• Title/Summary/Keyword: 수술불안

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Multidirectional Instability of the Shoulder (견관절 다방향 불안정성의 치료)

  • Kim, Y.K.
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.5-12
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    • 2007
  • 견관절의 다방향 불안정성은 생역학 및 생화학적 이상의 복합적 요인에 의해 발생되는 것으로 알려져 있으나 이에 대한 보다 많은 연구가 이루어져야 될 것으로 생각된다. 최근 다방향 불안정성과 관련된 요소에 따라 분류가 세분화되어 치료가 이루어지고 있다. 따라서 진단시 세심한 병력과 진찰이 매우 중요하며 이에 따라 치료 방침을 결정해야 할 것이다. 많은 환자에서 삼각근, 회전근 개, 견갑 안정화 근육을 강화시킴으로써 증상이 호전되나 비수술적 치료에 호전이 없는 경우는 관절 낭 이동술을 이용하여 비교적 만족스러운 결과를 얻을 수 있다. 일반적으로 개방적 술식이 다방향 불안정성을 위한 수술적 치료의 표준적 술식으로 알려져 있으나. 최근에는 여러 관절경적 술식이 개발되고 있고 이에 따른 중 단기 추시 결과도 비교적 좋은 것으로 보고되고 있다. 그러나 이 술식에 대한 정확한 평가를 위해서는 많은 경험과 장기 추시 결과를 요한다.

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The Effects of Abdominal Breathing on the Preoperative Anxiety and Blood Pressure of Upper and Lower Limbs Surgical Patients (복식호흡이 상.하지 수술 환자의 수술 전 불안과 혈압에 미치는 효과)

  • Kwak, Mi-Gyeong;Kim, Yun-Kyung;Hong, Hae-Sook
    • Journal of Korean Biological Nursing Science
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    • v.13 no.1
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    • pp.23-28
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    • 2011
  • Purpose: The aim of this study were to examine the effects of abdominal breathing on preoperative anxiety and blood pressure. Methods: The research was a non-equivalent control group pretest-posttest design. The subjects were 60 patients that operated on under local anesthetic. Thirty subjects in the experimental group and 30 subjects in the control group. Data on anxiety and blood pressure for this study were collected from them. The collected data were analyzed by t-test, $X^2$-test, paird t-test. Results: After abdominal breathing, there was a statistically significant decline in the psychological anxiety level of the experimental group. With regard to the physical anxiety level, no statistically significant drop was detected in blood pressure. Conclusion: The findings of the study confirmed that abdominal breathing reduced preoperative anxiety of upper and lower limbs surgical patients.

Postoperative Quality of Life in Patients with Papillary Thyroid Cancer (갑상선 유두암환자의 수술 후 삶의 질)

  • Kim, Ju-Sung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.3
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    • pp.1260-1269
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    • 2011
  • The purpose of this study was to determine postoperative quality of life(QoL), thyroid specific symptoms(TSSs), self care compliance, anxiety and depression in patients with papillary thyroid cancer and to identify factors influencing their postoperative QoL. 154 patients were surveyed using structured questionnaires and data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple regression with SPSS/WIN 18.0 program. The mean score of postoperative QoL in the subjects was 2.72 and the postoperative QoL score of social/family well being subscale showed the lowest score. Most of the subjects suffered from TSSs such as fatigue, cold intolerance, and mood swings. The most frequent activity for self care compliance was taking thyroid hormone(100%) and OPD follow up was the second activity(99.4%). Anxiety score was 45.3 indicating a medium level however 63% of the subjects were evaluated as depression status. Postoperative QoL in thyroid papillary cancer patients showed significantly negative correlations to TSSs, anxiety, and depression (r=-.573, p<.001; r=-.739, p<.001; r=-.742, p<.001). The factors influencing postoperative QoL were TSSs, anxiety, and depression, which explained about 64.9% of the variance. Thus to improve postoperative QoL in patients with papillary thyroid cancer, health care providers should relieve negative emotions related to long term cancer management, develop the support system and provide practical information to apply patients' physical, and psychological symptoms control.

Risk Factor Analysis for $SaO_2$ Instability after Systemic-pulmonary Shunt (전신-폐 단락술 후 산소포화도의 불안정성의 위험인자 분석)

