종합병원 세탁물의 외주용역과 자체직영에 대한 비교분석

강화자,Gang, Hwa-Ja 대한병원협회 1992 대한병원협회지 Vol.21 No.7.8

복강경 담낭절제술시 Clonidine 전투약이 술 전 진정상태와술 후 통증에 미치는 영향

강화자,박성욱,최원준 경희대학교 2004 慶熙醫學 Vol.20 No.1

산소공급과 과통기법이 기관내관 흡인후 동맥혈 산소 분압에 미치는 영향

강화자,이성민,김건식 경희대학교 2001 慶熙醫學 Vol.17 No.1

Nitrous Oxide 가 Propofol 의 최면용량에 미치는 영향

강화자 대한정맥마취학회 2001 정맥마취 Vol.5 No.2

Background: Nitrous oxide reduces the minimal concentration requirement for volatile anesthetics and decreases the need for intravenous anesthetics. Therefore we evaluated the efficacy of N_2O as a component of drugs used to induce a anesthesia. Methods: Sixty patients (ASA Ⅰ or Ⅱ) were randomly divided into four groups: Group 1 received 1 ml saline and inhaled 6 L/min O_2, Group 2 received 1 ml saline and inhaled 4 L/min N_2O + 2 L/min O_2, Group 3 received 1 ㎍/㎏ fentanyl and inhaled 6 L/min O_2, Group 4 received 1 ㎍/㎏ fentanyl and inhaled 4 L/min N_2O + 2 L/min O_2. Propofol was administered in bolus doses of 0.2 ㎎/㎏ every 30 sec until loss of response to verbal command. Results: The mean doses of propofol for hypnosis was 1.74 ±0.23 ±㎎/㎏(group 1), 0.89 ±0.36 ㎎/㎏ (group 2), 1.38 ±0.51 ㎎/㎏ (group 3) and 0.79 ±0.42 ㎎/㎏ (group 4), and time of loss of response to verbal command was 235 ±37.5 ㎎/㎏ (group 1), 145 ±40.1 sec (group 2), 210 ±51.3 sec (group 3) and 127 ±39.7 sec (group 4). Conclusions: We conclude that coadministration of N_2O during induction of anesthesia reduces the hypnotic dose of propofol.

유도 저혈압 마취시 Sodium Nitroprusside 가 혈소판 응집 기능에 미치는 영향

강화자,최영규,이두익 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.28 No.4

Sodium nitroprusside is reported to inhibite platelet aggregation. We studied the effects of sodium nitroprusside on platelet aggregation function were in 30 adult patients undergoing spine surgery with enflurane anesthesia. Platelet-rich plasma from patients receiving sodium nitroprusside was studied for aggregation in response to adenosine diphosphate, epinephrine and collagen. Maximum aggregation rate and maximum aggregation time were evaluated serially from the samples collected at post-induction (pre-sodium nitroprusside infusion), 30 min and 90 min after sodium niroprusside infusion. The mean maximum aggregation rate of adenosone diphosphate, epinepherine and collagen at post-induction decreased significantly 30 min and 90 min after sodium nitroprusside infusion (P 0.05),but maximum aggregation time showed no significant changes. The correlation between total sodium nitroprusside dose delivered and maximum aggregation rate of adenosine diphosphate, epinepherine and collagen were r=-0.54 (P$lt;0.05), r=-0.706 (P$lt;0.05) and r=-0.794 (P$lt;0.05). In summary, in situation in which sodium nitroprusside is administered during deliberate hypotensive anesthesia, the anesthesiologist must be aware of the potential for the inhibition of platelet aggregation.

