• Title/Summary/Keyword: 수술후 관리

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A Successful Management of an Esophageal Perforation Caused by Esophageal Foreign Body with a Non-operative Treatment in a Dog (개에서 식도 이물에 의한 식도 천공의 비침습적 치료를 통한 성공적 관리 증례)

  • Lee, Hyeon-Suk;Baek, Dae-Seung;Ju, Ho-Jong;Kim, Jun-Hwan;Hong, Yeon-Jung;Park, Jin-Ho;Cho, Ho-Seong;Park, Chul
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.506-508
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    • 2012
  • A 5-year-old, intact female, Pomeranian was presented with a persistent vomiting for 5 days after swallowing a chicken bone. The dog was diagnosed with an esophageal foreign body, and a small perforation was found after the endoscopic removal of the chicken bone. The dog was determined to be treated with a non-operative management, and a complete closure of the perforation was confirmed by a flexible endoscopy 3 weeks after removal of a chicken bone. This paper reports the case of esophageal perforation caused by foreign body in esophagus managed with the non-operative therapy instead of surgical correction.

The Competence and Satisfaction on Inventory Management of the Operating Room Nurses (수술실 간호사의 물품관리 업무역량과 업무만족도 연구)

  • Son, Jeong-Sook;Choi, kyung-Sook;Kim, Hyun-Joo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.6
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    • pp.449-458
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    • 2016
  • The study verified the work capacity (job performance, perception, knowledge) and satisfaction on managing the inventory of operating room nurses working in a more than 700-bed hospital. The purpose of this study was to provide basic data of education for work capacity and satisfaction and quality insurance by analyzing the scores between the three different operating rooms and the correlation between the work capacity and satisfaction by investigating the related factors. This study presented a structured and self-administered questionnaire to 181 nurses who had been working in the operating room more than six months. The mean and standard deviation of the job performance, perception, knowledge, and satisfaction were 4.2(${\pm}0.56$), 3.4(${\pm}0.76$), 3.5(${\pm}0.40$), and 3.4(${\pm}0.55$), respectively. The work capacity and satisfaction of each group did not show a statistically significant difference. The correlations between the job performance and knowledge, knowledge and perception, perception and satisfaction were positive (r=.627, p<0.01), (r=.663, p<0.01) and (r=.485, p<0.01), respectively. Among the factors related to the general characteristics of operating room nurses, only age significantly affected their job performance. This study provides basic data on the maintenance and improvement of their competence and satisfaction by being served as a resource for sustainable human resources management and training, and efficient management of the communication channel between hospitals.

Recovery of Pulmonary Function according to the Operative Sites after General Anesthesia (전신마취를 이용한 수술에서 수술부위에 따른 폐기능의 회복)

  • Kim, Hyeon-Tae;Lee, Sang-Moo;Uh, Soo-Taek;Chung, Yeon-Tae;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.3
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    • pp.250-258
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    • 1993
  • Background: After general anesthesia, decrease of functional residual capacity and lung compliance, ventilation/perfusion imbalance, and transpulmonary shunting can provoke hypoxemia during postoperative periods. Diaphragmatic dysfunction may be the main cause of these physiological abnormalities. Thus, we evaluated the change of pulmonary function after general anesthesia according to the operative sites, which could suggest clinical course and critical period of respiratory care of postoperative patients. Method: Preoperative portable spirometric evaluation and arterial blood gas analysis were performed at sitting or most-sitting position just previous day of surgery. Pulmonary function tests were also as same condition from postoperative day 1 to day 5. Results: 1) For thoracic surgery, FEV1 and FVC were not recovered at day 5, but FEV1/FVC was not decreased. $PaCO_2$ was slightly elevated at postoperative one day. 2) After upper abdominal surgery, postoperative day 5 did not show the recovery of FEV1 and FVC, but mild hypoxemia was developed at postoperative day 1. 3) Pulmonary function was recovered as preoperative value at postoperative day 5 in lower abdominal operation, but mild hypoxemia was also noted at postoperative day 1. 4) Surgery of peripheral areas did not show significant pulmonary function change and hypoxemia and hypercapnia from postoperative day 1. Conclusion: Surgery involving diaphragm provoke significant postoperative pulmonary function change after day 5. For the operation of peripheral sites adequate respiratory care during operation and postoperative period within 24 hours could prevent patients from respiratory complication.

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Retrospective Analysis of Equine General Anesthesia Performed at Korea Racing Authority (한국마사회에서 실시한 말의 전신마취에 대한 후향 분석)

  • Kim, Ahrham;Yang, Youngjin;Song, Daeyoung;Kim, Jinkap;Kim, Hagi;Kwon, Cheoljae;Seo, Eugene;Jeong, Hyohoon;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.31 no.2
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    • pp.102-107
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    • 2014
  • This study was conducted to analyze the results of inhalation anesthesia performed at the equine hospital of Korea Racing Authority (KRA) and to find out the influencing factors on mortality during and/or after inhalation anesthesia. Among 585 cases of anesthesia, orthopedic surgery (410) was performed the most frequently, followed by colic surgery (85) and upper airway surgery (45). Twenty out of 585 horses were either euthanized or died during and/or after anesthesia. Among those twenty horses, fourteen horses received colic surgery, three received orthopedic surgery, and three others received upper airway surgery. The major causes of mortality were rupture of intestine in colic surgery and airway obstruction during recovery in upper airway surgery. Myopathy, refracture, laminitis were the causes of mortality in orthopedic surgery. Consequently, the horses that received colic and upper airway surgeries showed significantly high mortality rate rather than horses that received orthopedic surgery (p < 0.01). According to the results, horses that received colic surgery showed the highest mortality rate from euthanasia due to poor and grave prognosis. To reduce the perioperative mortality of horses, it is recommended to perform perioperative intensive care for colic surgery and careful monitoring for upper airway surgery during recovery.

