• 제목/요약/키워드: postoperative

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근무력증 환자의 외과적 치료 (Clinical effect of Thymectomy for Patients in Myasthenia Gravis)

  • 정원상
    • Journal of Chest Surgery
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    • 제23권1호
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    • pp.152-157
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    • 1990
  • A clinical study for thymectomy for 23 patients in Myasthenia Gravis was done between May, 1982 and July, 1989. at the department of Thoracic and Cardiovascular Surgery, College of Medicine, Han Yang University. Among Z3 patients, male to female ratio was 11: 12 and Age of onset was ranged from 15 years-old to 52 years-old. Previous symptom duration from diagnosis until operation was ranged from 2 months to 96 months, and Mean duration was 28.74 months. The severity of disease was classified by Osserman`s classification preoperatively. In histopathology of thymus, Thymic hyperplasia 7 cases, Thymoma 7 cases, Invasive thymoma 3 cases, Within Normal Limit 5 cases, and Thymic Atrophy 1 case. Correlation between preoperative symptom duration and postoperative clinical course was statistically significant. The shorter of preoperative symptom duration, The better of postoperative clinical course. Grading of postoperative course was classified by Papatestas in 1975. Follow-up for postoperative course was ranged from 3 months to 7 year and 4 months, Cases of complete remission 1 year postoperative period were 9 cases and cases of Improvement were 8 cases, So totally 17 cases among 23 cases[73.91%] found good results.

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근치적 절제후 병기 II,IIIA 비소세포암에서 수술후 방사선 치료의 역할 [연세암센터 20년 경험] (Postoperative Radiation Therapy in Resected Stage stage II and IIIA Non-Small Cell Lung Cancer (Yonsei Cancer Center 20-Year Experience))

  • 이창걸
    • Journal of Chest Surgery
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    • 제26권9호
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    • pp.686-695
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    • 1993
  • A total of eighty one patients with resected stage II and IIIA non-small cell lung cancer treated with postoperative adjuvant radiation therapy between Jan. 1971 and Dec. 1990 were retrospectively analysed to evaluate whether postoperative radiation therapy improves survival. Patterns of failure and prognostic factors were also analysed. The 5 year overall and disease free survival rate were 40.5%, 43.4% and median survival 30 months. The 5 year actuarial survival rates by stage II and IIIA were 53.9% and 36.2%. Loco-regional failure rate was 14.7% and distant metastasis rate was 33.3% and both 4%. Statistically significant prognostic factor affecting survival was presence of mediastinal lymph node metastasis[N2]. This retrospective study suggests that postoperative radiation therapy in resected stage II and IIIA non-small cell lung cancer can reduce loco-regional recurrence and may improve survival rate as compared with other studies which were treated by surgery alone.

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Intravenous Patient-controlled Analgesia Has a Positive Effect on the Prognosis of Delirium in Patients Undergoing Orthopedic Surgery

  • Heo, Dae Young;Hwang, Byeong Mun
    • The Korean Journal of Pain
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    • 제27권3호
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    • pp.271-277
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    • 2014
  • Background: Postoperative delirium is relatively common. However, the relationship between intravenous patient-controlled analgesia (IV-PCA) and delirium has not been thoroughly investigated. The aim of this study was to evaluate the effects of IV-PCA on the prognosis of postoperative delirium in patients undergoing orthopedic surgery. Methods: Medical records of 129 patients with postoperative delirium were reviewed. Patients were divided into two groups according to whether they used IV-PCA with fentanyl and ketorolac. The IV-PCA group consisted of 73 patients who were managed with IV-PCA; the NO-PCA group consisted of 56 patients who were managed without PCA. Results: Incidences of multiple psychiatric consultations and prolonged delirium were significantly lower in patients using IV-PCA with fentanyl and ketorolac than in those without PCA. Conclusions: We recommend the use of IV-PCA for pain control and management of delirium in patients with postoperative delirium.