악골골수염환자의 구강위생 및 간호에 대한 연구

강화자 대한치과의사학회 1993 대한치과의사학회지 Vol.14 No.3

Metoclopramide 가 Thiopental 과 Propofol 의 최면용량에 미치는 영향

강화자,김건식,김동욱,최영규,신옥영,이두익,권무일,김동수,신광일 대한정맥마취학회 1999 정맥마취 Vol.3 No.3

서론: 선택적 D_2 dopamine 수용체의 길항제인 metoclopramide를 정주시 진정효과를 나타낸다. 따라서 본 연구에서는 metoclopramide 전처치가 전신 마취 유도제인 thiopental과 propofol의 최면 용량에 미치는 영향을 관찰하였다. 방법: 마취전투약을 하지 않은 성인환자 120명을 대상으로 thiopental군(60명)과 propofol군(60명)으로 나눈 후 각 군을 다시 20명씩 대조군, metoclopramide 0.1 ㎎/㎏ 전처치군과 metoclopramide 0.2 ㎎/㎏ 전처치군으로 나누어 마취유도 5분전에 실험약제를 투여한 후 thiopental과 propofol을 정주하면서 최면 종료점에서 최면 용량을 측정하였다. 결과: Thiopental군과 propofol군 모두에서 metoclopramide 0.2 ㎎/㎏을 전처치한 경우 최면용량의 유의한 감소를 보였다(p<0.05). 결론: Metoclopramide는 thiopental과 propofol의 최면 용량을 감소시켰으며, 이는 metoclopramide의 D_2 dopamine 수용체 길항 작용에 의한 것으로 사료된다. Background: Metoclopramide has been shown to decrease thiopental and propofol requirement for induction of anesthesia. Therefore we evaluated the effect of metoclopramide. Methods: The effect of metoclopramide (0.1 ㎎/㎏, 0.2 ㎎/㎏) on the hypnotic dose for thiopental and propofol were studied in unpremedicated 120 ASA physical statal Ⅰ or Ⅱ patients. Loss of the ability to open eye on verbal command was used as a hypnotic end-point. Results: Metoclopramide in dose of 0.2 ㎎/㎏ significanty decreased thiopental and propofol requirement for hypnosis (P<0.05). Conclusion: Metoclopramide reduced the hypnotic dose of thiopental and propofol in a dose dependent fashion.

충수절제술 환자에서 수술 전후에 정주한 Lidocaine이 장기능과 통증에 미치는 영향

강화자,오재열 대한정맥마취학회 2000 정맥마취 Vol.4 No.2

서론: 복강내 수술 후 발생되는 장폐색증은 환자에게 심한 통증 및 구토를 유발하고 복부팽만을 일으키므로 경구 영양섭취의 지연등으로 환자 회복이 늦어진다. 따라서 수술 후 장기능 향상을 위한 노력이 행해졌다. 경막외로 사용된 국소마취제는 전신으로 흡수되어 장기능 회복과 진통효과에 영향을 미친다고 한다. 따라서 수술 전후로 정주한 lidocaine이 수술 후 장기능 회복, 진통효과 및 진통제 사용량에 미치는 영향을 관찰하였다. 방법: 충수절제술을 받는 환자 30명을 대상으로 15명씩 2개의 군으로 나누어 lidocaine군은 마취 유도 직전에 lidocaine 1.5 ㎎/㎏ 정주하였고 기관내 삽관후부터 lidocaine 2 ㎎/min을 피부봉합 1시간후까지 정주하였으며 대조군은 생리식염수를 동일한 방법으로 정주하였다. 통증의 정도는 통증 점수(0-10)로 측정하였고 통증을 호소하는 경우에는 ketorolac을 정주하였다. 입원기간중 사용된 진통제 총용량과 통증점수는 수술 후 4일까지 측정하였고 장운동 회복은 첫 번째 가스 배출과 배변 시간으로 기록하였다. 결과: 통증점수는 회복실, 수술 후 1일, 2일에 lidocaine군은 4.8 ± 1.9, 2.1 ± 1.0, 1.4 ± 0.9이고 대조군은 7.5 ± 2.1, 4.1 ± 1.3, 3.0 ± 1.1로 수술 후 2일까지 의미있는 차이를 보였고(P < 0.05) 수술 후 사용된 ketorolac의 총용량은 의미있는 차이가 없었다. 수술 후 장가스 첫배출시간과 배변시간은 대조군에서 35.1 ± 12.3시간과 49.5 ± 13.7시간이고 lidocaine군은 22.5 ± 11.0시간과 39.7 ± 15.2시간으로 양군에서 의미있는 차이를 보였다(P < 0.05). 결론: 충수절제출을 받는 환자에서 수술 전후의 lidocaine 정주가 술후 통증에 대한 진통효과와 장기능 회복에 효과적이었으나 이에 대한 연구가 더 필요한 것으로 사료된다. Background: Postoperative ileus can cause vomiting, nausea and pain. Epidural anesthesia and analgesia can speed up the return of normal bowel function after surgery. The use of epidural local anesthetics can result in significant plasma levels. The aim of this study was to determine the effects of systemic lidocaine on bowel function and pain. Methods: Thirty patients undergoing appendectomy were randomly divided into two groups; one lidocaine group received a lidocaine bolus (1.5 ㎎/㎏) and infusion (2 ㎎/㎏) (n = 15); the other control group received the same volume of saline bolus and infusion (n = 15). Intravenous lidocaine initiated before anesthesia was administered and continued for 1h postoperatively. We compared the patients' daily pain scores. the time the patient first experienced flatus and the first bowel movement, and the total amount of analgesics. Results: The time the patient first experienced flatus and had the first bowel movement was significantly short in lidocaine group (P < 0.05). Postoperative pain score decreased significantly from recovery room to postoperative day 2 in lidocaine group (P < 0.05). There was no significant difference in the amount of used analgesic between two groups. Conclusions: Lidocaine-treated patients had less pain and faster return of bowel function.

