• 제목/요약/키워드: Spleen injury

검색결과 85건 처리시간 0.027초

소아질환의 형상의학적 치료 (Treatments of Infantile Diseases in Hyungsang Medicine)

  • 정행규;강경화;이용태
    • 동의생리병리학회지
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    • 제21권2호
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    • pp.561-566
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    • 2007
  • After researching on infantile diseases in Hyungsang medicine, the writer got the conclusions as follows. The infants who are excess of the Yang energy need to nourish the Eum- blood. The main causes of the infantile disorders are congenital defect and malfunction of internal organs by nature, as results of these they suffer from mental disorders or being undergrown. And after birth they get ill from internal injury or external affections, mainly epilepsy by retention of undigested food, fever, cough, asthma, nasal obstruction, dermatopathia, and affection by cold, etc. In Hyungsang medicine Dam-body is apt to get ill from deficiency of Eum-blood and bangkwang-body from deficiency of Yang-energy. And infants are hare to be moderate in food, so they become to diseases of the Spleen and stomach, especially infants with Yangmyung type get to epilepsy, cough, skin disorders, and obese for the reasonof overeating. Among main infantile symptoms congenital defects, infantile mental disorders, and convulsive diseases come from congenital defect and malfunciton of internal organs, so it must be treated the symptoms following the reasons. Above all infantile mental disorders are treated not to separate the spirit from the body. And fever, cough and asthma, affection by cold, skin diseases, poor appetite, and obese come from deficiency of Kidney or the deficiency and excess of the Spleen and stomach. In order to prevent from infantile diseases right antenatal training, taking medicine rightly, exercise and eating good habits are needed to give guidance. Seeing through the clinical cases in Hyungsang medicine, we come to know that the infantile mental disorders come out primarily for the reasons of the congenital defect, and the infantile epilepsy come from malfunction of internal organs, and the nasal obstruction and skin diseases come from deficiency of Kidney or the deficiency and excess of the Spleen and stomach.

체간부 장기 손상을 동반한 외상성 체간부 동맥 손상 환자의 치료 방침 (Therapeutic Plan for Traumatic Truncal Arterial Injury Associated with Truncal Organ Injury)

  • 조충현;정용식;김욱환;조영신;안정환;민영기;정윤석;김성희;이국종
    • Journal of Trauma and Injury
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    • 제22권1호
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    • pp.77-86
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    • 2009
  • Purpose: The appropriate management of traumatic truncal arterial injury is often difficult to determine, particularly if the injury is associated with severe additional truncal lesions. The timing of repair is controversial when patients arrive alive at the hospital. Also, there is an argument about surgery versus stent-graft repair. This study's objective was to evaluate the appropriate method and the timing for treatment in cases of truncal abdominal injury associated with other abdominal lesions. Methods: The medical records at Ajou University Medical Center were reviewed for an 8-year period from January 1, 2001, to December 31, 2008. Twelve consecutive patients, who were diagnosed as having had a traumatic truncal arterial injury, were enrolled in our study. Patients who were dead before arriving at the hospital or were not associated with abdominal organ injury, were excluded. All patients involved were managed by using the ATLS (Advanced Trauma Life Support) guideline. Data on injury site, the timing and treatment method of repair, the overall complications, and the survival rate were collected and analyzed. Results: Every case showed a severe injury of more than 15 point on the ISS (injury severity score) scale. The male-to-female ratio was 9:3, and patients were 41 years old on the average. Sites of associated organ injury were the lung, spleen, bowel, liver, pelvic bone, kidney, heart, vertebra, pancreas, and diaphragm ordered from high frequency to lower frequency. There were 11 cases of surgery, and one case of conservative treatment. Two of the patients died after surgery for truncal organ injury: one from excessive bleeding after surgery and the other from multiple organ failure. Arterial injuries were diagnosed by using computed tomography in every case and 9 patients were treated by using an angiographic stent-graft repair. There were 3 patients whose vessels were normal on admission. Several weeks later, they were diagnosed as having a truncal arterial injury. Conclusion: In stable rupture of the truncal artery, initial conservative management is safe and allows management of the major associated lesions. Stent grafting of the truncal artery is a valuable therapeutic alternative to surgical repair, especially in patients considered to be a high risk for a conventional thoracotomy.

