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신승권,김하봉,류형선,윤광혁,박명호 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.3
1988년 1월부터 1992년 12월까지 만 5년간 목포 성골롬반병원 산부인과에 입원 분만하였던 산모 총 17,755명중 502명의 임신중 고혈압성 질환 환자를 대상으로 임상통계학적으로 조사분석한 결과 다음과 같은 결론을 얻었다. 1. 총분만수에 대한 임신중 고혈압성 질환의 발생빈도는 2.83%였고, 매년 감소하는 경향을 보였다. 2. 분류에 의하면 경증 자간전증이 56.98%(286예), 중증 자간전증이 38.25%(192예), 자간증이 1.59%(8예), 만성 고혈압성 혈관질환이 3.18%(16예)였다. 3. 연령별 분포는 발생수는 25-29세군에서 가장 많았으나, 임신중 비고혈압성 질환군과 비교하였을때 35세이상에서는 높은 빈도를 보였다(p$lt;0.05). 4. 분만횟수별 발생수는 초산부에서 가장 많았고, 임신중 비고혈압성 질환군과 비교하였을때도 초산부에서 발생빈도가 가장 높았다(p$lt;0.05). 5. 계절별 분포는 동계에 가장 높은 분포를 보였으나 계절간의 의의있는 창를 보이지는 않았다. 6. 모체 혈액형에 따른 발생빈도는 A형에서 가장 높았다. 7. 태아 성별은 남아에서 53.7%로 빈도가 더 높았으나 큰 차이는 보이지 않았다. 8. 다태임신시 발생빈도는 18.75%로 단태임신에서의 임신중 고혈압성 질환의 발생빈도보다 월등히 높았다. 9. 임신기간과 신생아 체중은 임신중 고혈압성 질환군과 임신중 비고혈압성 질환군을 비교하였을때, 임신중 고혈압성 지롼군에서 조산과 저체중아의 발생빈도가 월등히 높았다(p$lt;0.05). 10. 산전관리 횟수는 전혀 산전관리를 받지 못한 경우가 32.1%였으며, 1회의 산전관리만을 받은 경우는 36.6%였다. 11. 분만방법은 질식자연분만이 30.9%, 질식유도분만이 21.9%, 질식흡입분만이 7.8%, 제왕절개술에 의한 분만이 39.4%였다. 12. 모성합병증은 빈혈 24.5%, 산후출혈, 4.6%, 태반조기박리 3.4%였고, 모성사망은 0.2%(1예)였다. 13. 태아 및 신생아 합병증은 자궁내 발육지연이 20.3%였고, 사산아는 0.8%, 신생아 사망은 3.6%였다. 14. 혈소판치가 10만/mm^3이하로 감소된 경우는 4.5%였다. This clinical study was undertaken for evaluation of 502 cases associated with hypertensive disorders in pregnancy, who were admitted to department of Obstetrics and Gynecology, St.Columban Hospital from January, 1988 to December, 1992. The results were as follows; 1. The incidence of hypertensive disorders in pregnancy (HDIP) was 2.83% of total deliveries. 2. Using the classification of American committee on Maternal Selfare, the incidence of hypertensive disorders in pregnancy was as follows; Preeclampsia, mild: 56.9% Preeclampsia, severe: 38.25% Eclampsia: 1.59% Chronic hypertensive vascular disorders: 3.18% 3.The highest number of HDIP was observed in the age group of 25-29, but the frequency of disease was higher in the age group above 35 years old. 4. According to parity, the higher frequency was noted innullipara. 5. Among four seasons, 29.5% of the patients were occurred in winter which was the most prevalent season, but a significant difference in seasonal distrubution was not noted. 6. Among four blood type, 44.8% of the patients were occurred in blood type A which was followed by B,O,AB,in orders. 7. There was slightly higher male predominance in fetuses of the hypertensive disorders in pregnancy, but a significantl difference was not seen. 8. The incidence of HDIP in twin pregnancy was 18.75%. 9. As to the gestational age and the birth weight, the preterm and the low birth weight were higher incidence in HDIP group than non-HDIP group. 10. The disease was more prevalent in women who did not take antenatal care. 11. 60.6% of the patients were delivered vaginally, 30.9% spontaneous, 21.9% induced, 7.8% with vacuum extraction and 39.4% of the patients were performed cesarean section. 12. As to maternal complication, anemia was found in 24.5$, postpartum hemorrhage in 4.6%, abruptio placentae in 3.4% and maternal death in 0.2%. 13. As to fetal complication, intrauterine growth retardation was found in 20.3%, stillbirth in 0.8% and neonatal death in 3.6%. 14. The mean level of platelet count was 226,800 /mm^3, and the group less than 100,000 was 4.5%
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이지신,신승권,김하봉,윤광혁,양해관,이성봉 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.8
저자들은 45세된 환자에서 난소에 발생한 평활근종 1예를 경험하였기에 간단한 문헌고찰과 함께 보고하는 바이다. Although smooth muscle is sometimes seeing a minor component of benign ovarian mullerian epithelial tumors, primary smooth-muscle tumors of the ovary are rare. These tumors only originate from smooth muscle in the walls of blood vessels in the cortical stroma, in the corpus luteum and in the ovarian ligaments at there point of attachment of the ovary. These tumors are usually asymptomatic and are usually found incidentally during operations or at autopsies. A case of 45-year-old woman with a leiomyoma of the ovary which was experienced on our hospital recently is presented with a review of literatuers.
