• 제목/요약/키워드: Coagulation therapy

검색결과 80건 처리시간 0.027초

만성 요추간판성 통증 환자에서 선택적 조직 응고술 후 유발성 추간판조영술의 진단적 소견 변화 (Provocative Discography Following Focal Selective Coagulation in a Patient with Chronic Lumbar Discogenic Pain)

  • 김단;김낙환;이상헌
    • Clinical Pain
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    • 제18권2호
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    • pp.142-146
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    • 2019
  • This is a case report of the provocative discographic findings before and after focal selective coagulation of the major annular fissure using intradiscal navigable catheter. A 46-year-old woman had a 30-month history of axial low back pain and magnetic resonance imaging findings suspicious for painful L4/5 disc. The provocative discography confirmed painful disc before coagulation. The final electrode tip position in the coagulation procedure was at the largest fissure within the outer annular margin identified through the discography. Six months after the successful coagulation therapy, inadvertently performed discography resulted in decreased pressure rise over time. Neither evoked pain nor change in the integrity of outer annulus as compared with the previous results was reported. Such an interventional method has not been reported previously, and the analytic results suggest that it may be possible to relocate the pressure of the entire nucleus pulposus only by focal selective coagulation of the fissure.

기관 재건술후 발생한 협착증에 대한 Microwave 조직응고법을 이용한 치료 -1례 보고- (A Micorowave Tissue Coagulation Therapy in the Restenosis of the Tracheal Reconstruction -A Case of Report-)

  • 김남혁
    • Journal of Chest Surgery
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    • 제28권4호
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    • pp.416-418
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    • 1995
  • The microwave tissue coagulation therapy was originally used for hemostasis in the hepatic surgery, which is effectively applied in the endoscopic surgery such as the hemostasis of gastric ulcer or tumor bleeding, stenosis relieving of esophageal or rectal stenosis and tumor reduction in inoperable early cancer cases.We experienced one case of the restenosis after the tracheal reconstruction. The patient, who was 42 year-old male, had severe dyspnea due to the tracheal stenosis for 4 years. The resection of tracheal stenosis and tracheal reconstruction was done. But the restenosis occurred at the tracheal anastomosis site because of the protrusive granulation at one month after operation. The patient was successfully treated by the microwave tissue coagulation therapy.

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신생아에서의 항응고요법, 혈전용해요법 및 혈액제제 사용 (Anticoagulation Therapy, Thrombolytic Therapy, and Use of Blood Products in Neonates)

  • 최창원
    • Neonatal Medicine
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    • 제18권1호
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    • pp.34-41
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    • 2011
  • 신생아에서 발생하는 혈액응고장애, 혈전증 및 색전증은 신속한 치료가 필요하며 치료가 적절한 시기에 이루어지지 않는 경우 사망 및 심각한 장기(long-term) 후유증을 초래할 수 있다. 그러나 신생아에서의 혈액응고장애, 혈전증 및 색전증에 대한 현재의 치료지침은 대부분 무작위 대조군 연구에 의해 뒷받침되지 못하고 경험적으로 도출된 것이며 아직 객관적인 근거가 부족한 상태에 머무르고 있다. 따라서 실제 신생아에서 이러한 문제들에 부딪혔을 때 치료의 선택에 있어 어려움이 있는 것이 사실이다. 본 종설에서는 문헌의 고찰을 통해 혈액응고장애, 혈전증 및 색전증을 가지고 있는 신생아에서 현재 실제로 적용이 되고 있는 치료방법 및 현재 연구단계에 있는 치료방법을 소개하고자 한다.

