http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
Low Flux 혈액 투석막을 이용한 일시적 정정맥 혈액여과법
이윤정 ( Lee Yun Jeong ),전성희 ( Jeon Seong Hui ),정금모 ( Jeong Geum Mo ),최현종 ( Choe Hyeon Jong ),박종필 ( Park Jong Pil ),김정화 ( Kim Jeong Hwa ),이광영 ( Lee Gwang Yeong ) 대한신장학회 2003 Kidney Research and Clinical Practice Vol.22 No.6
배 경 : 지속적 정정맥 혈액 여과 (continuous veno-venous hemofiltration, CVVH)는 혈역동 상태가 불안정한 급성 신부전이나 난치성 부종 등의 치료에 효과적으로 사용되고 있으나, 이에 이용되는 high flux 혈액 여과막 (hemofilter)이 비교적 고가이고 CVVH용 설비 (machine)를 구입한 병원에서 시행할 수 있다. 저자들은 low-flux 혈액 투석막 (hemodialyzer)과 혈액 펌프 (blood pump)만 기능하는 폐기된 혈액 투석기를 이용하여 간단한 일시적 정정맥 혈액 여과 (temporary veno-venous hemofiltration, TVVH)를 시행하여 그 방법을 소개한다. 방 법 : 환자들은 핍뇨성 급성 또는 만성 신부전에 동반된 금성 폐부종으로 호기말 양압 (positive end-expiratory pressure, PEEP)을 가해 기계 호흡 치료 중이어서, 인공 신장실로 옮기어 혈액 투석 치료를 받기 불가능한 환자들이었으며, 9명의 환자들에게 총 13회의 TVVH를 시행하였다. Low-flux 혈액 투석막과 혈액 점프만 작동되는 혈액투석기를 사용하였고, 혈류 속도는 150-200 mL/min로 유지하였다. 결 과 : TVVH 치료는 평균 17.0±16.7시간 동안 시행하였으며, 초여과 속도는 평균 440±203 mL/hour이었다. 9명의 환자 중 6명 (66.7%)에서 혈액 여과가 성공적으로 이루어져 기계호흡을 제거할 수 있었으며 증상 호전되어 퇴원하였다. 결 론 : CVVH 시설이 없고, 중환자실에서 혈액 투석이 가능한 이동식 정수 시설이 갖추어지지 않은 병원에서 low flux 혈액 투석막과 혈액 점프만 작동되는 페기된 혈액투석기를 이용한 TVVH가 일시적으로 간단히 사용할 수 있는 효과적인 치료 방법으로 사료된다. Background : Continuous veno-venous hemofiltration (CVVH) is one of the continuous renal replacement therapies for managing patients with refractory edema or oliguric renal failure with unstable vital signs. High-flux hemofilters are usually used for CVVH, but low-flux hemodialyzers are not used for CVVH. We tried temporary veno-venous hemofiltration (TVVH) procedures using low-flux hemodialyzers for 9 patients with acute or chronic renal failure who were on mechanical ventilation with positive end-expiratory pressure (PEEP) in the ICU. Methods : All of the nine patients with acute or chronic oligo-anuric renal failure could not receive hemodialysis treatment in the hemodialysis room, because they were on mechanical ventilation with PEEP in the ICU due to severe fluid overload with elevated CVP and acute pulmonary edema. Low-flux hemodialyzers with effective membrane area of 10.-1.1m² and blood pumps on the discarded hemodialysis machines were used for TVVH procedures. Results : Mean duration fo TVVH was 17.0±16.7 hours and mean ultrafiltration rate was 440±203mL/hour. After finishing the TVVH procedures, CVP decreased from 22.9±8.5 ㎝H₂O to 6.4±2.4㎝H₂O. Of nine patients, 6 patients (67%) were able to be off the mechanical ventilation with clinical improvement. Conclusion : Even if CVVH is usually done with expensive high-flux hemofilters and CVVH machines, simplified and cheaper TVVH procedures using lowflux hemodialyzers and discarded hemodialysis machines with functioning blood pumps can be done with good results and cost effectiveness, especially in institutions not equipped with facilities such as CVVH machines or portable water purification systems for hemodialysis in the ICU. (Korean J Nephrol 2003;22(6):706-712)
정상 신기능 환자에서 Sodium Phosphate 복용 후 발생한 중증 고인산혈증 및 저칼슘 강직
최현종 ( Choe Hyeon Jong ),박종필 ( Park Jong Pil ),이윤정 ( Lee Yun Jeong ),전성희 ( Jeon Seong Hui ),정금모 ( Jeong Geum Mo ),김정화 ( Kim Jeong Hwa ),이광영 ( Lee Gwang Yeong ) 대한신장학회 2003 Kidney Research and Clinical Practice Vol.22 No.6
Oral sodium phosphate (NaP) is increasingly used to prepare patients for gastrointestinal procedures such as colonoscopy. Severe hyperphosphatemia may complicate bowel-cleansing preparation using oral NaP. The risk of hyperphosphatemia is known to increase with excessive and/or repeated doses, increased intestinal absorption, or impaired renal excretion of phosphate. Hyperphosphatemia may produce acute renal failure, but the mechanism is not yet clear. Some authors suggest that renal injury is caused by intrarenal calcium-phosphate deposition, but others suggest that direct tubular toxicity or a disturbance in renal hemodynamics may induce renal injury. A 74-year-old woman was admitted with generalized weakness after taking NaP for colonoscopy. She had no underlying diseases such as renal disease. She was hypotensive and had carpopedal spasm with hypocalcemia, severe hyperphosphatemia, metabolic acidosis, and non-oliguric acute renal failure. She was treated with aggressive hydration, calcium replacement and aluminum-containing antacid, but hyperphosphatemia was aggravated (35.6 mg/dL). Hemodialysis was done and phophate concentration was lowered to 5.5 mg/dL. It is suggested that caution should be taken when using phosphatecontaining laxatives especially for elderly patients even if they have no underlying diseases. (Korean J Nephrol 2003;22(5):736-739)
수술 위험도가 높은 다장기 부전을 동반한 급성담낭염 환자에서 병상에서의 초음파유도하 경위 담낭 흡인 및 세척
윤소희 ( So Hee Yun ),박문식 ( Moon Shik Park ),이재운 ( Jae Un Lee ),양민아 ( Min A Yang ),한상훈 ( Sang Hoon Han ),이영재 ( Young Jae Lee ),정금모 ( Geum Mo Jeong ),조용근 ( Yong Keun Cho ),김지웅 ( Ji Woong Kim ),조진웅 ( Jin W 대한소화기학회 2015 대한소화기학회지 Vol.65 No.6
Cholangitis and cholecystitis are intra-abdominal infections that show poor prognosis upon progression to sepsis and multiorgan failure. Administration of antibiotics with high antimicrobial susceptibility and removal of infected bile at the initial treatment are important. After undergoing ERCP for diagnostic purposes, a 58-year-old man developed acute cholangitis and cholecystitis accompanied by rhabdomyolysis, multi-organ failure, and severe sepsis. Broad-spectrum antibiotics with bedside endoscopic nasobiliary drainage were administered, but clinical symptoms did not improve. Therefore, bedside EUS-guided transgastric gallbladder aspiration and lavage was performed, resulting in successful treatment of the patient. We report the above described case along with a discussion of relevant literature. (Korean J Gastroenterol 2015;65:370-374)