• 제목/요약/키워드: enema

검색결과 145건 처리시간 0.021초

만성 리튬 중독환자의 지연성 정정맥 혈액 투석여과 사례 (Delayed Continuous Venovenous Hemodiafiltration in Chronic Lithium Intoxication)

  • 김태수;차용성;김현;김오현;차경철;이강현;황성오
    • 대한임상독성학회지
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    • 제11권1호
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    • pp.28-30
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    • 2013
  • A 66-year-old male with chronic alcoholism presented with tremor, gait disturbance, memory impairment, insomnia, decreased appetite, and confusion. The patient had been taking lithium daily for treatment of bipolar disorder. Brain CT showed no specific abnormality, and serum lithium and ammonia levels were 3.63 mEq/L (therapeutic range, 0.6~1.2 mEq/L) and $85{\mu}g/dL$ (reference range: $19{\sim}54{\mu}g/dL$), respectively. Therefore, the initial differential diagnosis included chronic lithium intoxication, hepatic encephalopathy, Wernicke encephalopathy, or alcohol withdrawal syndrome. Even with the provision of adequate hydration, the patient's neurologic status did not show improvement, so that lactulose enema, thiamine replacement, and continuous venovenous hemodiafiltration (CVVHDF) were started on the third admission day. By the fifth admission day he had made a rapid neurologic recovery, and was discharged on the 20th admission day. Therefore, CVVHDF might be a treatment for patients with chronic lithium intoxication, because, even if serum lithium concentration is normal, lithium concentration in the brain may be different from that of the serum.

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한우 송아지에서 결장폐쇄의 방사선 진단례 (Radiographic Diagnosis of Atresia Coli in a Korean Native Calf)

  • 성윤상;장광호
    • 한국임상수의학회지
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    • 제28권3호
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    • pp.336-338
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    • 2011
  • 5일령 한우 송아지가 식욕부진, 배변불능, 침울, 복부팽만으로 내원하였다. 결장폐쇄로 잠정진단하고 폐쇄 부위와 양태를 확인하기 위해 단순촬영과 조영촬영을 실시하였다. 단순촬영상에서 대장이 가스로 확장되어 있었으나 하행결장 내에 변은 존재하지 않았다. 조영촬영상에서는 조영제가 집적된 끝 부분이 확장된 결장내로 돌출해 있고 조영제가 모여 있는 중간 부위는 좁아져 있었다. 이들 소견은 부검에서 확인된 확장된 나선결장과 위축된 원위결장 사이의 점막성 폐쇄를 잘 설명해주었다. 방사선 조영촬영은 결장폐쇄의 위치 및 양태 확인에 효율적이라 판단된다.

일 지역 의료인의 가정간호사업 및 서비스 제공 가능성에 대한 인식 조사 (Recognition of Home Care Services for Nurses and Physicians)

  • 고영애;백희정;박진경;김미주
    • 한국보건간호학회지
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    • 제19권1호
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    • pp.108-116
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    • 2005
  • The purpose of this study is to determine the level of recognition of home care services and to provide basic data for implementation of home care services. Data collection was carried out between December 2004 and January 2005 by surveying 88 nurses and 40 physicians working at a general hospital and 28 physicians working at different clinics in the Seoul metropolitan city area. The results of this study were as follows: 1. Home care services were recognized by $94.2\%$ of nurses, $77.5\%$ of physicians and $92.9\%$ of clinic physicians. The main sources of information for most of them were medical and nursing journals. 2. The percentages of staff regarding find home care services as necessary for the institutions were $88.6\%$ of nurses, $74.4\%$ of physicians and $57.1\%$ of clinic physicians. All of them anticipated that home care services would maintain 'continuous care' and 'long-term patient care'. 3. The percentages of staff willing to refer their patients to home care were $95.5\%$ of nurses, $100\%$ of physicians and $87.1\%$of clinic physicians. However, only $7.1\%$ of clinic physicians were willing to refer actively. 4. Most nurses and physicians replied that a majority of test-related services is suitable for home care services. However, among medication-related services, intravenous injections were not suitable for home care services. Among treatment-related services, most nurses and physicians replied that Levin tube feeding, oral and nasal suction, simple dressing, perineal care, and enema were suitable for home care services, but incision and drainage, and tracheostomy tube change were not suitable for home care services. In conclusion, for the implementation of hospital-based home care services, it is necessary to educate nurses and physicians on the present condition and precedent at other hospitals.