흉부손상의 임상적 고찰 (Clinical evaluation of chest trauma)

  • 김영호
    • Journal of Chest Surgery
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    • 제15권4호
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    • pp.414-421
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    • 1982
  • 200 patients admitted to the Chest Surgery Department of Jeonbug National University Hospital from January, 1974 to December, 1981 were analyzed clinically. The ratio of male to female was 7: 1, which showed male predominance. Distribution of patients according to age disclosed that over half [62%] of the patients was social age between 20 and 49 years. The most common cause of chest trauma was traffic accident [39%], and the next were stab wound, fall down [17.5%], and hit [8.5%] in decreasing order. Common lesions due to chest trauma were as follows; rib fracture [51%], hemopneumothorax, hemothorax, and pneumothorax in decreasing number. The most common cause of rib fracture was traffic accident [50%] and the associated organ injuries were long bone fracture, head injury, spine and pelvic bone fracture, spleen rupture, and liver laceration. Hemothorax, pneumothorax, and hemopneumothorax were treated with insertion of thoracic catheter in 90 cases, pure thoracentesis in 11 cases, and emergency thoracotomy in 11 cases. In flail chest, 6 patients were treated by intramedullary insertion of Kirschner`s wire and the results were good. The incidence of complication was 17%, including atelectasis [11 cases], pyothorax, fibrothorax, pneumonia, and acute respiratory failure. Four patients were died [2%], and the causes were acute respiratory failure in 2 cases, spinal cord injury in one case and head injury in one case.

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소아에서 추락사고에 의한 복부손상 (Abdominal Injury by Falls from a Height in Children)

  • 최금자
    • Advances in pediatric surgery
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    • 제11권2호
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    • pp.115-122
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    • 2005
  • Falls from a height are the leading cause of injury and death among urban children. This study describes the incidence, clinical characteristics, and treatment results of children under 15 year of age who fell from a height of more than one meter and were admitted for abdominal injury. The medical records of 585 consecutive patients treated between January 1997 and December 2003 at Ewha Womans University Mokdong Hospital were analyzed retrospectively. The falling heights were 1 to 31.2 meters, and 28 patients(4.8 %) suffered from blunt abdominal trauma. The male to female ratio was 2.1: 1. The median age of the victims was 5.5 years, and the median height fallen was 3 meters. Fifteen patients (53.6 %) were injured during the summer and seventy-nine percent of the falls occurred between noon and 9 pm. Eighteen (64.3 %) of falls occurred in residential place and 19(67.8 %) of patients arrived at the emergency department within 30 minutes of the accident. Only 16 patients (57.1 %) complained of abdominal pain. Liver injuries were found in 12(42.9 %), spleen injuries in 5(17.9 %), kidney injuries 3(10.7 %), pancreatic injuries in 1(3.6 %) and nonspecific abdominal injuries in 9(32.1 %) cases. Increased SGOT and SGPT were found in 23(82.2 %) and 18(64.3 %) cases. Eleven patients (39.3 %) had associated head injuries. Limb injuries were present in 17.9% and thoracic injuries in 7.1%. Twenty-five patients (89.3 %) recovered without operation. The median length of hospital stay was 6 days (2 -20 days). Despite the absence of abdominal symptoms or shock, falls from a height in children may carry significant intra-abdominal organ injuries. The height falling could not predict the degree of the abdominal injury. For the evaluation of potential abdominal injuries, CT scan should be utilized.