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신승권,한세준,최대용,최호준,김하봉,고종석 대한산부인과학회 1990 Obstetrics & Gynecology Science Vol.33 No.11
1981년 1월 1일부터 1987년 12월 31일까지 목포성골롬반병원 산부인과에서 자궁외임신 진단하에 입원 수술 후 병리학적 검사로 확인되었던 250예에 대하여 임상적 고찰을 하여 다음과 같은 결과를 얻었다. 1. 자궁외임신의 분만수에 대한 발생빈도는 1:77이었다(250예/19.222분만). 2. 호발연령군은 30∼34세로서 29.6%를 점유하였다. 3. 미산부가 24.4%였으며 인공유산의 경험이 있었던 경우가 66%였다. 4. 평균 Hb치는 9.9이었다. 5. 초기 수축기 혈압이 100이상인 경우가 80.4%였고 평균치는 109.7이였다. 6. 임상증상은 64.8%가 최종 월경일로부터 5∼8주에 나타났다. 7. 복강내 출혈량은 500∼1000ml가 22.4%, 1000ml이상은 66.4%, 500ml이하인 경우가 11.2%였다. 8. 착상부위는 난관이 97.8%, 난소 2.4%, abdomen이 0.4%였고, 난관중 팽대부가 79.2%, 간질부 4%, 협부 10.8% 난관채 3.8%였다. 9. 수술시 소견으로 골반염증 24.5%, 난소낭종 11.6%, 자궁근종이 0.4%였고, IUD를 장치한 경우도 5.2%였다. 10. 기왕력중 복강경 난관결찰술 15%, 반복 자궁외임신이 7.6%, 충수돌기 절제술 5.2%, 제왕절개술이 1.2%였다. 11. Douglas와 천자는 87.1%에서 적중율을 보였고, 12.9%에서는 음성을 보였고, 임신 반응검사는 65%에서 양성으로 나타났다. 12. 수술방법은 환측 난관절제술이 82%, 환측 부속기 제거가 13.6%, 자궁전적출이 2.8%이였다. 13. 사망률은 1예도 없었다. This study was undertaken for the clinical evaluation and statistical analysis on the 250 patients with ectopic pregnancy who had been admitted and treated at the Mokpo St. columban Hospital from Jan. 1, 1981 to Dec. 31, 1987. The results were obtained as follows. 1. Hospital incidence of ectopic pregnancy was 1 in 77 deliveries(250/19222). 2. Ectopic pregnancy was found to occur most frequently in the age group, ranging from 30 to 34 years(29.6%). 3. Nullipara was 24.4% and woman who had experienced artificial abortion was 66%. 4. Mean hemoglobin level 9.9mg/이. 5. Initial systolic blood pressure rise above 100 mmHg was in 80.4%. The mean value was 109.7 mmHg. 6. The clinical manifestation were appeared in 64.8% from the last menstrual peiod to the next 5∼8 weeks. 7. Total amount of intraperitoneal hemorrhage was between 50∼ 1000ml was in 22.4%, above the 1,000ml was 66.4% and less the 500ml was 11.2%. 8. Ectopic pregnancy was implanted in fallopian tube 97.8%, ovary in 2.4% and abdomen in 0.4%. Among tubal pregnancies, ampullar portion was involved in 79.2% interstitial portion in 4%, isthmic portion in 10.8% and fimbrial portion in 3.8%. 9. The combined pelvic disorders found during poeration were pelvic inflammatory disease in 24.5%, ovarian cyst in 11.6%, uterine myoma in 0.4% and the case applicated with IUD in 5.2%. 10. In past history, the laparascopic tubal ligation was in 15%, repeated ectopia was in 7.6%, appendectomy was in 1.5% and cesarean section was in 1.5%. 11. Culdocentesis was positive in 87.1%, negative in 12.9%, and Gravindex test was positive in 65%. 12. 82% of total cases was treated by salpingectomy, 13.6% by salpingoophorectomy and 1.6% by hysterectomy. 13. Of 250 total cases, no death occured.
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