골반경수술 215 예에 대한 고찰

신원춘(WC Shin),안광순(KS Ahn),황경진(KJ Hwang) 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.1

저자들은 1992년 6월부터 1995년 6월까지 본 병원 산부인과에서 215예의 골반경수술을 시행한 결과 다음과 같은 결과를 얻을 수 있었다. 1. 골반경수술의 적응증은 총 215예중 불임증이 78예(36.3%), 자궁외임신이 36예(16.7%), 난소낭종이 26예(12.1%), 수난관이 20예(9.3%)로써 대부분을 차지했다. 2. 골반경 수술방법은 총 215예중 골반강내 유착박리술이 40예(18.6%), 난관개구부 형성술이 20예(9.3%), 난소 낭종절제술이 18예(8.4%), 난관절제술이 17예(7.9%) 순으로 많았다. 3. 환자들의 연령분포는 26세에서 30세가 34.9%로 가장 많았고 평균연령은 31.1세였다. 4. 환자들의 평균 출산력은 0.9회였다. 5. 입원기간은 수술후 1일에서 6일 사이였으며 평균 입원기간은 3.5일 이었다. Two-hundred and fifteen cases of pelviscopic operation were performed at Tae Nung Sung Sim Hospital from June, 1992 to June 1995. The results of this study were summarized as follows; 1. Major indications were infertility 78 cases(36.3%), ectopic pregnancy 36 cases(16.7%) and ovarian cyst 26 cases(12.1%). 2. The major types of surgery were adhesiolysis 40 cases(18.6%), Salpingoneostomy 20 cases(9.3%) and ovarian cystectomy 18 cases(0.4%). 3. The age of the patients ranged from 22 to 53 years and the mean age was 31.1 years. 4. The mean parity of the patients was 0.9. 5. The mean duration of hospitalization was 3.5 days. In our conclusion, pelviscopic surgery makes minimal incision, minimal postoperative discomfort with low complication and short hospitalization. So this pelviscopic surgery is very useful method in gynecologic field.

子宮腺筋症의 臨床的 考察

趙庸均,辛源春,金鐘國,劉泰煥,金福麟,李鴻均 인제대학교 1994 仁濟醫學 Vol.15 No.2

부인과 질환중 상당한 비율을 차지하고 있는 자궁선근증의 빈도, 증상, 동반된 질환 및 수술전 진단의 가능성 등을 조사하여 수술전 진단의 정확성을 높임으로써 효과적인 치료를 할 수 있게 하기 위하여 본 연구를 시행하게 되었다. Adenomyosis is a singular disease whose diagnosis frequently eludes the physician. In spite of the fact that it causes distressing and often serious functional disturbances requiring major operation for correction, many physicians, even gynecologists, tend to neglect the possibilty of this entity Adenomyosis was encountered in 199 cases or 25.5% of the surgically removed uteri from women who had been admitted to Sanggye Paik Hospital from Sep. 1, 1989, to Dec. 31, 1992. The peak incidence was in the fifth decade (51.8%), in late reproductive life or early menopausal years. Of the 199 patients, 186 (93.5%) were parous and 13 (6.5%) were nulliparous. Menorrhagia, metrorrhagia, pelvic pain, lumbago, and dysmenorrhea were common symptoms in this study and 17 patients (8.6%) had no symptoms. In comparing uterine weight in those cases wish and without associated myoma, we find the distribution is similar in both groups except for a larger number of uteri in the "under 120gms without myoma" category. Preoperative diagnosis of the adenomyosis was possible in only 3.5% Leiomyoma was the most common associated disease with adenomyosis and the incindence was 39.7%. Proliferative phase of the endometrium was the most frequent endometrial findings, an incidence of 51.8%, and the secretory phase, 29.1%.

Treacher Collins 증후군 1 례

김복린,김명주,박경미,김종국,신원춘 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.5

본 저자 등은 Treacher Collins 증후군 1례를 경험하였기에, 간단한 문헌고찰과 함께 보고하는 바이다. Treacher Collins syndrome is rare, genetically transmitted congenital malfomation syndrome which has an incidence of 1/50,000 live births and involving primarily the facial bones. It is inherited as an autosomal dominant trait with variable expressivity. The chief features of this syndrome including the following: hypoplasia of the facial bones especially the malar bones and mandible, antimongoloid slant of the palpebral fissures, coloboma of outer third of lower eyelid, malformation of the auricles with external ear canal defects and frequent conductive deafness, cleft palate. We experienced a case of Treacher Collins syndrome in a male infant with the chief complaints of hypoplastic mandible, antimongoloid palpebral fissure and ear malformation. We report the case with a brief review of literature.