식도위 문합술후 재협착증에 대한 microwave 조직응고법적 치험 례 (An Experience of The Microwave Tissue Coagulation Therapy in The Restenosis of The Esophagogastrostomy)

  • 남충희;안욱수;이길노
    • Journal of Chest Surgery
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    • 제20권4호
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    • pp.859-864
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    • 1987
  • The microwave tissue coagulator was originally used for hemostasis in the hepatic surgery, which is effectively applied in the endoscopic surgery such as the hemostasis of gastric ulcer or tumor bleeding, stenosis relieving of esophageal or rectal stenosis and tumor reduction in inoperable early cancer cases. We experienced the good result of the microwave tissue coagulation therapy in the patient with the restenosis of esophagogastrostomy. The patient was 67 year-old female, who was admitted due to the lye stricture of esophagus for 40 years. We made the lower esophagectomy and the esophagogastrostomy with the upper intact esophagus in the right thorax. But the restenosis occurred at the esophagogastrostomy site because of the polypoid mucosal protrusion at one month after operation. We applied the microwave tissue coagulator 3 times with 6 day interval under esophagoscopy and the good symptomatic and endoscopic relief was alleviated. We think that the microwave tissue coagulation is a very convenient and advisable method in the case of restenosis after esophageal surgery.

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항응고제 투여 환자에서 약사의 효과적인 ACS를 통한 방광암 조기발견 사례 (Early-stage Diagnosis of Bladder Carcinoma by a Clinical Pharmacist's Effective Anti-coagulation Service in a Patient with Anticoagulation Therapy: a Clinical Case Report)

  • 안성심;방준석;나현오
    • 한국임상약학회지
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    • 제20권1호
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    • pp.85-87
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    • 2010
  • Recently, the prevalence of bladder cancer is increasing in the Korean society. As the risk factors of bladder carcinoma are variable, the early-stage diagnosis is regarded the best preventive practice. Hematuria is a specific sign of the malignancy as well as a kind of various medication-related adverse reactions. Some anti-coagulation therapy can cause bleedings including hematuria to the patients with cardiovascular diseases such as paroxysmal atrial fibrillation (PAF). Therefore, to the clinical pharmacists working in the anti-coagulation services (ACS), a closer monitoring of patients can give an opportunity to find certain ailments unexpectedly. In this case, a patient with PAF had episodes of sporadic hematuria in the course of warfarin therapy even though with its low levels of INR. An ACS pharmacist found a discrepancy between the bleeding symptoms and INR values, and recommended properly the patient to refer urologist. Fortunately, an early-stage of bladder carcinoma was found then followed by an excision performed to the lesion. Therefore, alert-minded and precise monitoring done by ACS pharmacist could optimize the therapeutic outcomes as well as increase the quality of life of the patient.

수혈 감소 전략을 위한 점탄성 응고 검사법의 유용성 (Viscoelastic Coagulation Test Guided Therapy for a Strategy to Reduce Transfusions)

  • 박선영
    • 대한수혈학회지
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    • 제29권3호
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    • pp.240-252
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    • 2018
  • 점탄성 응고 검사법은 전혈 검사법으로 혈장성분뿐 아니라 응고 과정의 세포 기반 측면까지 동시에 볼 수 있는 방법이다. 프로트롬빈시간이나 활성화부분트롬보플라스틴시간과 같은 기존의 응고 검사법과 달리 이 검사는 현장 현시 검사로 즉시 시행할 수 있다. 점탄성 응고 검사법은 사망률 등의 예후 예측 인자이고, 응고 장애를 좀 더 예민하게 감지하여 결과적으로 출혈을 줄여주는 효과를 줄 수 있다. 점탄성 응고 검사 결과를 이용한 수혈 전략이 수혈 요구량을 줄여주었다고 보고되기도 하였다. 아직 이 방법의 정확성과 신뢰도에 대한 우려가 있기도 하지만, ROTEM 등의 점탄성 응고 검사법은 환자혈액관리에 응용하는 것은 유용할 것이다.

