• 제목/요약/키워드: Bleeding control

검색결과 515건 처리시간 0.035초

일차 구개성형술 후 발생된 지속적인 술후출혈;증례보고 (CONTINUOUS POSTOPDRATIVE BLEEDING AFTER PRIMARY PALATORRHAPHY;A CASE REPORT)

  • 심정환;김영균;채병국
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제23권5호
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    • pp.458-460
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    • 2001
  • A 11-month-old infancy was referred for treatment of cleft palate. The patient's congenital deformities had included oronasal fistula on the soft palate and bifid uvula. Furrow double-opposing Z-plasty was performed under general anesthesia. However, postoperative bleeding developed at ward. Despite the pressure of operative wound, venous oozing continued and hemoglobin concentration and RBC were decreased (Hb: 5.5g/dL, RBC: $1.98{\times}10^6/mm^3$). The patient was pale and confused and transferred to Surgical Intensive Care Unit(SICU) We could not keep the peripheral venous line and there was a high risk of hypovolemic shock. Emergency transfusion was performed through the central femoral venous line and emergency operation for bleeding control was carried out. We explored the operation site and found bleeding point from the posterior pharyngeal wall. Electrocoagulation and surgicel packing were carried out and bleeding was stopped.

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Spinal Hemangiopericytoma Which Needed Intraoperative Embolization due to Unexpected Bleeding

  • Lee, Chang-Hyun;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • 제54권3호
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    • pp.253-256
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    • 2013
  • Spinal intradural hemangiopericytoma is a very rare tumor and can be characterized by massive bleeding during surgeries, frequent recurrence, and metastasis. However, definite radiologic differential points of hemangiopericytoma are not known. We describe an unexpected hemangiopericytoma case with large bleeding and management of the tumor. A 21-year-old man visited complaining of progressive neck pain and tingling sensation in both hands. Magnetic resonance imaging of his spine revealed C1-2 ventral intradural mass. When the dura was opened, the intradural tumor was placed behind spinal accessary nerves. The tumor was partially exposed only after some accessary nerves had been cut. When internal debulking was performing, unexpected bleeding was noted and it was difficult to control because of narrow surgical field and hypervascularity. Intraoperative spinal angiography and embolization were performed. The tumor was completely removed after embolization. Pathological diagnosis was consistent with hemangiopericytoma. When surgeons meet a flesh-red tumor that bleeds unexpectedly during surgery, hemangiopericytoma may be considered. When feeder control is hard due to reciprocal location of spinal cord, the tumor, and feeders, intraoperative angiography and embolization may be a possible option.

Single Nucleotide Polymorphism in Cytochrome P450 2E1 among Korean Patients on Warfarin Therapy

  • Han, Dong-Hoon;Lee, Min-Jeon;Kim, Jeong-Hee;Lee, Suk-Hyang
    • Biomolecules & Therapeutics
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    • 제14권4호
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    • pp.189-193
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    • 2006
  • This study was designed to assess the distribution of cytochrome P450 2E1 (CYP2E1) polymorphism among Korean patients on warfarin therapy. CYP2E1 polymorphism was analyzed at 5' flanking region of CYP2E1 gene using restriction fragment length polymorphism method. Patient characteristics including the measured internal normalized ratio (INR) were also evaluated. Based on the warfarin dose and the bleeding cases, the patients were grouped as the regular dose control, the regular dose bleeding, the low dose control, and the low dose bleeding. Total 96 patients were evaluated for both Pst I and Rsa I loci of the CYP2E1 gene and the results showed that both loci were tightly linked. Thirty-three patients(34.4%) were heterozygotes and 4 patients(4.2%) were homozygote. There was no significant difference in patient characteristics in the dose and bleeding case groups. CYP2E1 polymorphism showed a little difference among the groups but was not statistically significant, however, lower INR value was observed in homozygote genotype groups. It was also revealed that genotype allele frequencies of CYP2E1 in Korean was close to other Asian groups but was significantly different from other Caucasian and African-American populations.

Case Series: Successful Resuscitation of Severe Facial Injuries Caused by a Chainsaw

  • Choi, Han Joo
    • Journal of Trauma and Injury
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    • 제32권3호
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    • pp.168-171
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    • 2019
  • The treatment outcome remains poor of severe facial injuries because of the high risk of compromised airway or massive bleeding. We experienced two successful treatment cases of severe facial injury by the chainsaw. A 52-year-male had his face injured by the chainsaw during his work. He was transferred to the Level I trauma center using the Doctor-Helicopter. During his flight, bleeding control was tried and the information was given to the trauma surgeons before his arrival. His consciousness was alert and the vital signs were stable. The crushing wound, mandible open fracture, deep laceration of tongue, lip, neck and arterial bleeding were noted around his mandible. Nasotracheal intubation was performed under the bronchoscope-guided. Emergency operation (open reduction & internal fixation, primary repair with neurorrhaphy) was performed. At 30 hospital days, he was discharged with facial palsy on left mandibular area. A 30-year-male had his face injured by the chainsaw. He was transferred to our Level I trauma center from the local hospital. The deep-mutiple lacerations on right upper eyelid and forehead with the bony exposure were noted. The vital signs were stable and emergency operation was performed. He was discharged at 20 hospital days. Bone loss or tissue loss were not devastating than we expected even though the injury was occurred by the chainsaw. Aggressive treatment including airway manipulation or bleeding control and maximal opportunity of therapy are absolutely needed.