아동병동 간호사의 수술 후 통증 관리에 대한 지식과 태도 (Pediatric Nurses' Knowledge and Attitude towards Management of Children's Postoperative Pain)

  • 조은영;최혜란
    • Perspectives in Nursing Science
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    • 제12권2호
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    • pp.71-81
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    • 2015
  • Purpose: This study aimed to describe pediatric nurses' knowledge and attitude towards management of children's postoperative pain. Methods: In this cross-sectional descriptive study, the participants were 220 pediatric nurses who worked at a general hospital in Seoul. The survey questionnaires used to assess the nurses' knowledge and attitude regarding children's postoperative pain were developed for this study. Results: The average score for knowledge was 67.7 out of 100. The mean score for attitude was 72.5 out of 100. The factor related to the knowledge level was education for pain management. Moreover, age, working department, position, working experience, education level, and number of children were associated with the attitude. Conclusion: The findings of this study suggested the need for a systematic education program for pain management of children in the postoperative condition.

노인 환자의 수술 전 영양상태가 수술 후 임상경과에 미치는 영향 (The Effect of Preoperative Nutritional Status on Postoperative Outcome in Elderly Patients)

  • 김민영
    • Journal of Korean Biological Nursing Science
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    • 제21권4호
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    • pp.292-299
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    • 2019
  • Purpose: The purpose of this study was to determine whether poor preoperative nutritional status in elderly patients exhibited a negative influence on postoperative clinical outcomes. Methods: The medical records of 645 elderly patients were examined retrospectively. The patients had undergone major surgery between January 2017 and January 2018. Their nutritional status was measured using the Nutritional Risk Screening 2002. The data were analyzed using the chi-squared test, the Mann-Whitney U test, logistic regression, linear regression, Cox proportional hazards regression, and the Kaplan-Meier analysis. Results: Preoperative malnutrition was found in 73 patients (11.3%). Poor preoperative nutritional status was significantly associated with pressure ulcers, length of hospitalization, discharge to patient care facilities rather than home, and mortality rate at three months. Conclusion: Preoperative malnutrition in elderly patients was associated with negative postoperative clinical outcomes. These results indicate that an effective nutritional program before surgery can lead to a more rapid postoperative recovery.

부인과 복강경 수술 후 한의진료 방향에 대한 고찰 (Traditional Korean Medicine(TKM) Management for the Recovery after Laparoscopic Gynecological Surgery)

  • 정재철;최민선;김동일
    • 대한한방부인과학회지
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    • 제21권4호
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    • pp.218-227
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    • 2008
  • Purpose: The purpose of this study is to report the TKM Management for the recovery after laparoscopic gynecological surgery. Methods: The basic informations about laparoscopy and report 3 laparoscopic postoperative patients were managed with TKM. Patients had taken the surgery for the different gynecologic diseases. Results: The 3 patients' symptoms were improved gradually. TKM management is good for the recovery of laparoscopic surgery. And the management need to reflect postoperative complications. the cause and part of operation. and postoperative common symptoms. Conclusion: The TKM managements are effective in the postoperative recovery after laparoscopic gynecological surgery. And more study is needed for developing the model.

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The Effect of Postoperative Korean Traditional Medicine for the of Proximal Humeral Fracture: A Case Report

  • Go, Hyun Il;Choi, Hangyul;Hong, Jieun;Cho, Nam geun
    • Journal of Acupuncture Research
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    • 제36권1호
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    • pp.50-54
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    • 2019
  • The purpose of this case study is to examine the effects of Korean traditional medicine in the postoperative treatment of proximal humeral fracture. The patient with postoperative pain following proximal humeral fracture surgery was treated with Korean traditional medicine including acupuncture cupping therapy and herbal medicine in hospital for 67 days. The effects of the treatment were evaluated using the Numerical Rate Scale (NRS), Range Of Motion (ROM), and Shoulder Pain and Disability Index (SPADI). As a result of treatment, the NRS score was reduced from 7 to 3, the ROM was improved (on average by 21%), SPADI was reduced from 93 to 25.9. This study proposes that Korean traditional medicine may be effective in postoperative treatment for proximal humeral fracture.