자궁내 태아발육지연의 임상적 고찰

최훈,이홍균,김복린,조용균,유태환,김종국,신원춘,서정식 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.10

1991년 1월 1일부터 1993년 12월 31일까지 상계백병원에서 분만한 한국인 단태출생아중 임신 32주이후 출생한 출생아를 대상으로 태아발육지연아의 발생율을 조사하고 가능한 위험요인을 분류하여 다음과 같은 결론을 얻었다. 1. 태아발육지연아의 발생율은 10.45%였다. 2. 태아발육지연은 20대에 가장 많았으나 상대적인 빈도는 10대 산모와 고령산모에서 높았다. 3. 태아발육지연의 원인적 분류에서 원인을 알 수 있는 경우는 43%였고, 태아발육지연과 관계있는 산모측 요인은 고혈압성 질환이 가장 많았고, 빈혈, 결핵, 간염에서도 높은 발생율을 보였다. 4. 태아발율지연은 초산부에서 많이 발생하고 출생성비는 여자에서 높았다. 5. 태아측 원인으로서 선천성 기형이 있는 경우는 3.3%였다. 6. 태아발육지연아는 비정상적 태위인 경우에 비교적 높게 나타났다(8.6%). 7. IUGR의 기왕력이 있는 경우는 15.5%였다. This study was undertaken at the Department of Obstetrics and Gynecology, College of Medicine, Inje University, Sanggye Paik Hospital, to investigate the association between some of the risk factor and the incidence of fetal growth retardation. The studied population were selected from patients who admitted at Sanggye Paik Hospital during period of 1991 through 1993, with following criteria; Korean, singletone pregnancy with live birth and known gestational weeks with 32 or more. And then, the risk factors were analyzed in terms of maternal factor, placental factor and the fetal factor. The following results were obtained. The incidence rate for IUGR during period of 1991 through 1993 was 10.45%. The increased incidence rates of IUGR were shown in the group of teenaged mother, primigravida and old aged mother. Only 40% of etiologic factors for the IUGR were found to have known causes. The risk factors of the IUGR, such as hypertensive disorder during pregnancy, anemia, pulmonary tuberculosis, cardiac disease were associated with the increased incidence. The relative risk of IRGR was much higher in neonates born with congenital anomalies. But there was not association between placental cause such as placenta previa and abruptio placenta and IUGR.

10 대 임산부의 산과적 합병증에 관한 임상 통계학적 고찰

최훈,이홍균,김복린,조용균,유태환,김종국,신원춘,서정식 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.10