살모사 교상 후 발생한 범발성 혈관내 응고장애 2례 (Two Cases of Disseminated Intravascular Coagulation (DIC) Following Pit Viper Envenomation)

  • 김석환;최세민;오영민;박규남;이원재;최경호
    • 대한임상독성학회지
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    • 제4권2호
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    • pp.137-142
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    • 2006
  • Our records include two cases of DIC in snakebite patients. One patient, who was 48-years old, was bitten in his left ankle 3 days before admission to our hospital. Initial symptoms were painful swelling, extensive ecchymosis, and persistent bleeding at the bite site. He visited and was admitted to a local hospital, but his condition did not improve with supportive care that included a single dose of antivenin. He was transferred to our hospital. His condition was compatible with DIC. We tried multi-dose antivenin therapy and blood product transfusion. At the seventh hospital day, the patient's symptoms were completely resolved. The other patient, who was 75 years old, was bitten in his right thumb. Initial symptoms were painful swelling of the right arm and persistent bleeding at the bite site, and within minutes of hospital admission, the patient experienced massive hematochezia. We peformed laboratory tests, the results of which were compatible with DIC, and the next day a sigmoidscopic examination showed ischemic colitis. We administered multi-dose antivenin therapy and blood product tranfusion. At the third hospital day mild anemia still existed, but the patient's clinical condition was improved. No signs or symptoms of gastrointestinal bleeding were observed. In these two cases, multi-dose antivenin therapy and transfusion effectively resolved symptoms of DIC. Platelet concentrate transfusion was required only for acute thrombocytopenia. After resolution of DIC, platelet counts were returned to normal ranges within a few days. The authors propose that multidose antivenin therapy and coagulation factor transfusion might be useful for improving coagulopathy in snakebite patients.

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한약 투여가 허혈성 질환 환자의 혈액 응고계에 미치는 영향 (Herbal Medicines Effect on Coagulation System of Ischemic Patients)

  • 이성근;유현희
    • 동의생리병리학회지
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    • 제18권4호
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    • pp.1213-1217
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    • 2004
  • Many ischemic disease patients have been taking herbal medicine and there are some papers that prescription of herbal medicine to ischemic disease patients are useful. Mechanism of herbal medicines on ischmeic disease have been investigated in many ways, but anticougulation or anti platelet effect of herbal medicines is not known obviously. And recently patients receiving anticougulation therapy are discouraged from taking herbal medicines. In this study, we investigate PT, INR, platelet of patients receiving herbal medicine therapy to study whether herbal medicines effect coagulation system of ischemic patients. In PT, INR, platelet values obtained from the patients, before and after administering herbal medicine, there were no significant changes.

Advanced Gastric Cancer Associated with Disseminated Intravascular Coagulation Successfully Treated with 5-fluorouracil and Oxaliplatin

  • Lee, Dong Seok;Yoo, Seung Jin;Oh, Ho Suk;Kim, Eun Jung;Oh, Kwang Hoon;Lee, Sang Jin;Park, Jong Kyu;Ahn, Yong Chel;Eom, Dae-Woon;Ahn, Heui June
    • Journal of Gastric Cancer
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    • 제13권2호
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    • pp.121-125
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    • 2013
  • Gastric cancer patients with acute disseminated intravascular coagulation experiences a rare but severe complication resulting in a dismal prognosis. We report a case of advanced gastric cancer complicated with disseminated intravascular coagulation with intractable tumor bleeding which was successfully treated with chemotherapy consisting of 5-fluorouracil and oxaliplatin. The patient was a 63-yearold man who complained of abdominal pain, melena, and dyspnea on 24 November 2010. We diagnosed stage IV gastric cancer complicated by disseminated intravascular coagulation. Gastric tumor bleeding was not controlled after procedures were repeated three times using gastrofiberscopy. With the patient's consent, we selected the 5-fluorouracil and oxaliplatin combination chemotherapy for treatment. After one cycle of 5-fluorouracil and oxaliplatin therapy, symptoms of bleeding improved and the disseminated intravascular coagulation process was successfully controlled. The primary tumor and multiple metastatic bone lesions were remarkably shrunken and metabolically remitted after eight cycles of chemotherapy. In spite of progression, systemic chemotherapy is effective in disease control; further, the patient gained the longest survival time among cases of gastric cancer with disseminated intravascular coagulation.