  • Jung Sung-Ho;Yun Sok-Won;Park Jung-Jun;Seo Dong-Man;Kim Young-Hwue;Ko Jae-Kon;Park In-Sook;Yun Tae-Jin
    • Journal of Chest Surgery
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    • v.38 no.4 s.249
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    • pp.277-283
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    • 2005
  • Arterial oxygen saturation $(SaO_2)$ instability frequently takes place after systemic-pulmonary shunt without shunt occlusion. We analyzed actual incidence and risk factors for $SaO_2$ instability after shunt operations, and possible mechanisms were speculated on. Material and Method: Ninety three patients, who underwent modified Blalock-Taussig shunt from January 1996 to December 2000, were enrolled in this study. Adequacy of shunt was verified in all patients, either by ensuing one ventricle or biventricular repair later on or by appropriate pulmonary artery growth on postoperative angiogram. Age, body weight, hemoglobin level at operation were 3 day to 36 years (median: 1.8 months), 2.5kg to 51kg (median: 4.1kg) and $10.7\~24.3$ gm/dL (median: 15.2 gm/dL) respectively. Preoperative diagnoses were functional single ventricle with pulmonary stenosis or atresia in 39, tetralogy of Fallot in 38 and pulmonary atresia with intact ventricular septum in 16. Pulmonary blood flow (PBF) was maintained pre-operatively by patent ductus or previous shunt in 64 and by forward flow through stenotic right ventricular outflow tract (RVOT) in 29. $SaO_2$ instability was defined as $SaO_2$ less than $50\%$ for more than 1 hour with neither anatomic obstruction of shunt nor respiratory problem. Result: 10 patients $(10.7\%)$ showed $SaO_2$ instability after shunt operation. After shunt occlusion was ruled out by echocardiogram, they received measures to lower pulmonary vascular resistance (PVR), which worked within a few hours in all patients. Risk factors for $SaO_2$ instability included older age at operation (p=0.039), lower preoperative $SaO_2$ (p=0.0001) and emergency operation (p=0.001). PBF through stenotic RVOT showed marginal statistical significance (p=0.065). Conclusion: $SaO_2$ instability occurs frequently after shunt operation, especially in patients with severe hypoxia pre-operatively or unstable clinical condition necessitating emergency operation. Temporary elevation of pulmonary vascular resistance is a possible mechanism in this specific clinical setting.

Changes in Quality of Life and Related Factors of Surgical Patients with Thyroid Cancer (갑상선암 수술환자의 삶의 질 변화와 관련요인)

  • Choi, Hyang-Suk;Kang, Young-Mi;Lee, Tae-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.370-379
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    • 2018
  • This study was conducted 1) to investigate the effects of treatment and other factors on the quality of life of thyroid cancer surgical patients and 2) to provide fundamental data for development of an intervention and symptom management program to improve the quality of life of those patients. A total of 76 patients who were diagnosed with thyroid cancer and underwent thyroidectomy from July 2013 to December 2014 participated in this study. To investigate the factors affecting quality of life, a t-test and ANOVA analyses were conducted, after which multiple regression analysis was performed. The results were statistically significant between preoperative and one month after surgery of sex, cancer history, fatigue, and quality of life until 3 months after surgery of stage, cancer history, anxiety, and pain. Multiple regression analysis showed that the most influential factors affecting the quality of life were depression and fatigue at one month prior to and after surgery and anxiety at three months after surgery, while no factors were found to be influential at six months after surgery. Overall, the results of this study suggested that it is imperative to manage depression and fatigue one month prior to and after surgery to reduce the physical and psychological pain experienced by thyroid cancer patients. Moreover, three months after the surgery, anxiety should be closely monitored and controlled to improve the quality of life of the patients. This approach is expected to reduce the burden on the health care system and social costs, which will positively affect public health.

Proper Surgical Methods of Posterolateral Rotatory Instability of the Knee (슬관절 후외측 회전 불안정성의 적합한 수술적 방법)

  • Jung Young Bok;Lee Yong Seuk;Song Kwang Sup;Jin Ho Sun;Lee Jong Seok
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.49-55
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    • 2004
  • Purpose: we would like to suggest the proper surgical methods according to the severity of instability by analyzing the results. Materials and Methods: Between January 1998 and August 2002, eighty five patients have been operated on because of posterolateral rotatory instability (PLRI). The materials were included the patients who had followed-ups for over 2 years in sixty one patients and the patient's assessments were done by clinical score (OAK, IKDC) and posterolateral drawer and dial test. Results: Through our results, the fibular tunnel turned out to be superior compared to the tibia tunnel method in rotational stability. Hughston-Jacobson methods and biceps tenodesis showed poor results. Fibula head tunnel was superior to tibia tunnel in rotational stabiliaty Conclusion: The surgical technique that passes the modified posterolateral corner sling through the fibula head tunnel may provide good clinical results in grade II PLRI. It is necessary to reconstruct both tibia and fibula tunnel in grade III PLRI. When there is combined varus instability, a positive result may be obtained if an additional LCL reconstruction is performed.

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The Effect of Music Therapy on Anxiety of Cesarean Section Wemen (음악요법이 제왕절개 임부의 수술불안에 미치는 영향)

  • Kwun Young-Sook;Kim Tae-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.3
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    • pp.466-478
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    • 2000
  • The purpose of this study was to identify the effects of music therapy on anxiety of cesarean section wemen. The research design was a nonequivalent control group non-synchronized design. The subjects of this study were 65 cesarean section wemen scheduled for surgery. The study was conducted from October 15, 1999 to January 5, 2000. Two groups consisted of subjects assigned : one the experimental group(33 wemen), and the other the control group(32 wemen). The music therapy was performed 3 times to experimental group just before surgery day, on surgery day. The level of anxiety was measured by State Anxiety Inventory, blood pressure, pulse rate, respiratory rate. The data were analyzed using descriptive statistics, $x^2-test$, t-test, Repeated measures of ANCOVA. The results of study were as fellows : 1) State anxiety scores were significantly different between the experimental group and the control group after music therapy. 2) Systolic blood pressures and diastolic blood pressures were significantly different between the experimental group and the control group after music therapy. 3) Pulse rates were significantly different between the experimental group and the control group after music therapy. 4) Respiratory rates were significantly different between the experimental group and the control group after music therapy. According to these results, music therapy can be regarded as an effective nursing intervention that relieves anxiety of cesarean section wemen.

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