다량의 산업부산물을 활용한 슬러리계 되메움 재료의 물성 및 현장적용 가능성 평가 (Properties and Applicability Evaluation of Control Low Strength Materials Used Industrial by-Products of A Great Quantity)

  • 료효개;허재원;김동훈;임남기
    • 한국건축시공학회:학술대회논문집
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    • 한국건축시공학회 2020년도 가을 학술논문 발표대회
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    • pp.40-41
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    • 2020
  • This study has resulted in the following findings. First, Using more than 30% of GBFS to replace FA enabled bleeding control through improved fluidity. Moreover, it has been confirmed that effective strength and proper quality can be achieved when it was applied as a backfilling material with higher early strength than the base material. Second, When using more than 30% of FNS to replace sand, it was found that adding 0.3~0.35 of the AE agent is effective for bleeding control through improved fluidity. Third, When using more than 30% of both GBFS and FNS in combination, it was found that adding 0.3~0.35 of the AE agent is effective for bleeding control through improved fluidity. Also, it was confirmed that proper mixing of 15~60% of GF secured the effective strength and desired quality as a refiller and joint filler material.

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초음속 흡입구 형상 설계 및 Bleeding을 활용한 유동제어 연구 (Supersonic Intake Design & Flow Control Analysis using Bleeding Condition)

  • 최재환;천소민;김종암
    • EDISON SW 활용 경진대회 논문집
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    • 제1회(2012년)
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    • pp.77-80
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    • 2012
  • 초음속 흡입구는 설계점에서 안정적으로 작동하지만 설계점 밖에서는 엔진성능이 급격히 감소하거나 층 격파 불안정 문제가 발생할 수 있다. 초음속 흡입구의 일반적인 특성을 파악하기 위해 2단 꺾임각을 갖는 외부 압축식 2차원 흡입구를 설계하고 EDISON_열유체 시스템을 이용하여 최종적으로 설계 마하수 2.5에서 작동하는 형상을 얻었다. 그러나 설계 마하수 이하의 영역에서는 충격파-경계층, 충격파간 상호작용으로 인해 유동에서 박리가 발생하고 최종적으로 흡입구 목을 질식시켜 아임계 상태로 천이된다. 이를 해결하기 위해 유동 제어 방법 중 하나인 bleeding을 이용하여 경계층을 제거하거나 유동의 박리를 방지하여 충격파를 cowl lip 전방에 안정하게 고정시킬 수 있었으며, 결과적으로 목적하였던 마하수 2.0에서 2.5에 이르는 작동 영역에서 강건하게 운용될 수 있는 초음속 흡입구를 설계하였다.

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A Comparative Study to Evaluate a Simple Method for the Management of Postoperative Bleeding Following Palatoplasty

  • Rossell-Perry, Percy;Schneider, William J.;Gavino-Gutierrez, Arquimedes M.
    • Archives of Plastic Surgery
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    • 제40권3호
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    • pp.263-266
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    • 2013
  • Bleeding, is one of the most common postoperative complications after palatoplasty in patients with cleft palate. The purpose of this article is to present our experience using a Foley catheter balloon for perioperative palatoplasty bleeding management. A retrospective data analysis was performed for all cases of palatoplasty performed by the author from 1999 to 2012 that experienced postoperative hemorrhage. These patients were managed by utilizing posterior nasal compression with a Foley catheter balloon for the period 2006 to 2012. We have compared two methods (we use before 2006 the reoperative method) with regards to the later development of palatal fistulae and cases with reoperative hemostasis. The study found no statistically significant differences between the conventional and proposed method in relation to the development of palatal fistulae (P=0.7). These findings suggest that nasal packing using a Foley balloon is a safe and effective method for postoperative bleeding control after palatoplasty in patients with cleft palate.

무릎전치환술 환자에서 일회성 복재신경차단술이 수술 후 출혈량 감소에 미치는 영향 (A single injection of saphenous nerve block reduces postoperative bleeding after total knee arthroplasty)

