• 제목/요약/키워드: left flank pain

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경피적 추체 성형술 시행 시 환자와 시술자의 방사선 피폭선량에 관한 연구 (A Study on Radiation Exposure Dose of Patients and Operator during Percutaneous Vertebroplasty)

  • 이재헌;신성규;이효영
    • 한국방사선학회논문지
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    • 제11권2호
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    • pp.139-144
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    • 2017
  • 경피적 추체 성형술은 최소 침습적 척추 수술로 골다공증성 압박골절, 골수종 그리고 암에 의한 척추 전이 등에 치료방법으로 많이 사용되어 왔다. 이러한 최소침습적 시술은 환자에게 작은 수술 흉터, 통증, 출혈, 짧은 회복시간등 여러가지 장점이 많으나, 환자와 시술자가 방사선의 위험으로부터 벗어날 수 없다. 이에 본 연구의 목적은 경피적 추체 성형술을 하는 동안 방사선 조사시간의 측정과 함께 시술자와 환자의 방사선 피폭선량을 측정해 보았다. 본원에 내원한 경피적 추체 성형술 시행 대상인 환자를 3명의 마취통증의학과 전문의가 동일한 방법으로 총 20명의 환자에게 경피적 추체 성형술을 실시하였다. 방사선 조사시간을 측정하고 전자선량측정계를 이용하여 총 6군데의 방사선 피폭량을 측정해 보았다. 환자는 직접 엑스선을 측정하였으며, 전 후면과 옆면 부위에 전자선량측정계를 위치하였고, 시술자는 환자로부터 산란되는 산란선을 측정하였으며, 납가운 바깥쪽에 위치한 갑상선, 왼쪽 가슴, 왼쪽 허벅지 그리고 납가운 안쪽에 위치한 왼쪽 가슴부위에 전자선량측정계를 위치하였다. 총 시술 시간은 $19.3{\pm}3.88min$이며, 방사선에 의한 노출 시간은 $3.6{\pm}0.71min$ 이었다. 환자의 피폭선량은 전후면 일 때 $121.4{\pm}48.15{\mu}Sv$ 였으며, 측면 일 때 피폭선량은 $614.7{\pm}177.14{\mu}Sv$ 이다. 시술자가 받은 피폭선량은 납가운 바깥쪽의 갑상선 부분이 $33.7{\pm}7.30{\mu}Sv$ 이고, 왼쪽 가슴 부위가 $49.2{\pm}15.09{\mu}Sv$ 이고, 왼쪽 허벅지 부위가 $12.8{\pm}3.80{\mu}Sv$ 이며, 납가운의 안쪽 가슴에 위치한 부위의 선량계는 $4.2{\pm}1.44Sv$ 이였다. 경피적 추체 성형술 시행 시 방사선의 위험으로부터 벗어나기 위해 C-arm 튜브에서 환자에게 엑스선이 도달하여 산란되는 거리를 최대한 멀게 유지하여야 하며, 방사선이 조사되는 시간을 줄이고, 납가운등 보호장구를 적절히 착용하여 방사선 피폭을 줄임으로써 시술자와 환자 모두 안전한 시술이 되도록 노력하여야 할 것이다.

흉(胸)·요추(腰椎) 압박골절(壓迫骨折) 환자(患者)에 대한 임상적(臨床的) 고찰(考察) (The clinical study on 44 cases of patient with Thoracolumbar Compression Fracture)

  • 임정은;김기현;황현서
    • Journal of Acupuncture Research
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    • 제17권2호
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    • pp.41-51
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    • 2000
  • Clinical observation was made on 44 cases of stable thoracolumbar compression fracture that were confirmed through simple x-ray and neurological examination. They were hospitalized and treated by acupuncture and moxibustion, bed rest, herb medicine and physical therapy. If necessary, patient was given an enema. The results obtained are as follows. 1. The patient distribution ratio, in regard to sex, was shown to be 1: 13.7 for males to females. In regard to age, it was shown that people in their 60's was the most predominant case, followed by people in their 70's, 80's, 50's and 40's, respectively. 2. In regard to contributing factors, it was observed that accidental falls were most frequent, followed by reasons unknown, repetitive lifting of heavy objects, overlaboring and bruise in that order. 3. In regard to duration of illness before treatment, it was found that treatment within 1 week was most predominant, followed by over 4 weeks, and 1-2 weeks, respectively. 4. With regard to the duration of hospitalization, hospitalization within 2 weeks was found to be most predominant, followed by 2-4 weeks. 5. In regard to the level of the affected vertebral body; The affected vertebral bodies distributed between T3 to L5 except for T7; T12 was found to be most predominant, followed in turn by L1 and L5. 6. In regard to the number of affected vertebral bodies, 2 was the most frequent followed by 1 and 3, in that order. The average of the number of affected vertebral bodies was observed to be 2.8 and single vertebral body compression fracture was shown to have no clinical and statistical difference as compared with multiple vertebral body compression fractures. 7. In regard to the grade of the seriousness of symptoms, it was found that Grade IV was most predominant, followed by Grade III. 8. With regard to signs at the first medical examination, low back pain was seen in the highest number, and followed in order by gait disturbance, flank pain, flexion-extension disturbance, disturbance of rotation to right or left, and bowel dysfunction. 9. Concerning the effect of treatment, good results were most predominantly seen, and 95.5% of total patients showed fair results. 10. The duration of admission treatment due to the grade of clinical symptoms was as follows; In the case of the Grade IV, it was observed that within 2 weeks was most predominant and for Grade III was 2-4 weeks. It was also found that the grade of clinical symptoms was not in proportion to the duration of admission treatment. 11. In regard to the result of treatment due to the grade of clinical symptoms; It was found that in the case of Grade IV, within 2 weeks was most predominant, and for Grade III, it was found to be 2-4 weeks. 12. Intestinal obstruction was shown in 50% of total patients; In the case of duration of constipation, more than 1 week was found to be most predominant, followed by 2 and 4 days respectively. 13. With regard to the treatment of intestinal obstruction, using acupuncture and moxibustion, herb - medicine and enema together were found to be most effective. 14. Intestinal obstruction was mostly seen in the case of Grade IV.

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