외래 및 퇴원환아 부모의 전화상담요구와 간호중재에 대한 조사연구

강화자,한경자,최명애,박승현,김영미,권원경,김선구,안혜영,허미영,Kang Hwa Ja,Han Kyung Ja,Choe Myoung Ae,Park Seung Hyun,Kim Young Mi,Kwon Won Kyoung,Kim Sun Gu,Ahn Hye Young,Heo Mi Young 한국아동간호학회 1996 Child Health Nursing Research Vol.2 No.1

The purpose of this study was to investigate the current status of the need of telephone call and to identify the status of nursing intervention through telephone. Head nurses of the pediatric nursing unit and a nurse of pediatric outpatient clinic wrote down the telephone record of calls by parents of children discharged from hospital from 7 am to 3 pm during the period of March to June, 1995. Content of 120 telephone calls but for 26 calls with incomplete record among 146 calls were analyzed into frequency of general characteristics, needs and nursing intervention. The needs of telephone call were identified and classified into 11 areas and analyzed into frequency of detailed content by 11 areas. Nursing intervention was identified and classified into 10 categories, and analyzed into frequency of detailed content by 10 categories. The findings of this study were as follows ; The need of telephone call was identified with nutritional state, medication, vital signs, language retardation, personal hygiene, vaccination, administration procedure, physical symptoms, follow up care management and others. The most frequent needs were physical symptoms and vaccination. A kind of food among nutrition dose of drugs among medication, fever among vital signs, cough among physical symptoms, and content of vaccination among vaccination was the most frequent needs. Nursing intervention through telephone was identified with instruction, knowledge offer, information offer, judgement, solicitation, referral and instruction, referral, connection, reassurance, reservation, and regulation. Instruction, knowledge offer and information offer was the most frequent nursing intervention by telephone call. Instruction was about a visit to hospital, a visit to nearby clinic, instruction about symptoms,, instruction about nursing care procedure, retelephoning and vaccination. Knowledge offer was about vaccination, knowledge related to medication, and dental care. Information offer and judgement was about vaccination and medication. Referral and instruction delivery was about instruction delivery following consultation to doctor, visit to emergency room and a visit to hospital following consultation to doctor. These results suggest that telephone call intervention program should be established as a field of extended pediatric nursing role in health care delivery system for the children.

Fechtner 증후군 환자에 있어 신장 이식 수술 시행의 경험

강화자,김형곤 경희대학교 경희의료원 2012 慶熙醫學 Vol.28 No.1