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졸업학년 간호학생의 핵심기본간호술 학습경험과 수행자신감 조사연구: 실습교과를 중심으로 (A Study on Learning Experiences and Self-Confidence of Core Nursing Skills in Nursing Practicum among Final Year Nursing Students)

  • 한애경;조동숙;원종순
    • 기본간호학회지
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    • 제21권2호
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    • pp.162-173
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    • 2014
  • Purpose: This study was done to identify learning experiences and self-confidence and to analyze nursing students' self-confidence according to learning experiences for core nursing skills (CNS). Method: Participants were 502 final year nursing students. Data were collected using a structured questionnaire and analyzed using descriptive statistics and t-test. Results: Over 60% of participants had practiced 15 items of the 24 CNS in the basic nursing lab (BNL). In clinical practice (CP), they had practiced five items but experienced only one item in a simulation lab (SL). Items with the highest confidence level were vital signs (4.69) followed by blood sugar test (4.60), pulse oximeter (4.38), and oral medication (4.12). Items with the lowest confidence level were blood transfusion (2.17) followed by enema (2.64) and indwelling catheterization (2.67). The group with CNS experience in the practice curriculum was generally more confident than the group with no experience. Self-confidences in some skills was significantly different depending on availability of SL, credits for BNL and CP, and presence of preceptors. Conclusion: Results indicate a need to develop practice education strategies such as changing the CP to practice-centered learning with preceptors and including well-designed SL to increase confidence of nursing students.

육군자탕 투여 후 호전된 흡인성 폐렴 환자 치험 1례 (Case Report of Aspiration Pneumonia Treated with Yukgunja-tang)

  • 박성운;김민지;서윤정;강다현;김영기;노현인;배재룡;이재원;이진원;최근욱;류재환
    • 대한한방내과학회지
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    • 제37권2호
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    • pp.176-181
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    • 2016
  • Objectives: This clinical study reports on the effects of Yukgunja-tang on aspiration pneumonia.Method: This case examined a comatose male patient who suffers from continuous regurgitation. He showed symptoms of aspiration pneumonia with accompanying gastroesophageal reflux. We gave the patient Yukgunja-tang for 28 days and observed any changes in symptoms.Results: During the period when the patient was given Yukgunja-tang, he defecated on his own without glycerin enema, regurgitation occurred less frequently, and the aspiration pneumonia symptoms improved.Conclusion: Yukgunja-tang helped the patient's bowel movements move more quickly and smoothly through his colon. As a result, Yukgunja-tang appears to have prevented regurgitation and aspiration pneumonia.

난소과자극증후군의 예방에 관한 한의 임상 연구 고찰 (Review for Clinical Studies of Oriental Medicine on the Prevention of Ovarian Hyperstimulation Syndrome)

  • 구수정;황덕상;이진무;이창훈;장준복
    • 대한한방부인과학회지
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    • 제33권1호
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    • pp.1-18
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    • 2020
  • Objectives: This review is aimed at assessing the efficacy and effectiveness of oriental medicine for the prevention of Ovarian Hyperstimulation Syndrome (OHSS) through literature research and overview. Methods: Database searching was conducted to identify relevant randomized controlled trials (RCTs) on oriental medicine for the prevention of Ovarian Hyperstimulation Syndrome. Studies were searched from Journal of Korean Obstetrics and Gynecology, Korean studies Information Service System, Korean Medical Database, China National Knowledge Infrastructure, Cochrane library, PubMed and EmBase up to 7th November, 2019. Results: Ten RCTs were finally selected. Eight studies intervened with oral Chinese herb medicine, one is intervened with Chinese medicine enema and the other with acupuncture. Eight studies concluded that intervention with oriental medicine significantly decreased OHSS incidence. Five studies showed significantly higher pregnancy rate in the intervention groups. Two studies reported higher ovulation rate and other two studies showed more maturated eggs than the control groups. Four studies showed opposite results in serum Estradiol level. Vascular Endothelial Growth Factor level was significantly lower in the intervention groups in two studies. Conclusions: From ten studies, oriental medicine reduced OHSS incidence rate and showed preventable effectiveness. Further strictly designed studies and acupuncture intervened studies are needed to establish evidences.