Long term prognosis of patients who had a Fontan operation (폰탄 수술을 받은 환아들의 장기적 예후)

  • Kim, Hyun-Jung;Bae, Eun-Jung;Noh, Jung-Il;Choi, Jung-Yun;Yun, Yong-Su;Kim, Wong-Hwan;Lee, Jung-Yeul;Kim, Yong-Jin
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.40-46
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    • 2007
  • Purpose : This study assessed the long term survival rate and long term complications of patients who had a modified Fontan operation for functionally univentricular cardiac anomaly. Methods : Between June 1986 and December 2000, 302 patients with a functional single ventricle underwent surgical interventions and were followed up until February 2006. The mean follow-up period was $8.3{\pm}5.3years$ (range 3.5-18 years). Their median age was 2.4 years at the Fontan operation. The survival rate, the incidence and the risk factor of late complications were evaluated retrospectively. Results : The verall survival rate was 91 percent at 5 years and 87 percent at 10 years. In multivariate analysis, early calendar year of operation and significant regurgitation were risk factors of death. The surviving patients showed NYHA functional class I in 82 percent, class II in 15 percent, and class III in 3 percent. Redo Fontan operations were necessary in 8.8 percent of patients at average $12.8{\pm}3.6years$ after initial Fontan operation. The most common cause of Fontan conversion was atrial arrhythmia. The incidence of thromboembolic events was 9.3% and these complications were associated with the occurrence of atrial tachyarrhythmia. Supraventricular tachycardia including atrial flutter or fibrillation were reported on the follow-up examination by 11.2 percent of survivors after $8.4{\pm}5.6years$. Atriopulmonary connection showed higher rates of late tachycardia than lateral tunnel operation. Conclusions : This study revealed that the recent survival rate of Fontan type operation was satisfactory, but the occurrence of late complications after a Fontan type operation increased with the longer survival. There is a need for strict follow up and early treatment of late complications in patients who had a Fontan operation.

A Study on Perception and Nursing Activity for Patient Safety of Operating Room Nurses (수술실 간호사의 환자안전의식과 안전관리활동)

  • Park, So-Jeong;Choi, Eun-Hee;Lee, Kyeong-Soo;Chung, Kwi-Ae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.11
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    • pp.332-339
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    • 2016
  • This study aimed to investigate the awareness and performance of safety in operating room nurses. There were 161 operating room nurses from eight general hospitals included for analysis in this study. The data were analyzed with t-test, one-way ANOVA, correlation analysis, and Scheffe's test. The results show that their perception of patient safety was 3.33 out of a total of 5 points. Moreover, the score of safety management activity for patients in the operating room was 4.28 out of 5 points. As the perception of patient safety in operating room nurses was significantly correlated with their safety management activities, nurses with higher awareness of patient safety were found to have higher degree of performance of safety management activities. In conclusion, to improve safety management activities, open discussion about patient safety should be encouraged and periodic education regarding patient safety should be implemented for operating room nurses to increase the perception of patient safety.

The Convergent Development of Nursing Activity Index for postoperative patient using Patient Controlled Analgesia (자가통증조절기를 사용하는 수술 후 환자를 위한 간호 활동 목록의 융합적 개발)

  • Lee, Yoon-Young
    • Journal of the Korea Convergence Society
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    • v.7 no.5
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    • pp.43-49
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    • 2016
  • The purpose of this study was done to develop a nursing activity index for postoperative patient using Patient-controlled Analgesia(PCA). The study was developed in two steps: $1^{st}$ step) nursing activity index was developed through literature review and focus-group interview. $2^{nd}$ step) the nursing activity was ratified and Intervention Content Validity(ICV) was tested. Subjects were consisted of 5anesthesiologists, 6adult/fundamental nursing professors and 1acute pain management Clinical Nurse Specialist. We identified 12 items of nursing activity for postoperative patient using PCA. The Intervention Content Validity(ICV) score for each item ranged from 0.92 to 1.0. The nursing activity index for postoperative patient using PCA would be very useful in facilitating the nursing practice.

Operative Treatment of Patients Over 75 Years Old with Gastric Cancer (75세 이상 고령 위암환자들의 수술치료 성적에 의한 임상적 특성)

  • Lee, Yeon-Ah;Jung, Gui-Ae;Min, Young-Don
    • Journal of Gastric Cancer
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    • v.5 no.4 s.20
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    • pp.217-221
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    • 2005
  • Purpose: The incidence of gastric neoplasms is increasing in the elderly population, and a rational method of treatment for gastric cancer in the elderly is needed to improve survival. The purpose of the present study was to clarify whether the patient's age is an independent prognostic factor and to determine clinicopathological characteristics in the elderly. Material and Methods: Curative or palliative surgery for gastric cancer was carried out on 706 patients in Chosun University Hospital from March 1995 to February 2002. They were divided into the following two groups: elderly group (75 years or older) and control group (under 74 years old). The clinicopathologic features of these patients were reviewed retrospectively, and a multivariate analysis was performed. Results: There was no difference in clinicopathological appearances between the two groups, and the postoperative morbidity and mortality rates were similar in the two groups. The two groups showed similar survival rates. Conclusion: In this study, age was not a prognostic factor in surgery for gastric cancer. In the elderly, an oncologically correct surgical procedure can safely be prosecuted with satisfactory early and late results.

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