critically ill burn patients with an inhalation injury. Therefore, serial chest radiography is an important diagnostic tool for pulmonary complications during treatment. The radiographic findings of the chest include normal, consolidation, interstitial and alveolar infiltrates, peribronchial thickening, atelectasis, cardiogenic and non-cardiogenic pulmonary edema, and a pneumothorax as acute complications of smoke inhalation. In addition, bronchiectasis, bronchiolitis obliterans and pulmonary fibrosis can occur as late complications. We encountered a case of 44-year-old male who presented with acute lung injury after an inhalation injury. He required endotracheal intubation and mechanical ventilation due to respiratory failure. He was managed successfully with conservative treatment. Later, a cavitary lesion of the left upper lobe was observed on the chest radiography and computed tomography, which was complicated by massive hemoptysis during the follow-up. However, the cavitary lesion disappeared spontaneously without any clinical consequences.

Factors Associating Major Burn in Chemical Injury Patients due to Industrial Place Incident : A Retrospective study (산업장 화학 손상 환자에서 중증 화상에 영향을 미치는 요인)

  • Shin, Hee-Jun;Oh, Se-Kwang;Lee, Han-You
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.4
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    • pp.332-339
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    • 2016
  • This study examined the intensity of the association of factors affecting major burns by statistical analysis for patients injured by the release of chemical hazards. A total of 446 patients were evaluated as chemical injury patients, who had visited the emergency room from 1/Jan/2010 to 31/Dec/2014. The major burn was used as a dependent variable representing the severity of chemical injury. A chi-square test (CST) and binary logistic regression test (BLRA) were used as the statistical analysis method for determining the association between major burns and the independent variables. In CST, female and their presence at an incident scene, multiple site injury were associated with major burn (p<0.05). In BLRA, the presence at an incident scene and spills (comparing explosion), discharge (comparing admission) were associated with major burns (p<0.05). In this study, the presence at an incident scene was the most significant factor concerning major burns. Furthermore, gender and injury number, exposure mechanism (spill comparing explosion), and disposition (discharge comparing admission) were also associated with major burns.

Incidence of Hypothermia and Factors Associated with Body Temperature Changes during Surgery in Burned Patients (화상환자의 수술 중 저체온 발생 빈도와 체온변화에 영향을 미치는 요인)

  • Bae, Hye-Young;Kim, Hyunjung
    • Journal of Korean Biological Nursing Science
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    • v.18 no.4
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    • pp.231-238
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    • 2016
  • Purpose: The study aimed to evaluate the changes of body temperature and to identify the factors related to changes during surgery in burned patients. Methods: A retrospective study was conducted by reviewing the medical records of 439 adult burned patients who had a surgery under general anesthesia at the Burn Center of a university hospital. Results: After surgery, body temperature of the burned patients declined from $36.6^{\circ}C$ to $35.2^{\circ}C$; 52.2% were hypothermia. There were significant differences in the changes of body temperature according to the participants' characteristics including American society of anesthesiologists physical status, type of burn injury, total burn surface area, range of exposure, operation time, anesthesia time, amount of fluid, blood transfusion, use of tourniquet, and the method of warming therapy. Factors that influence the temperature changes were total burn surface area (${\beta}=0.26$), operation time (${\beta}=0.25$), amount of fluid (0.20), and warming therapy including 'Room temperature setting + Heated circuit + Hot line'(${\beta}=0.09$) and 'Room temperature setting+one of others'(${\beta}=0.08$). Conclusion: Burned patients experienced a decrease of their body temperature during surgery despite of warming therapy. A nursing protocol is needed to provide an appropriate warming therapy based on their characteristics in burned patients.