음부-골반통/삽입질환에 대한 중의학 임상연구 동향 (Review of Clinical Studies of Traditional Chinese Medicine on Genito-Pelvic Pain/Penetration Disorder in Women)

  • 남은영
    • 대한한방부인과학회지
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    • 제32권3호
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    • pp.214-226
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    • 2019
  • Objectives: The purpose of this study is to review clinical studies of Traditional Chinese medicine (TCM) on Genito-Pelvic Pain/Penetration Disorder (GPPPD) in women. Methods: Key words "Dyspareunia", "Vaginismus" were searched on Chinese National Knowledge Infrastructure Database (CNKI) on April 21th 2019. Results: 2 case reports and 7 clinical trials were collected in accordance with the selection and exclusion criteria. Among the 7 trials, 4 were controlled trials, and 3 were single-arm trials. The types of intervention were herb medication in 8 studies, and compound TCM treatment including acupuncture, moxibustion, and cupping therapy in 1 study. All 4 controlled trials were about dyspareunia and conducted by herbal medicine of TCM. The study results and methods of intervention were analyzed. Conclusions: 2 case reports described the effectiveness of compound TCM treatments (acupuncture, moxibustion, cupping therapy) and herb medicine in dyspareunia. In 4 controlled trials, 2 trials described the effectiveness of herb medicine (oral or vaginal agent) compared to western treatment in dyspareunia, and other 2 trials described no effectiveness of herbal enema compared to danazol. In 3 single-arm trials, 1 trial of dyspareunia and 2 trials of vaginismus described the effectiveness of herb medicine. All the 9 selected studies reported improved or disappeared symptoms of GPPPD, or high effective rate after TCM treatment. There was limitation that the selected studies were retrieved from only one site of CNKI, and generalized results could not be derived, further studies should be carried out. Additional well-designed clinical studies on GPPPD in women are needed in Korea.

소아에서 만성 기능성 변비의 분변 박힘 제거에 대한 전해질이 함유된 Polyethylene Glycol(PEG)의 효과 및 안전성에 관한 연구 (Efficacy and Safety of Polyethylene Glycol(PEG) with Electrolytes for Disimpaction in Children with Chronic Functional Constipation)

