• 제목/요약/키워드: Post-Traumatic

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다발성 외상 환자에서 췌장 손상 치료 경험 (Management of Traumatic Pancreas Injury in Multiple Trauma - Single Center Experience)

  • 장현아;심홍진;차성환;이재길
    • Journal of Trauma and Injury
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    • 제24권2호
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    • pp.111-117
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    • 2011
  • Purposes: Pancreatic injury is rare in abdominal trauma patients (3%~12%). but it could result in significant morbidity and even mortality. Early and adequate decision making are very important in the management of patients with traumatic pancreatic injury. The purpose of this study was to assess the kinds of management and outcome through the review of our experience of pancreatic injury with multiple trauma. Methods: We reviewed 17 patients with traumatic pancreas injury via electronic medical records from Jan. 2002 and April. 2011. We collected demographic findings; the type, location and grade of pancreas injury, the treatment modality, and patient's outcomes, such as complications, length of hospital stay (LOS), and mortality. Results: Total 17 patients were reviewed, and man was 13 (88%). Traffic accident was the most common cause of injury. Pancreas neck was the most common injured site, and occured in 5 patients. Ductal injury was detected in 7 cases. Eleven patients were treated by surgical procedure, and in this group, 3 patients underwent the endoscopic retrograde pancreas drainage procedure coincidently. ERPD was tried in 8 patients, and failed in 2 patients. The major complications were post-traumatic fluid collection and abscess which accounted for 70 % of all patients. The hospital stay was 35.9 days, and it was longer in patient with ductal injury ($38.0{\pm}18.56$ vs. $34.5{\pm}33.68$ days). Only one patient was died due to septic shock associated with an uncontrolled retroperitoneal abscess. Conclusion: Early diagnosis is the most important factor to apply the adequate treatment option and to manage the traumatic pancreas injury. Aggressive treatment should be considered in patients with a post-operative abscess.

사회복지사의 외상사건경험에 따른 외상후스트레스와 정신건강의 영향관계에서 회복탄력성의 매개효과 (The Study on the Mediating Effect of Resilience in the Relationship between Post-traumatic Stress and Mental Health of Social Worker who Experienced Traumatic Event)

  • 김평호;이유리
    • 디지털융복합연구
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    • 제14권9호
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    • pp.545-552
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    • 2016
  • 본 연구는 외상후스트레스와 정신건강간의 구조적 관계에서 회복탄력성이 갖는 매개효과를 분석하는데 목적이 있다. 이를 위해 전남, 광주 사회복지사를 대상으로 외상경험, 외상후스트레스, 사회적지지, 회복탄력성, 정신건강척도를 이용하여 설문조사 하였고, 주요 분석결과는 다음과 같다. 첫째, 외상후스트레스, 회복탄력성, 정신건강 간에 직접적인 영향관계가 있는 것으로 나타났고, 둘째, 회복탄력성은 외상후스트레스와 정신건강간의 영향관계에서 부분적인 매개효과가 있는 것으로 분석되었다. 이 결과를 토대로 사회복지사의 회복탄력성과 정신건강의 증진을 위한 포괄적인 개입방법을 제안하였다.

Validity of the scoring system for traumatic liver injury: a generalized estimating equation analysis

  • Lee, Kangho;Ryu, Dongyeon;Kim, Hohyun;Jeon, Chang Ho;Kim, Jae Hun;Park, Chan Yong;Yeom, Seok Ran
    • Journal of Trauma and Injury
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    • 제35권1호
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    • pp.25-33
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    • 2022
  • Purpose: The scoring system for traumatic liver injury (SSTLI) was developed in 2015 to predict mortality in patients with polytraumatic liver injury. This study aimed to validate the SSTLI as a prognostic factor in patients with polytrauma and liver injury through a generalized estimating equation analysis. Methods: The medical records of 521 patients with traumatic liver injury from January 2015 to December 2019 were reviewed. The primary outcome variable was in-hospital mortality. All the risk factors were analyzed using multivariate logistic regression analysis. The SSTLI has five clinical measures (age, Injury Severity Score, serum total bilirubin level, prothrombin time, and creatinine level) chosen based on their predictive power. Each measure is scored as 0-1 (age and Injury Severity Score) or 0-3 (serum total bilirubin level, prothrombin time, and creatinine level). The SSTLI score corresponds to the total points for each item (0-11 points). Results: The areas under the curve of the SSTLI to predict mortality on post-traumatic days 0, 1, 3, and 5 were 0.736, 0.783, 0.830, and 0.824, respectively. A very good to excellent positive correlation was observed between the probability of mortality and the SSTLI score (γ=0.997, P<0.001). A value of 5 points was used as the threshold to distinguish low-risk (<5) from high-risk (≥5) patients. Multivariate analysis using the generalized estimating equation in the logistic regression model indicated that the SSTLI score was an independent predictor of mortality (odds ratio, 1.027; 95% confidence interval, 1.018-1.036; P<0.001). Conclusions: The SSTLI was verified to predict mortality in patients with polytrauma and liver injury. A score of ≥5 on the SSTLI indicated a high-risk of post-traumatic mortality.