Regional nerve blocks for relieving postoperative pain in arthroscopic rotator cuff repair

  • Tae-Yeong Kim;Jung-Taek Hwang
    • Clinics in Shoulder and Elbow
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    • 제25권4호
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    • pp.339-346
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    • 2022
  • Rotator cuff tear is the most common cause of shoulder pain in middle-age and older people. Arthroscopic rotator cuff repair (ARCR) is the most common treatment method for rotator cuff tear. Early postoperative pain after ARCR is the primary concern for surgeons and patients and can affect postoperative rehabilitation, satisfaction, recovery, and hospital day. There are numerous methods for controlling postoperative pain including patient-controlled analgesia, opioid, interscalene block, and local anesthesia. Regional blocks including interscalene nerve block, suprascapular nerve block, and axillary nerve block have been successfully and commonly used. There is no difference between interscalene brachial plexus block (ISB) and suprascapular nerve block (SSNB) in pain control and opioid consumption. However, SSNB has fewer complications and can be more easily applied than ISB. Combination of axillary nerve block with SSNB has a stronger analgesic effect than SSNB alone. These regional blocks can be helpful for postoperative pain control within 48 hours after ARCR surgery.

노인 환자의 골관절염 수술 후 발생한 섬망과 섬망 위험요인 (Postoperative Delirium in Elderly Patients with Osteoarthritis Surgery: Incidence and Risk Factors)

  • 박은아;김민영
    • 근관절건강학회지
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    • 제22권2호
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    • pp.57-66
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    • 2015
  • Purpose: The purpose of this study was to evaluate the incidence of postoperative delirium in elderly patients with osteoarthritis surgery and identify risk factors for its development. Methods: This study enrolled 288 patients who underwent osteoarthritis surgery in a hospital between May and November 2014. Data were collected prospectively. The Nursing Delirium Screening Scale was used to detect delirium. Multivariable logistic regression analysis was used to identify independent risk factors for postoperative delirium. Patients were also followed for outcome. Results: Postoperative delirium developed in 42 patients (14.6%). Logistic regression analysis identified old age, low physical activity, antipsychotic agents, number of catheters, and intensive care unit admission as risk factors. Worse outcomes, including increased hospital mortality, reoperation, and discharge at care facilities, occurred in subjects who developed delirium. Conclusion: Osteoarthritis surgery in elderly patients was associated with a high incidence of postoperative delirium. The results of the this study regarding patient populations vulnerable to delirium should be taken into account so that such patients could be identified preoperatively or in the immediate postoperative period.

절제 가능한 진행위암에서 수술 후 조기 복강 내 화학요법의 예후인자로서의 가치 (Prognostic Value of Early Postoperative Intraperitoneal Chemotherapy in Resectable Advanced Gastric Cancer)

  • 유완식;정호영
    • Journal of Gastric Cancer
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    • 제1권4호
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    • pp.197-201
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    • 2001
  • Purpose: There are variants of gastric cancer assoclated with predominantly peritoneal spread of with haematogenous metastases. Perioperative intraperitoneal chemotherapy as an adjuvant to surgery is considered as a rational therapeutic modality to prevent peritoneal spread. We evaluated the influence of early postoperative intraperitoneal chemotherapy on the prognosis of resectable advanced gastric cancer. Materials and Methods: From 1990 to 1995, 246 patients with biopsy proven advanced gastric cancer were enrolled in the study. Among them 123 patients received early postoperative intraperitoneal mitomycin C and 5-fluorouracil. The survival rate was calculated using by the Kaplan-Meier method and was compared using the log-rank test according to 13 clinico-pathologic factors. Multivariate analysis was performed with the Coxproportional hazards model. Results: Gastric resection plusearly postoperative intraperitoneal chemotherapy showed an improved survival rate as compared to surgery alone ($54.1\%\;versus\;40.3\%;$ P=0.0325). Depth of tumor invasion, degree of regional lymph vode metastasis, distant metastasis, tumor size, tumor location, extent of gastric resection, and curability of surgery significantly influenced survival. When a multivariate analysis was performed, depth of tumor invasion, lymph node metastasis, early postoperative intraperitoneal chemotherapy, curability of surgery, and extent of gastric resection emerged as the statistically significant and independent prognostic factors. Conlusion: Early postoperative intraperitoneal chemotherapy is one of the independent prognostic indicators of resectable advanced gastric cancer.

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