  • 소홍섭;배선환;윤혜선;황진순
    • Clinical and Experimental Pediatrics
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    • 제46권11호
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    • pp.1089-1094
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    • 2003
  • 목 적 : 전해질이 함유된 PEG 용액은 삼투성 제재로 소아의 대장내시경 및 수술 전 저치를 위한 장세척에 주로 사용되어 왔으나 다른 삼투성 제재에 비하여 만성 기능성 변비 치료의 분변박힘 제거에 대한 연구는 극히 미흡하다. 이에 저자들은 만성 기능성 변비로 입원한 환아들을 대상으로 분변 박힘 제거에 있어서 전해질이 함유된 PEG 용액의 효과 및 안전성에 대하여 알아보고자 하였다. 방 법: 2000년 5월부터 2003년 7월까지 을지병원 소아과에 입원한 만성 기능성 변비 환아 26명(11명은 외래에서 일반적 방법으로 분변박힘 제거에 실패하였다)을 대상으로 전해질이 함유된 PEG 용액을 경구 요법(9명, 34.6%), 관장 요법(10명, 38.4%), 또는 병행 요법(7명, 14.3%)을 시행하여 분변 박힘 제거의 효과와 배변횟수의 변화, 부작용의 발생을 확인하였다. PEG 용액은 경구 요법의 경우 1회 60-80 mL/kg(PEG로 3.9-5.3 g/kg)를 3시간 이내에 음용하였으며, 하루에 1-2회 시행하였다. 관장 요법의 경우 1회 15-25 mL/kg(PEG로 0.975-1.625 g/kg)로 하루에 1-3회 관장을 시행하였다. 결 과 : 모든 환아에서 PEG 용액 요법 시행 전에 단순 복부 방사선 사진에서 분변 박힘이 확인되었으며 시행 후에는 분변 박힘이 호전되었다. 배변횟수는 관장 요법을 시행한 환아 중에서 1명을 제외한 모든 환아에서 유의한 증가를 보였다. 부작용은 하루 6회 이상의 수양성 변이 3명(11.5%)에서 발생하였고, 두통이 1명(3.8%)에서 발생하였으나 별다른 치료없이 호전되었다. 이외의 부작용의 증상은 발생하지 않았다. 치료 후 혈청 전해질 농도 검사는 16명의 환아에서 시행되었으며 두통을 호소했던 환아에서 경미한 고나트륨혈증(146 mmol/L)이 있었으며 이외의 환아에서는 정상 범위 내로 나타났다. 치료 후 혈청 삼투질 농도 검사는 11명의 환아에서 시행됐으며 모두 정상 범위 내로 나타났다. 순응도는 경구 복용군의 환아들이 짠맛에 대한 부담감을 호소하였으나 복용에는 지장이 없었다. 결 론 : 일반적인 요법으로 분변 박힘 제거에 실패한 환아를 비롯한 만성 기능성 변비 환아에서 전해질이 포함된 PEG 용액은 분변 박힘 제거에 효과가 있었으며 심각한 부작용은 없었으며 순응도도 좋은 것으로 나타났다. 그러나 연구 대상의 수가적고, 모든 환아에서 치료 후의 혈청 전해질 농도 및 삼투질 농도의 확인이 이루어지지 않은 문제점이 있기 때문에 향후 보다 많은 소아를 대상으로 연구가 시행되어져야 할 것으로 생각된다.

자궁경부암의 고선량 치료후의 장관 합병증 (Early and Late Bowel Complication Following Irradiation of Cancer of the Uterine Cervix)

  • 김명세;김경애;김성규;신세원;이승호;장재천
    • Radiation Oncology Journal
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    • 제7권1호
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    • pp.59-70
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    • 1989
  • 자궁경부암은 치료후의 생존율이 좋은 암으로 인정되고 있으나 전 자궁경부암의 $44\%$는 재발되며 재발암의 대부분은 국소재발이다. 더욱이 재발된 암은 어떤 방법으로 치료한다 하더라도 5년 생존율은 $2\~9\%$에 불과하다고 보고되고 있다. 이러한 사실은 적극적인 국소치료법이 필요함을 시사하고 있으나 국소방사선 조사선량을 증가시켜 치료율을 높이려 할 경우 필연적으로 따라오는 합병증의 증가가 우려되어 불충분함을 인정하면서도 전골반에 4500cGy이하, A점에 8500cGy정도가 사용되어 왔다. 1986년 4월부터 1987년 12월까지 영남대찰 치료방사선과에서 중앙차폐없이 전골반에 5000cGy, 고선량률 강내치료로 A점에 3900cGy, 외부선량을 포함한 A점 총 선량 8900cGy를 조사함으로서 종래의 치료보다 $500~1000cGy$를 더 조사받은 자궁경부암 환자 103명중 추적 치료가 불가능 하였던 환자를 제외한 96명을 대상으로 장관합병증을 분석하였다. 종래보다$500\~1000cGy$를 더 조사 받았으나 합병증이 증가되지 않았음을 보고함으로서 합병증의 증가 없이 생존율의 증가를 얻을 수 있는 최고선량을 결정하는 기초자료로 삼고자 본 연구를 시도하였다. 평균 추적기간은 21개월이었고 대부분의 증상은 12개월 이내에 나타났단. 이급후증(tenesmus), 하복부 동통을 포함한 장관합병증은 $46\%$였고 입원치료를 받은 환자는 6명 $(0\%)$이었으나 수술이 필요한 환자는 1명분이었다. X선 대장촬영과 직장경 검사를 실시하였으나 바리움 대장촬영에서 1명만이 비정상적인 소견을 보여 직장손상의 진단에 효율이 적음을 시사하였다. 환자의 연령, 총 조사선량, 총 TDF, 직장조사선량과 장관합병증은 무관함을 보여주었다. 입원치료가 필요한 6명의 환자 중 5명이 축소조사야를 사용한 추가치료를 했던 환자로서 추가치료가 합병중의 위험 인자임을 시사하였다(p<0.01). 심한 합병증을 보인 6명중 3명 이 방사선 치료전 수술경험이 있었으며 직장선량이 다른 환자들의 평균직장선량(7300cGy) 보다 작음에도 불구하고 (5252 cGy) 심한증상을 보여 치료전의 수술기왕력 이 위험 인자가 될 수 있음을 시사하였다. 종래의 치료양보다 $500\~1000cGy$ 더 높은 선량에도 불구하고 입원치료가 필요하였던 환자는 $6\%$, 수술이 필요하였던 환자는 $1\%$로 합병증의 증가 없이 A점에 8900cGy, 직장에 7300cGy정도의 국소치료가 가능함을 보여 주었으나 생존율에 대한 추후 분석이 따라야 할 것으로 사료된다.