마음빼기명상 프로그램이 119 구급대원의 외상 후 성장과 회복탄력성에 미치는 효과 (Effects of Mind Subtraction Meditation Program on Post-traumatic Growth)

  • 이인수;전민영;유양경
    • 한국화재소방학회논문지
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    • 제32권5호
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    • pp.95-104
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    • 2018
  • 119 구급대원은 외상성 사건에 지속적으로 노출되며 이로 인해 다양한 사회심리적 문제와 삶의 질 저하를 경험할 위험이 있다. 이에 본 연구에서는 마음빼기명상 프로그램이 119 구급대원의 외상 후 성장과 회복탄력성에 미치는 효과를 확인하였다. $201^*$년 A소방본부 구급대원 26명을 연구대상으로, 2박 3일간 단기집중 마음빼기명상 프로그램을 적용하기 전과 명상 완료 후에 외상 후 성장과 회복탄력성 설문지를 이용하여 대상자의 상태를 측정하였다. 연구 결과 마음빼기명상 프로그램은 119 구급대원의 외상 후 성장을 $2.85({\pm}.67)$점에서 $3.60({\pm}.72)$점으로 유의하게 증가시켰고, 회복탄력성은 $2.45({\pm}.39)$점에서 $2.83({\pm}.48)$점으로 유의하게 증가시켰다. 결론적으로 마음빼기명상 프로그램은 119 구급대원의 외상 후 성장과 회복탄력성을 향상시키는 효과가 있었으므로, 본 연구에 적용한 마음빼기명상은 119 구급대원의 정신건강관리 프로그램으로 제안될 수 있을 것이다.

직업적 외상 노출이 역치 하 외상 후 스트레스 증상을 보이는 소방공무원의 뇌 기능적 연결성에 미치는 영향: 휴지기 기능적 자기공명영상 연구 (Effects of Occupational Trauma Exposure on Brain Functional Connectivity in Firefighters With Subclinical Post-Traumatic Stress Symptoms: A Resting-State Functional Magnetic Resonance Imaging Study)

  • 허율;방민지;이상혁;이강수
    • 대한불안의학회지
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    • 제18권2호
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    • pp.39-47
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    • 2022
  • Objective : This study investigated brain functional connectivity in male firefighters who showed subclinical post-traumatic stress disorder (PTSD) symptoms. Methods : We compared the data of 17 firefighters who were not diagnosed with PTSD and 18 healthy controls who had no trauma exposure. The following instruments were applied to assess psychiatric symptoms: Korean version of the Post-traumatic stress disorder Checklist for DSM-5 (PCL-5-K), Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI). For all subjects, functional magnetic resonance imaging was performed, and functional connectivity was compared between the two groups (family-wise error-corrected p<0.05). Additionally, correlations between psychiatric symptoms and functional connectivity were explored. Results : The following connectivity was higher than that of healthy controls: 1) the central opercular cortex-superior temporal gyrus, 2) planum polare-parahippocampal gyrus, 3) angular gyrus-amygdala, and 4) temporal fusiform cortex-parahippocampal gyrus. The functional connectivity of 1) the lateral occipital cortex-inferior temporal gyrus, 2) superior parietal lobule-caudate, and 3) middle temporal gyrus-thalamus were lower in firefighters. In firefighters, the connectivity of the planum polare-parahippocampal gyrus showed a negative correlation with the severity of arousal symptoms (rho=-0.586, p=0.013). The connectivity of the middle temporal gyrus-thalamus showed a positive correlation with the severity of intrusion (rho=0.552, p=0.022) and arousal symptoms (rho=0.619, p=0.008). The connectivity of the temporal fusiform cortex-parahippocampal gyrus was negatively correlated with intrusion (rho=-0.491, p=0.045) and arousal (rho=-0.579, p=0.015). Conclusion : Our results indicate that the brain functional connectivity is associated with occupational trauma exposure in firefighters without PTSD. Therefore, this study provides evidence that close monitoring and early intervention are important for firefighters with traumatic experience even at a subthreshold level.