  • 최윤숙;윤소희;조승연;송승은;김상림
    • Journal of Medicine and Life Science
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    • 제18권1호
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    • pp.11-15
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    • 2021
  • In elderly patients, the vital parameters tend to fluctuate based on the blood volume status, which may cause sudden hypovolemic shock if the postoperative bleeding continues. Particularly, those who undergo surgery for arthritis needs to pay extra attention because the bleeding may persist over the joints after the surgery. Therefore, appropriate pain control is required to reduce the postoperative blood loss. This retrospective chart review study was conducted to assess the postoperative pain control and reduction of blood loss with a single injection of saphenous nerve block (SNB) in elderly patients with osteoarthritis. We reviewed the electronic medical records of patients who underwent knee total arthroplasty with spinal anesthesia between January and May 2016. A total of 51 patients participated in this study. All patients were treated with intravenous patient-controlled analgesia for the postoperative pain control, and additional analgesic agents were administered at a visual analogue scale above a score of 6. In 25 patients, SNB was performed using ultrasound with the administration of 0.75% ropivacaine (15 mL) after the surgery. Patients who received additional analgesics were significantly low in the nerve block group (P=0.009). Additionally, the volume of blood loss from catheter drainage was significantly low at 2 and 3 days postoperatively (P=0.013 and P=0.041, respectively) in the nerve block group. In patients who underwent total knee arthroplasty with osteoarthritis, only a single injection of saphenous nerve block was sufficient for the postoperative pain control and reduced bleeding.

자궁체부암 출혈에 대한 보존적 치료로써의 경카테터 동맥 색전술 (Transcatheter Arterial Embolization for Palliation of Uterine Body Cancer Bleeding)

  • 최재연;신지훈;추희호
    • 대한영상의학회지
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    • 제84권3호
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    • pp.606-614
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    • 2023
  • 목적 자궁체부암 출혈에 대한 경카테터 동맥 색전술의 효과와 안전성을 평가하였다. 대상과 방법 20년 동안 자궁체부암 출혈로 경카테터 동맥 색전술(transcatheter arterial embolization; 이하 TAE)을 시행 받은 여섯 명의 환자들의 자료를 후향적으로 수집하였다. 혈관조영술 및 단면 영상 소견, TAE의 세부사항과 임상 경과를 탐구하였으며, TAE의 기술적, 임상적 성공률(technical and clinical success rate)을 각각 계산하였다. 결과 환자군은 자궁내막양 선암종, 육종, 그리고 임신융모종양으로 이루어졌으며, 대부분이 말기 암 환자들이었다. 출혈은 네 명의 환자에서 질출혈로 나타났다. 여섯 명의 환자들에서 일곱 번의 TAE가 시행되었고, 모든 TAE 시술에서 기술적 성공이 달성되었다. 자궁절제술을 받은 두 명의 환자들에서는 골반강 내 재발한 종양의 출혈이 혈변으로 나타났고, 이 환자들에서도 TAE는 기술적 성공을 보였다. 임상적 성공률은 50%로 절반의 환자에서 일주일 이상 출혈 조절이 되었다. 재출혈은 한 명의 환자에서 사망과 직접적으로 연관되었다. 한 명의 환자에서 시술 다음 날 경미한 부작용이 있었다. 결론 TAE는 자궁체부암 출혈에 대한 효과적이고 안전한 방법이며 특히 진행암, 말기암 환자들의 질병 경과 중의 위험한 시기에서 고려될 수 있다.

만성치주염 환자에 대한 저용량 독시싸이클린의 임상적 효과 (Clinical Effect of the Subantimicrobial Dose of Doxycycline ( SDD ) on the Chronic Periodontitis)

  • 김윤식;백정원;김창성;최성호;김종관
    • Journal of Periodontal and Implant Science
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    • 제32권2호
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    • pp.415-428
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    • 2002
  • Periodontal disease is a complex infectious disease caused by bacteria in the oral mucosa, which results in gingival inflammation, breakdown of periodontal tissues, bone resorption, and finally tooth loss. Mechanical plaque control methods-scaling and root planing are effective methods to stop the progression of such periodontal disease. It was reported that subantimicrobial dose of doxycycline(SDD) regimen could improve clinical conditions of periodontal tissues without causing the overgrowth of opportunistic organisms that was a typical antibiotic side effect. Therefore pharmacological therapy, used in conjunction with mechanical therapy could be considered a useful treatment modality in the treatment of chronic periodontal disease. In this study, 30 patients diagnosed as moderate to advanced chronic periodontitis were divided into 2 groups. In this double-blind, placebo-controlled study, the patients were administered 20mg doxycycline capsule or placebo capsule b.i.d. for 4months, after scaling and root planing. Clinical parameters-bleeding on probing, pocket depth and clinical attachment level were compared and evaluated between these groups at periods of first visit, 1 month, 2 months, 3 months, 4 months. The results were as follows ; 1. In case of moderate periodontitis, pocket depth showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in pocket depth was observed in the experiment group compared to the control group(p<0.05). 2. In case of moderate periodontitis, clinical attachment level showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in clinical attachment level was observed in the experiment group compared to the control group(p<0.05). 3. Bleeding on probing improved after treatment in both the groups. In case of moderate periodontitis, the experiment group showed statistically significant reduction of bleeding on probing when compared with the control group at 1 and 4 months after treatment(p<0.05). In case of advanced periodontitis, treatment resulted in statistically significant reduction of bleeding on probing in both the groups(p<0.05). These results indicate that the use of subantimicrobial dose of doxycycline is a useful supplement to mechanical treatment for periodontal patients in ameliorating the clinical parameters such as periodontal pocket, attachment level, and bleeding on probing.