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Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma Center

  • Lee, Min A;Lee, Seung Hwan;Choi, Kang Kook;Park, Youngeun;Lee, Gil Jae;Yu, Byungchul
    • Journal of Trauma and Injury
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    • 제34권3호
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    • pp.177-182
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    • 2021
  • Purpose: Traumatic pancreatic injuries are rare, but their diagnosis and management are challenging. The aim of this study was to evaluate and report our experiences with the management of pancreatic injuries. Methods: We identified all adult patients (age >15) with pancreatic injuries from our trauma registry over a 7-year period. Data related to patients' demographics, diagnoses, operative information, complications, and hospital course were abstracted from the registry and medical records. Results: A total of 45 patients were evaluated. Most patients had blunt trauma (89%) and 21 patients (47%) had pancreatic injuries of grade 3 or higher. Twenty-eight patients (62%) underwent laparotomy and 17 (38%) received nonoperative management (NOM). The overall in-hospital mortality rate was 24% (n=11), and only one patient died after NOM (due to a severe traumatic brain injury). Twenty-two patients (79%) underwent emergency laparotomy and six (21%) underwent delayed laparotomy. A drainage procedure was performed in 12 patients (43%), and pancreatectomy was performed in 16 patients (57%) (distal pancreatectomy [DP], n=8; DP with spleen preservation, n=5; pancreaticoduodenectomy, n=2; total pancreatectomy, n=1). Fourteen (31%) pancreas-specific complications occurred, and all complications were successfully managed without surgery. Solid organ injuries (n=14) were the most common type of associated abdominal injury (Abbreviated Injury Scale ≥3). Conclusions: For traumatic pancreatic injuries, an appropriate treatment method should be considered after evaluation of the accompanying injury and the patient's hemodynamic status. NOM can be performed without mortality in appropriately selected cases.

위증에 대한 동서의학적(東西醫學的) 고찰(考察) (The Literatual Study on the Wea symptom in the View of Western and Oriental Medicine)