유방암 환자의 회복탄력성과 외상후 스트레스가 삶의 질에 미치는 영향 (Effects of Resilience, Post-traumatic Stress Disorder on the Quality of Life in Patients with Breast Cancer)

  • 하부영;정은정;최소영
    • 여성건강간호학회지
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    • 제20권1호
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    • pp.83-91
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    • 2014
  • Purpose: The purpose of this study was to identify relationships of resilience, Post-Traumatic Stress Disorder(PTSD), and quality of life of breast cancer patients. The findings from this study would provide baseline data needed for nursing intervention. Methods: A sample of 129 breast cancer patients was recruited from three hospitals in J and C cities in Korea. The survey was conducted with participants by utilizing self-reported questionnaires. Results: Quality of life showed statistically significant differences on religion (t=2.11, p=.033) and hobby (t=2.79, p=.006). Resilience and PTSD had a negative correlation (r=-.22, p=.010). Resilience and quality of life of the participants had a positive correlation (r=.58, p<.001), whereas PTSD and quality of life had a negative correlation (r=-.45, p<.001). Significant predictors of quality of life were resilience and PTSD. These variables explained 44.9% of the variance in quality of life. Conclusion: Findings indicate that as resilience of breast cancer patients rose higher and PTSD got lower, their quality of life increased. Based on these results, nursing interventions directed towards improving resilience and relieving PTSD is proposed.

Frequency of Post-Concussion Syndrome in Korean Patients with Minor Head Injury

  • Lee, Ji Young;Yoon, Young Hoon;Lewis, Roger J.;Tolles, Juliana
    • Journal of Trauma and Injury
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    • 제30권2호
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    • pp.41-46
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    • 2017
  • Purpose: To determine the incidence of post-concussion syndrome (PCS) in Korean patients after minor traumatic brain injury. Methods: We conducted an observational cohort study of a convenience sample of patients presenting to the emergency department of a major academic Korean hospital. Patients who visited the Emergency Department for head trauma were screened. A researcher questioned the subject regarding his or her symptoms. Subjects were contacted by phone approximately 2 weeks after their Emergency Department visit and questioned about subsequent symptoms and subsequent visits for medical care. Results: Only 8% of subjects reported any post-concussion symptoms. Only 0.4% had three or more symptoms which might have met criteria for PCS. The median peak onset of symptoms was 3 days after injury. Conclusion: The incidence of PCS is Korean patients is much lower than that documented for patients in the United States or other western countries. On the other hand, this study results could give an idea that mild trauma could also cause the PCS. Further study is needed to replicate this finding and investigate possible explanations for this difference.

정적 자전거 피팅에 적용 가능한 체중 분포 측정장치의 구현 (Implementation of a Body Weight Distribution Measurement System Applicable to Static Bicycle Fitting)

  • 윤선호;권준혁;김청월
    • 센서학회지
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    • 제27권4호
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    • pp.242-248
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    • 2018
  • Bicycle fittings have been used to ride bicycles comfortably while minimizing non-traumatic injuries. To analyze the cause of non-traumatic injuries, it is necessary to measure the body weight distribution in various biking positions. In this study, a weight distribution measurement system was implemented by installing five weighable devices on the saddle, both pedals, and both handle grips of a bicycle. To measure the body weight applied through the saddle, the structure of a commercial seat post was modified and a load cell was installed inside. Weighable pedals and handle grips were designed using a 3D modeling program and fabricated by employing a 3D printer. The body weight distribution for ten bicycle riders was measured when the two pedals were aligned horizontally and vertically. Experimental results showed that the body weight distribution varied significantly depending on human body shape, even after the bicycle fitting was completed. The difference between the body weight measured by the proposed system and a commercial scale was less than 3 %.

외상후 스트레스 장애와 감별이 필요한 외상관련 자기애적 증상(TANS) - 증 례 보 고 - (Trauma-Associated Narcissistic Symptoms as a Differential Diagnosis from Post-Traumatic Stress Disorder - A Case Report -)

  • 전상원;박효인;김대호
    • 대한불안의학회지
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    • 제5권2호
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    • pp.133-138
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    • 2009
  • Diagnosing post-traumatic stress disorder (PTSD) is challenging for several reasons: a lack of training in trauma assessment for most clinicians, underreporting and avoidance by patients, the overlapping of symptoms, and a high comorbidity with other mental disorders. Thus, a careful evaluation and differential diagnosis are essential for the treatment and management of this population. A concept of posttraumatic reaction in people with narcissistic vulnerability, called Trauma-Associated Narcissistic Symptoms (TANS) had appeared in the literature; this has not been, however, systemically investigated. This study examines three cases of TANS that developed after traumatic events such as traffic accidents and physical assault. TANS may mimic PTSD and can show similar features; however, a careful attention to the context and meaning of symptoms can help the clinicians in differentiating TANS from PTSD. Clinicians working with trauma and compensation evaluators should be on alert for this easily overlooked condition.

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