• Tuberculosis and Respiratory Diseases
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• 제66권3호
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• pp.211-215
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• 2009

폐색전증은 일반적으로 고령의 환자, 거동이 불가능한 경우, 만성 내과 질환, 외상이나 술 후 또는 혈액응고질환 등의 위험인자를 갖고 있는 환자에서 호발하는 질환으로 알려져 있다. 그러나, 최근 컴퓨터가 보편화되고 특히 젊은 연령층에서 컴퓨터 게임이 대중화 됨에 따라 이 또한 폐색전증의 위험인자가 될 수 있음을 이 증례를 통하여 보고하고자 한다. 36세 남자 환자가 가슴답답함과 호흡곤란증세로 급성심근경색 의증 하에 응급실로 전원되었다. 환자는 청색증과 저산소증을 보였으며, 흉부컴퓨터단층촬영상 양측 주 폐동맥에 혈전증이 관찰되었으며, 혈전용해술을 시행하여 성공적으로 치료하였다. 병력청취상 약 2주 전부터 하루에 12시간 이상 컴퓨터 게임을 하였으며, 이 외에 특별한 위험인자는 없었다. 현재 환자 상태는 양호하여 외래 추적관찰 중이며, 이 환자의 증례를 통하여 장시간의 컴퓨터 게임이 혈전용해술을 시행할 만큼 대량의 폐색전증을 발생할 수 있음을 알 수 있었고, 이에 대한 사회적인 인식 또한 필요할 것으로 사료된다.

• 대한의용생체공학회:의공학회지
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• 제39권1호
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• pp.36-42
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• 2018

The risk of venous thromboembolism (VTE) is known higher in cancer patients and lower incidence in the east country. This study was conducted in order to check the incidence rate of VTE in the Korean high risk patients who are treated in the intensive care unit (ICU), and to verify the correlation of the incidence of VTE and prophylaxis methods. This study was conducted as a retrospective study for 492 cancer patients from April 2011 to December 2014. According to the medical records of subjects, their prophylaxis methods and the incidence of VTE were surveyed and then correlation of them was investigated with statistical methods. 385 patients met the inclusion criteria. VTE occrred in 17 of them (4.4%). The prophylaxis methods are consisted of medical method (136 subjects), mechnical method(33 subjects), and medical & mechnkcal method (124 subjects). VTE occurred in 14 patients (4.8%) from 293 patients (76%) who were given at least one prophylaxis method. From all of 93 patients without prophylaxis, three patients experienced VTE (3.3%). The target patients were high risk in VTE, but the incidence rate of VTE was lower than reported in previous studies. The reason of this is considered that more active prophylaxis intervention was applied to the subjects because of their high risk status. As a result, it is considered that in the high risk patients, it would be effective to apply active and complex prophylaxis intervention for the prevention of VTE.

• Tuberculosis and Respiratory Diseases
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• 제47권3호
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• pp.394-399
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• 1999

저자들은 갑작스런 흉통을 주소로 내원한 젊은 남자에서 AT III 결핍증에 의한 폐색전증을 진단하고 세 자녀 모두에서도 AT III 결핍이 확인됨으로써 폐색전증을 동반한 선천성, 가족성 AT III 결핍증을 경험하였기에 문헌고찰과 함께 보고한다.

• Clinical and Experimental Reproductive Medicine
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• 제35권2호
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• pp.163-167
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• 2008

난소과자극 증후군 (Ovarian Hyperstimulation, OHSS)은 배란 유도의 가장 심각한 합병증 중의 하나로서 난소 비대, 복수, 흉수, 심막 삼출액, 혈액 농축, 전해질 이상 및 혈전증 등의 증상을 초래하는 것으로 알려져 있다. 특히 난소과자극 증후군 환자에서 혈전 색전증의 발생은 적절한 치료에도 불구하고 발생하고 예측이 어렵고 환자를 사망에 이르게 할 수도 있기에 가장 위험한 합병증 중의 하나로 인식되고 있다. 저자들은 체외수정 시술 후 중증 난소과자극 증후군 환자에서 본원 입원 치료 중 합병된 색전증에 대한 증례를 경험하였기에 보고하는 바이다.

• Journal of Chest Surgery
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• 제44권5호
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• pp.343-347
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• 2011

Background: Acute pulmonary thromboembolism is fatal because of abruptly occurring hypoxemia and right ventricular failure. There are several treatment modalities, including anticoagulation, thrombolytics, ECMO (extracorporeal membrane oxygenator), and thromboembolectomy, for managing acute pulmonary thromboembolism. Materials and Methods: Medical records from January 1999 to December 2004 at our institution were retrospectively reviewed for pulmonary thromboembolectomy. There were 7 patients (4 men and 3 women), who underwent a total of 8 operations because one patient had post-operative recurrent emboli and underwent reoperation. Surgery was indicated for mild hypoxemia and performed with CPB (cardiopulmonary bypass) in a beating heart state. Results: The patients had several symptoms, such as dyspnea, chest discomfort, and palpitation. Four patients had deep vein thromboembolisms and 3 had psychotic problems, specifically schizophrenia. Post-operative complications included hemothorax, pleural effusion, and pericardial effusion. There were two hospital deaths, one each by brain death and right heart failure. Conclusion: Emergency operation should be performed when medical treatments are no longer effective.