  • 김용성;김철중
    • 혜화의학회지
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    • 제8권2호
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    • pp.211-243
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    • 2000
  • This study was performed to investigate the cause, symptom, treatment, medicine of Wei symptom through the literature of oriental and western medicine. The results obtained were as follows: 1. Wei symptom is the symptom that reveals muscle relaxation without contraction and muscle relaxation occures in the lower limb or upper limb, in severe case, leads to death. 2. Since the pathology and etiology of Wei symptom was first described as "pe-yeol-yeop-cho"(肺熱葉焦) in Hung Ti Nei Ching(黃帝內經), for generations most doctors had have accepted it. but after Dan Ge(丹溪), it had been classified into seven causes, damp-heat(濕熱), phlegm-damp(濕痰), deficiency of qi(氣虛), deficiency of blood(血虛), deficiency of yin(陰處), stagnant blood(死血), stagnant food(食積). Chang Gyeng Ag(張景岳) added the cause of deficiency of source qi(元氣). 3. The concept of "To treat Yangming, most of all"(獨治陽明) was emphasized in the treatment of Wei symptom and contains nourishment of middle warmer energy(補益中氣), clearance of yangming-damp-heat(淸化陽明濕熱). 4. Since Nei-ching era(內經時代), Wei and Bi symptom(痺症) is differenciated according to the existence of pain. After Ming era(明代) appeared theory of co-existence of Wei symptom and pain or numbness but they were accepted as a sign of Wei symptom caused by the pathological factor phelgm(痰), damp(濕), stagnancy(瘀). 5. In the western medical point of view, Wei symptom is like paraplegia, or tetraplegia. and according to the causative disease, it is accompanied by dysesthesia, paresthsia, pain. thus it is more recommended to use hwal-hyel-hwa-ae(活血化瘀) method considering damp-heat(濕熱), qi deficiency of spleen and stornach(脾胃氣虛) as pathological basis than to simply differenciate Wei and Bi symptom according to the existence of pain. 6. The cause of Gullian-Barre syndrome(GBS) is consist of two factors, internal and external. Internal factors include asthenia of spleen and stomach, and of liver and kidney. External factors include summur-damp(暑濕), damp-heat(濕熱), cold-damp(寒濕) and on the basis of "classification and treatment according to the symptom of Zang-Fu"(臟腑辨證論治), the cause of GBS is classified into injury of body fluid by lung heat(肺熱傷津), infiltration of damp-heat(濕熱浸淫), asthenia of spleen and kidney(脾腎兩虛), asthenia of spleen and stomach(脾胃虛弱), asthenia of liver and kidney (肝腎兩虛). 7. The cause of GBS is divided by according to the disease developing stage: Early stage include dryness-heat(燥熱), damp(濕邪), phlegm(痰濁), stagnant blood(瘀血), and major treatment is reducing of excess(瀉實). Late stage include deficiency of essence(精虛), deficiency with excess(虛中挾實), and essencial deficiency of liver and kidney(肝腎精不足) is major point of treatment. 8. Following is the herbal medicine of GBS according to the stage. In case of summur-damp(暑濕), chung-seu-iki-tang(淸暑益氣湯) is used which helps cooling and drainage of summer-damp(淸利暑濕), reinforcement of qi and passage of collateral channels(補氣通絡). In case of damp-heat, used kun-bo-hwan(健步丸), In case of cool-damp(寒濕), used 'Mahwang-buja-sesin-tang with sam-chul-tang'(麻黃附子細辛湯合蓼朮湯). In case of asthenia of spleen and kidney, used 'Sam-lyeng-baik-chul san'(蔘笭白朮散), In case of asthenia of liver and kidney, used 'Hojam-hwan'(虎潛丸). 9. Following is the herbal medicine of GBS according to the "classification and treatment according to the symptom of Zang-Fu"(臟腑辨證論治). In the case of injury of body fluid by lung heat(肺熱傷津), 'Chung-jo-gu-pae-tang'(淸燥救肺湯) is used. In case of 'infiltration of damp-heat'(濕熱浸淫), us-ed 'Yi-myo-hwan'(二妙丸), In case of 'infiltration of cool-damp'(寒濕浸淫), us-ed 'Yui-lyung-tang', In case of asthenia of spleen, used 'Sam-lyung-bak-chul-san'. In case of yin-deficiency of liver and kidney(肝腎陰虛), used 'Ji-bak-ji-hwang-hwan'(知柏地黃丸), or 'Ho-jam-hwan'(虎潛丸). 10. Cervical spondylosis with myelopathy is occuered by compression or ischemia of spinal cord. 11. The cause of cervical spondylosis with myelopathy consist of 'flow disturbance of the channel points of tai-yang'(太陽經兪不利), 'stagnancy of cool-damp'(寒濕凝聚), 'congestion of phlegm-damp stagnant substances'(痰濕膠阻), 'impairment of liver and kidney'(肝腎虛損). 12. In treatment of cervical spondylosis with myelopathy, are used 'Ge-ji-ga-gal-geun-tang-gagam'(桂枝加葛根湯加減), 'So-hwal-lack-dan-hap-do-hong-eum-gagam(小活絡丹合桃紅飮加減), 'Sin-tong-chuck-ue-tang-gagam(身痛逐瘀湯加減), 'Do-dam-tang-hap-sa-mul-tang-gagam'(導痰湯合四物湯加減), 'Ik-sin-yang-hyel-guen-bo-tang'(益腎養血健步湯加減), 'Nok-gakyo-hwan-gagam'(鹿角膠丸加減). 13. The cause of muscle dystropy is related with 'the impairement of vital qi'(元氣損傷), and 'impairement of five Zang organ'(五臟敗傷). Symptoms and signs are classified into asthenia of spleen and stomach, deficiency with excess, 'deficiency of liver and kidney'(肝腎不足) infiltration of damp-heat, 'deficiency of qi and blood'(氣血兩虛), 'yang deficiency of spleen and kidney'(脾腎陽虛). 14. 'Bo-jung-ik-gi-tang'(補中益氣湯), 'Gum-gang-hwan'(金剛丸), 'Yi-gong-san-hap-sam-myo-hwan'(異功散合三妙丸), 'Ja-hyel-yang-gun-tang'(滋血養筋湯), 'Ho-jam-hwan'(虎潛丸) are used for muscle dystropy. 15. The causes of myasthenia gravis are classified into 'insufficiency of middle warmer energy'(中氣不足), 'deficiency of qi and yin of spleen and kidney'(脾腎兩處), 'asthenia of qi of spleen'(脾氣虛弱), 'deficiency of qi and blood'(氣血兩虛), 'yang deficiency of spleen and kidney'(脾腎陽虛). 16. 'Bo-jung-ik-gi-tang-gagam'(補中益氣湯加減), 'Sa-gun-ja-tang-hap-gi-guk-yang-hyel-tang'(四君子湯合杞菊地黃湯), 'Sa-gun-ja-tang-hap-u-gyi-eum-gagam'(四君子湯合右歸飮加減), 'Pal-jin-tang'(八珍湯), 'U-gyi-eum'(右歸飮) are used for myasthenia gravis.