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흉(胸)·요추(腰椎) 압박골절(壓迫骨折) 환자(患者)에 대한 임상적(臨床的) 고찰(考察) (The clinical study on 44 cases of patient with Thoracolumbar Compression Fracture)

  • 임정은;김기현;황현서
    • Journal of Acupuncture Research
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    • 제17권2호
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    • pp.41-51
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    • 2000
  • Clinical observation was made on 44 cases of stable thoracolumbar compression fracture that were confirmed through simple x-ray and neurological examination. They were hospitalized and treated by acupuncture and moxibustion, bed rest, herb medicine and physical therapy. If necessary, patient was given an enema. The results obtained are as follows. 1. The patient distribution ratio, in regard to sex, was shown to be 1: 13.7 for males to females. In regard to age, it was shown that people in their 60's was the most predominant case, followed by people in their 70's, 80's, 50's and 40's, respectively. 2. In regard to contributing factors, it was observed that accidental falls were most frequent, followed by reasons unknown, repetitive lifting of heavy objects, overlaboring and bruise in that order. 3. In regard to duration of illness before treatment, it was found that treatment within 1 week was most predominant, followed by over 4 weeks, and 1-2 weeks, respectively. 4. With regard to the duration of hospitalization, hospitalization within 2 weeks was found to be most predominant, followed by 2-4 weeks. 5. In regard to the level of the affected vertebral body; The affected vertebral bodies distributed between T3 to L5 except for T7; T12 was found to be most predominant, followed in turn by L1 and L5. 6. In regard to the number of affected vertebral bodies, 2 was the most frequent followed by 1 and 3, in that order. The average of the number of affected vertebral bodies was observed to be 2.8 and single vertebral body compression fracture was shown to have no clinical and statistical difference as compared with multiple vertebral body compression fractures. 7. In regard to the grade of the seriousness of symptoms, it was found that Grade IV was most predominant, followed by Grade III. 8. With regard to signs at the first medical examination, low back pain was seen in the highest number, and followed in order by gait disturbance, flank pain, flexion-extension disturbance, disturbance of rotation to right or left, and bowel dysfunction. 9. Concerning the effect of treatment, good results were most predominantly seen, and 95.5% of total patients showed fair results. 10. The duration of admission treatment due to the grade of clinical symptoms was as follows; In the case of the Grade IV, it was observed that within 2 weeks was most predominant and for Grade III was 2-4 weeks. It was also found that the grade of clinical symptoms was not in proportion to the duration of admission treatment. 11. In regard to the result of treatment due to the grade of clinical symptoms; It was found that in the case of Grade IV, within 2 weeks was most predominant, and for Grade III, it was found to be 2-4 weeks. 12. Intestinal obstruction was shown in 50% of total patients; In the case of duration of constipation, more than 1 week was found to be most predominant, followed by 2 and 4 days respectively. 13. With regard to the treatment of intestinal obstruction, using acupuncture and moxibustion, herb - medicine and enema together were found to be most effective. 14. Intestinal obstruction was mostly seen in the case of Grade IV.

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