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전신마취하 복강경 담낭절제술을 받은 환자의 근이완 길항제 종류에 따른 수술 후 호흡근육 활성도, 통증, 회복지수 및 회복실 체류시간 비교
이선경(Son Kyong Lee),유제복(Je Bog Yoo),정현택(Hyeon Taek Jung),송희정(Hee Jung Song),조은아(Eun Ah Cho) 한국자료분석학회 2018 Journal of the Korean Data Analysis Society Vol.20 No.1
본 연구는 전신마취 하에 복강경을 이용한 담낭절제술을 받은 환자의 수술 후 회복과정에서 근이완 길항제 종류에 따라 수술 후 호흡근육 활성도, 통증, 회복지수 및 회복실 체류시간의 차이가 있는지 확인하고자 실시하였다. 전신마취 하에 복강경 담낭절제술을 받는 성인 환자를 대상으로 sugammadex(1군)와 pyridostigmine(2군) 투여군을 각각 30명씩을 대상으로 조사를 하였으며 분석결과 호흡근육 활성도 평가는 수술 후 회복실 입실직후 1군 3.80±1.75점, 2군 2.83±1.32점(p<0.031)이었고, 입실 10분 후에도 1군 5.33±1.03점, 2군 4.30±1.44점(p<0.003)으로 유의한 차이가 있었고 1군이 2군에 비해 호흡근육 활성도가 높았다(집단*시점, p<0.049). 수술 후 통증의 정도는 1군과 2군의 두 그룹 간에 유의한 차이는 없었으나(p<0.567), 시점에 따른 차이는 있었으며(p<0.001), 교호작용은 없었다. 두 군간의 회복지수는 입실 시(12.13±0.90 vs 12.00±0.64, p<0.932)점, 퇴실 시(14.10±0.71 vs 13.87±0.43, p<0.323)점으로 두 군간의 유의한 차이가 없었다. 두 군의 회복실 체류시간(31.23min±11.19 vs 40.97min±12.54, p<0.002)으로 1군이 2군보다 회복실 체류 시간이 더 짧았다. 새로운 근이완 길항제의 개발이 회복 간호에 영향을 주는 요인을 파악하고 약제에 대한 효과와 원리 및 사용방법에 대한 간호 교육을 제언하는 바이다. The objective of this study was to identify the effects of sugammadex and pyridostigmine in the postoperative recovery including respiratory muscle activity, pain score, PAR score and postoprative period in the recovery room after laparoscopic cholecystectomy. Data were retrospectively collected from adult patients under general anesthesia in K hospital: 30 patients each group assigned to receive sugammadex (group 1) and pyridostigmine (group 2). There were significant differences in respiratory muscle activity score in two groups immediately after admission to the recovery room (3.80 ± 1.75 vs 2.83 ± 1.32, p<0.031) and at 10 minutes after admission to the recovery room (5.33 ± 1.03 vs 4.30 ± 1.44 points, p<0.003). Group 1 showed higher than group 2 (group*time p<0.049). Although there was no significant difference in overall postoperative pain between the groups (p<0.567). There were no differences in the recovery index. PACU stay was significantly shorter in group 1 than 2 (31.23 min ±11.19 vs 40.97 min ±12.54, p<0.002).
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담도 폐쇄로 인한 담도염 환자에 있어서의 담즙 내 세균에 대한 연구
성인경(In Kyung Sung),이규택(Kyu Taek Lee),이종균(Jong Kyun Lee),김영호(Young Ho Kim),이석호(Seok Ho Lee),송희정(Hee Jung Son),이준혁(Joon Hyoek Lee),이풍렬(Poong Lyunl Rhee),김재준(Jae Jun Kim),고광철(Kwang Chul Koh),백승운(Seung Wo 대한내과학회 1998 대한내과학회지 Vol.55 No.1
N/A has been focused on the Enterococcus due to increasing in incidence of nosocomial infection and resistance to broad range of antimicrobial agents of this organism The purpose of this study was to analyse the bacteriologic features of bile in patients with cholangitis. Methods : Bacteriological examination was made of bile from 356 patients with cholangitis due to biliary tract obstruction, 105 of them with common bile duct stone and 251 of them with malignant disease. Bile specimens were taken during percutaneous transhepatic biliary drainage of endoscopic nasobiliary drainage. The specimens were cultured aerobically and anaerobically and then the anti- biotic sensitivity test was done. Results: The overall positive culture rates was 81.4%. There was significant difference in positive culture rates between the patients with common bile duct stone and the patients with malignant disease,(88.5% vs 78.4%, p<0.05) But there was no significant difference in bacteriological features between the patients with common bile duct stone and the patients with malignant disease. The commonly isolated organisms were Enterococcus (21.6%), E.coli(19.7%), and Klebsiella(17.2%) respectively. The isolation rate of anaerobes were only 2%. The rate of polymicrobial infection was 78.1%. The rates of 3rd cephalosporins-resistant Klebsiella were over 30%. The rate of ampicillin-resistant Enterococcus was 35%. The rate of gentamicin-resistant Enterococcus was 28%. Conclusion : This study shows that 1) many micro- organisms have resistance to a broad range of antimicrobial agents, and 2) the antibiotic coverage against Enterococcus should be considered for the treatment of cholangitis due to the increasing tendency to Enterococcus infection.
KCI
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