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복부 고형 장기 외상에 대한 인터벤션의 임상적 역할 (Clinical Role of Interventional Radiology in Abdominal Solid Organ Trauma)

  • 정현석;전창호;서상현
    • 대한영상의학회지
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    • 제84권4호
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    • pp.824-834
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    • 2023
  • 외상성 복부 장기 손상 환자의 치료에서 비수술적 치료의 비중이 증가하고 있으며, 이는 혈관 내 인터벤션 치료의 발전과 보편화와 연관이 있다. 최근 American Association for the Surgery of Trauma (AAST)의 Organ Injury Scaling System과 World Society of Emergency Surgery (WSES)에서 간, 비장, 신장 외상 진료 및 치료에 대한 가이드라인을 발표하였고, 인터벤션 치료의 역할을 명확히 제시하였다. 이를 바탕으로 인터벤션 영상의학의 관점에서 외상 환자 치료에 참여하면서 기본적으로 알고 있어야 할 내용 및 각 장기별 인터벤션 치료시 고려할 사항에 대해 알아보고자 한다.

렴瘡에 對한 文獻的 考察 (A literatual study on the Ecthyma)

  • 김희택;오영선;노석선
    • 한방안이비인후피부과학회지
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    • 제10권1호
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    • pp.209-246
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    • 1997
  • In the literatual study on the Ecthyma, the results were as follows. 1. The pathogenic factors of Ecthyma is divided three parts. One is exogenous pathogenic factors which including the wind evil, wind heat and toxic material produced by wetness evil. Another is endogenous pathogenic factors which including the declination of kidney-yang, impairment of the liver and kidney, the lower classes of yin-fire, accumulation of wetness-heat in the spleen asthenia, impairment of the liver and kidney, wetness-heat of three yang, asthenic heat-syndrome of three yin. The other is pathogenic factors neither endogenous nor exogenous which including the food and living, uncontrol sexual excess, anxiety and angry, injury of skin, injury of insects and animals. 2. Five viscera which was concerned with Ecthyma are liver, spleen and kidney. 3. Frequent region of Ecthyma are S-36(足三里) and C-7(陰交). External Ecthyma was rose to wetness-heat of three yang channel that cured easily. Internal Ecthyma was rose to asthenic heat-syndrome of three yin channel that cured hardly. 4. In the frequency of prescription, the most numerous prescription is Bojungikgitang(補中益氣湯) and the next are Kyukgigo(隔紙膏) and Yukmijihwanghwan(六味地滉丸). 5. In the frequency of medicine, the most medicine is Calomelas(輕粉) which included Hydrargyrum(水銀) and the next are Olibanum(乳香) and Resina Commiphorae Myrrhae(沒藥) which regulating vital energy and pain control medicine used that in order to destroy insects and remove polson. 6. In classification of the medical action, medicine of clearing away summer-heat and heat evil and activating blood circulation to dissipate blood stasis used to be very busy which in order to remove the disorder of vital energy for virulent heat-evil. 7. In classification of four characters, the most part is warm medicine, the next are cold and cool medicine and there is a few that is hot medicine. 8. In classification of five tastes, the most numerous tastes are bitter and acrid, the next are sweet, salty and sour tastes. 9. In classification of virulence of medicine, the most part is non-toxic, the next are weakly and deadly poison. 10. In classification of channel distribution, the most is the medicine that belongs to liver channel, the next are the lung, spleen, stomach and kidney channel.