• Tuberculosis and Respiratory Diseases
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• 제50권1호
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• pp.106-116
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• 2001

연구배경 : 폐혈전색전증은 드물지 않은 질환이지만 치명적이며 많은 경우 진단되지 못하기도 한다. 폐혈전색전증이 증가되는 추세이나 연구는 많지 않은 실정이다. 저자는 폐혈전색전증으로 진단된 증례들을 통하여 임상상을 알아보고자 했다. 방법 : 1989년 1월부터 1995년 5월까지 임상적으로 폐혈관 색전증이 의심되었던 환자 중 폐관류 주사나 폐동맥 촬영술, 흉부 전산화 단층촬영술을 통해 확진 된 36명을 대상으로 조사하였다. 결과 : 1) 남녀의 성비는 같았고 평균 연령은 남자가 50.9세, 여자가 59.2세 이고 60세 이상 고령자는 38.9% 차지하였다. 2) 원인 질환으로 악성종양이 22.2%를 차지하였고 수술이 22.2%, 심장질환이 8.2% 등이었고 원인질환이 없는 경우가 33.3%이었다. 3) 가장 흔한 임상 징후는 호흡곤란(7.2%) 이었고 증상은 빈호흡이 61.1%로 가장 많았다. 증상이 없던 경우도 44.4%나 되었다. 4) 심전도는 정상소견을 보인 28.6%외에 대부분 ST 또는 QRS 변화를 관찰할 수 있었고 25.7%에서는 급성 폐성심의 양상을 관찰하였다. 동맥혈 검사상 77.8%에서 $PO_2$ 80mmHg 이하의 저산소증을 관찰하였다. 5) 흉부 방사선 소견상 71.4%에서 폐침윤, 폐동맥의 변화, 폐삼출 등을 관찰할 수 있었고 28.6%에서는 정상 소견을 보였다. 흉부 컴퓨터 단층 촬영은 12명이 실시하였고 그중 나선형 CT가 폐관류 주사나 폐동맥 촬영술과 좋은 연관관계를 보여 주었다. 폐관류 주사는 고확률 소견을 보인 경우가 55.5%, 저, 중동도 확률을 보인 경우는 44.4% 이었다. 6) 심초음파는 28명에서 실시하였는데 고확률 소견을 보인 군에서 폐동 맥압은 57.9 mmHg이었으며 더 높은 사망률(35%)을 보였으며 후에 사망한 군에서 폐동맥압이 57.4 mHg으로 회복된 군보다 높았다. 결론 : 폐혈전색전증은 우리나라에서 드물지 않게 발생하며 뚜렷한 원인 질환이 없을 경우 악성종양의 가능성을 생각해야하며 의심 시 빠른 진단과 치료가 필요하다.

• The Korean Journal of Pain
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• 제19권1호
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• pp.119-122
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• 2006

Upper thoracic back pain can be musculoskeletal in origin or it could be visceral referred pain, which may be indicative of a serious medical condition. We experienced a case of a 55-years-old female patient who complained of upper thoracic back pain for 1 month, which started 10 days after a traffic accident. She described the pain as being a dull, constant nagging sensation with an intensity of 4/10 on the visual analogue scale. Her pain did not subside after trigger point injection of the rhomboid and trapezius muscles. She reported intermittent palpitation, which indicated that the cardiovascular or pulmonary systems were involved. She was diagnosed with pulmonary thromboembolism by the imaging studies. Refractory upper thoracic back pain should be investigated to rule out this treatable, but potentially fatal condition.

• Journal of Yeungnam Medical Science
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• 제33권1호
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• pp.25-28
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• 2016

Nephrotic syndrome is associated with a hypercoagulable state, which results in thromboembolism as one of its main complications. Various pathogenetic factors that cause the hypercoagulable state in nephrotic syndrome have been recognized. We report on a 19-year-old female with a minimal-change disease who developed pulmonary thromboembolism combined with intracardiac thrombus while on tapering steroid. Our patient showed hypoalbuminemia with an episode of shock, and was successfully treated with thrombolysis and anticoagulation therapy.

• Journal of Chest Surgery
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• 제47권5호
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• pp.478-482
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• 2014

A 39-year-old man presented with cough, chest discomfort, and weight loss. On the basis of the patient history and laboratory findings, he was diagnosed with the hypereosinophilic syndrome. Transthoracic echocardiography revealed a large thrombus in the left ventricle. Medical treatment with anticoagulation and immunosuppression was commenced immediately. Fourteen days after the initial diagnosis, the patient presented with acute pain in his right leg. Computed tomographic angiogram showed embolic occlusion of the infrarenal abdominal aorta and bilateral iliac (including common, external, and internal iliac) arteries. Emergent thromboembolectomy and left ventricular thrombectomy were performed. The postoperative course was uneventful, and the patient has undergone follow-up for 2 months without any evidence of recurrence of thromboembolism.

• 한국간호교육학회지
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• 제19권4호
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• pp.531-541
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• 2013

Purpose: This study was done to examine the relationship among knowledge, health belief, and preventitive behavioral intention related to venous thromboembolism (VTE) in patients with lower-limb musculoskeletal disorders. Methods: This transversal descriptive study looked at 145 adult patients with lower-limb musculoskeletal disorders, who were hospitalized in C hospital in G city. Data were collected from September 29 to October 6, 2012. Knowledge, health belief and preventitive behavioral intention were measured by structured questionnaires. Date were analyzed by descriptive statistics, one-way ANOVA, independent t-test, and Pearson correlation, using the SPSS program. Results: The mean score of knowledge related to VTE was low. The mean scores of health belief and preventitive behavioral intention related to VTE were moderate or higher than average. Preventitive behavioral intention positively correlated with knowledge, perceived benefit, and health motivation. Whereas, there was a negative correlation between preventitive behavioral intention and perceived barriers. Conclusion: These results suggest that developing a health care program which is able to enhance knowledge, perceived benefit, and health motivation related to VTE and reduce perceived barriers, is essential in order to promote preventitive behaviors.