최근 의학적 및 사회적 많은 문제를 유발하는 10대의 임산부 합병증들의 특성 및 문제점들을 살펴보기 위해서 본 병원 산부인과에서 1989년 8월 15일부터 1994년 4월 15일까지만 4년 8개월간 경험하였던 10대 임산부 53명을 대상으로 임신과 분만에 따른 각종 합병증 및 위험인자 들을 비교분석한 결과 다음과 같은 결론을 얻었다. 1. 연령분포는 16개에서 19세사이였으며 19세가 가장 많은 52.8%를 차지했다. 2. 초경연령은 13세에서 18세사이로 다양하게 분포되었으며 평균연령은 15.0세로 대조군의 14.7세와 유의한 차이는 없었다. 3. 과거 임신경력은 첫번째 임신에 의한 출산이 35명(66%)로 가장 많았고 임신경험이 1회 있었던 16명중에는 만삭분만의 경험 3예와 제왕절개분만의 경험 1예가 포함되어 있었으며, 임신경험이 3회인 경우도 2예가 있었는데 그중 1예는 3회 모두 초기인공유산이었다. 4. 임신주수의 분포는 평균 40주 2일과 대조군의 40주 4일과 유의한 차이는 없었으나 37주이하의 미숙아 분만은 10대 임산부군에서 유의하게 높은 빈도를 나타내었다(p$lt;0.05). 5. 단 1회 산전진찰도 받지 않았던 경우는 28.3%로 대조군의 2%에 비해 유의하게 높았다(p$lt;0.05). 6. 태위는 두정위가 83%로 가장 많았으며 둔위가 15.2%, 횡위가 1예(1.8%)로 두 군 사이에 유의한 차이를 보이지 않았다. 7. 분만전 합병증에 있어서 10대 임산부의 혈색소농도 10gm% 미만의 빈혈 빈도는 37.7%이었고 임신성 고혈압의 빈도가 35.8%로서 대조군에 비하여 의미있게 높았으며 그밖의 다른 합병증 발생빈도는 유의한 차이를 보이지 않았다. 8. 분만방법에서는 질식분만율이 79.3%, 복식분만율이 20.7%로 대조군과 유의한 차이를 보이지 않앗다. 9. 제왕절개분만의 적응증으로는 태위이상이 45.4%로 가장 많았고 그밖에 아두골반 불균형이 9.1%, 태아곤란증 18.2%, 기제오아절개분만의 기왕력 18.2% 등이었고, 모두 대조군과 유의한 통계학적 차이는 보이지 않았다. 10. 분만증 합병증에서는 10대 임산부에서 태변착색이 18.8%로 가장 많았고, 태아곤란증 1.8%, 산도열상이 3.7%이었고 대조군과 유의한 차이는 없었다. 11. 신생아 체중은 2,500gm 이하였던 경우가 25.0%로써 대조군에 비하여 유의하게 높았으며 4,000gm이상인 군과의 빈도의 차이는 없었다. 12. 신생아 합병증에 있어서 1분 Apgar score가 4이하인 경우가 10대 임산부에서 10.7%로 대조군의 0.9%에 비하여 유의한 차이를 보여 주었다. 13. 분만후 합병증에서는 요로 감염증이 37.7%로 제일 많았으나 대조군의 25%보다는 높았으나 통계학적 의의는 없었으며 그밖에 산후출혈, 방광무력증 회음부 감염 등에서도 두 군간의 유의한 차이는 없었다. Teenage pregnancy which involves many social and medical problems is getting more and more serious. Obstetrically teenage pregnancy involves high risk perinatally and it gives rise to not only their own but serious social troubles. The cognition of traditional moral sense and sexual morality which is accompanied by the change of social and economical conditions has changed radically, and teenage pregnancy by premarital relations becomes an object of public concern. The purpose of this study is to make an analysis of the difference of what kind of obstetric complications happen more frequently in teenage pregnancies than elder pregnancies. The subject of study is fifty three teenage pregnancies who were delivered at the deaprtment of obstetrics and gynecology, Seoul Sanggye Paik Hospital from August 1989 to April 1994 and one hundred elder pregnancies who were chosen at random fro the same time were compared with then. The significant difference of two groups was determined by chi square x^2 test and a P value of 0.05 or less has been accepted as significant. The results were as follows; 1. All the cases were in the high teen group, age of 16, 17, 18, and 19 The majority (52.8%)were in the age of 19. 2. The mean of menarche was 15.0 years old. No significant difference was seen in the distribution of menarche when compared with the control group. 3. 35 cases(66%) had no previous pregnancy history sixteen patients(30%) had one time of previous pregnancy history, among them, three with previous fullterm delivery and one with previous cesarean section history. 4. In the gestational period, the incidence of preterm delivery(22.6%) was significnatly higher than control group(7.0%). 5. 28.3% of the teenage patients had no visit to prenatal clinic. This figure is significantly higher than control group. 6. 83% of the total(53 patients) were vertex presentation and 15.2%(8 case) were breech presentation. The incidence of various presentations were not significantly different between the two groups. 7. The birthweight of the infant was significantly smaller than control group. The incidence of low birth weight infant (25%) was significantly higher than control group(7.0%). 8. 42 cases(79.3%) were delivered vaginally and 11 cases (20.7%) were delivered by abdominal route. These results were not significantly idfferent between two groups. 9. The incidence of pregnancy induced Hypertension(35.8%) and anemia(51.2%) were significantly higher than control group. 10. The incidences in the intrapartum complications fetal distress. Meconium staining, uterine dysfunction birth canal laceration, precipitate labor were not significantly different between two groups. 11. The incidence of an.APGAR score of 4 or less at 1 minute was significnatly higher in the teenage patients. 12. In the postpartum morbidity, urinary tract infection occured more frequently in the teenage zatients than control group.