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대퇴동맥에 발생한 의인성 거대 가성동맥류에 대한 치료 (Treatment of giant iatrogenic pseudoaneurysm of the femoral artery)

  • 강우성;박찬용
    • 한국산학기술학회논문지
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    • 제20권3호
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    • pp.423-428
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    • 2019
  • 외상성 비장손상에 대한 비수술적 치료가 증가하면서 혈관조영술과 색전술의 역할이 증가하고 있다. 본 연구에서는 혈관조영술 후 발생한 대퇴동맥의 가성 동맥류를 트롬빈(thrombin) 주입과 코일(coil)을 이용한 색전술로써 효과적으로 치료한 증례를 보고하고자 한다. 55세 여자가 둔상성 외상으로 내원하였다. 전산화단층촬영에서 grade V 비장손상 소견을 보였으며, 조영제의 유출이 관찰되어 혈관조영술 및 색전술을 시행하였다. 내원 3일째 시행한 시행한 전산화단층촬영에서 비장의 재출혈 소견 보여 2차 색전술을 시행하였다. 내원 7일째 시행한 전산화단층 촬영에서 비장의 출혈 소견은 관찰되지 않았으나 우측 대퇴동맥 주위로 직경 $7.0cm{\times}4.0cm$ 크기의 가성동맥류가 발견되었다. 이 가성동맥류의 치료를 위해 초음파 유도하 트롬빈 주입을 시행하였으나 주입 후에도 혈류가 계속 유입되는 것이 컬러도플러초음파에서 관찰되었다. 이에 가성동맥류의 입구에 코일을 이용하여 색전술을 시행하였으며, 시술 후 혈관조영술에서 동맥류가 조영되지 않는 것을 확인하였다. 또한 추적 전산화단층촬영에서 동맥류가 조영되지 않고 크기도 감소하여 효과적으로 치료되었음을 확인하였다. 이후 환자는 특별한 합병증 없이 퇴원하였다. 저자들은 크기가 큰 대퇴동맥의 의인성 가성동맥류를 트롬빈과 코일을 이용하여 색전술을 시행함으로써 수술을 피하고 효과적으로 치료할 수 있었다.

역대의가(歷代醫家)들의 허노(虛勞)에 관한 문헌적(文獻的) 고찰(考察) - 간노(肝勞)를 중심(中心)으로 - (The Study of Literature Review on Consumptive disease(xulao) - Focused on Hepatic asthenia (ganlao) -)

  • 최창원;이강녕;이영수;김희철;곽정진
    • 대한한의학방제학회지
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    • 제10권1호
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    • pp.1-11
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    • 2002
  • From the 24 kinds of literature on the Consumptive disease, it can be concluded as follows. 1. The consumptive disease is the Imparement of deficiency type due to overstrain. it is a general term for these all symptom such as and Deficiency of primordial Qi and Essence of life and blood. 2. The excessive fire due to Yin-Deficiency and the injury of spleen-stomach is accounted much of the cause of Consumptive disease. 3. The main cause of the Hepatic asthenia are the Anger, Consumption and over-thinking. 4. The symptoms of the Consumptive disease are mainly caused by the functional disorder of Liver taking charge of tendons. storing and regulating blood, Heart being in charge of blood circulation. taking charge of mental activities. Spleen taking charge of muscles, transforting and transforming nutrients. Lung taking charge of skins and hairs, taking charge of respirations, Kidney taking charge of bones, storing essence of life. 5. The main symptoms of Hepatic asthenia are flaccidity of muscles and temeons which causes limited movement caused by muscular atonia and the loss of bightness of eyes. 6. The main treatments of Consumptive disease are the invigorating the Spleen-stomach and the invigorating the Kidney and storing essence of life. 7. The treatments of Hepatic asthenia are the moderating the middle and the nourishing the muscles and tendons.

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