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일개 농촌지역의 주민 이병 실태에 관한 조사 : 1981년도 경기도 남양주군 수동면 Su-Dong Myun, Nam Yang-Ju Gun, Kyung-Gi Do
김태경,선한규,이정규,정인영 이화여자대학교 의과대학 1982 梨花醫學誌 Vol.- No.14
A study on the morbidity status of a rural community ; Su-Dong Myun, Nam Yang Ju Gun, Kyung Gi Do was carried out from January 5, to 25, 1982 through analyzing the medical records of Su-Dong Health Subcenter during the period of September, 1980 to August, 1981 and following results was obtained. 1) The number of new patients during a year was 3,651 composed of 49.8% male and 50.2% female, and the cumulated visiting number of the out patients was 5,481. 2) The order of five major diseases which were classified the International Classitication of Diseases(I. C. D.) was Diseases of the Respiratory System(33.2%), Diseases of the Digestive System (21.3%), Diseases of the Skin and Subcutaneous Tissue (17.0%), AccidentsㆍPoisoningsㆍViolence (9.4%), and Diseases of the Nervous System and Sense Organs (8.4%). 3) Annual morbidity rate was 700.6 per 1,000 population and 699.6 for male and 710.6 for female. 4) The highest age specific morbidity rate per 1,000 population was 2,408.1 in the age group of 0 ∼ 4 and the lowest was 272.9 in the age group of 15 19. 5) The average clinic visiting times per out patient was 1. 6. 6) Medical fee of patients visited to Health Subcenter was covered from 3 different sources as follows ; 81.2% of total patients was paid by patient self, 9.5% by government as medical program, and 9.3% by medical insurance. 7) Average medical fee per first visiting was 1,970 ± 1,320(Won) and average medical fee per case was 2,990 ± 2,590(Won). 8) The annual utility rate of Health Subcenter of the community was 710.0 per 1,000 population, and the highest rate (1,350.4) was shown in the people of Ribsouk 2 Rie and the lowest(381.0) in Cidoon Rie.
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태변 착색된 임신에서 태아 심박자궁수축 곡선의 양상과 제대혈액 가스값의 변화
김승조,이헌영,김수평,이종건,신종철,선한규,김진흥 대한산부인과학회 1992 Obstetrics & Gynecology Science Vol.35 No.8
1. 전체 1749명 출생아중 태변착샐색 빈도는 218예(12.5%)이었고, 남녀 성별차이는 없었다. 2. 218분만 예중에서 경한 태변착색은 50예, 중등도의 태변착색은 67예, 심한 태변착색은 101예이었다. 3. 분만회수에 따른 태변착색의 빈도는 초산부에서 163예(75%), 경산부에서 55예(25%)의 빈도를 나타내었다. 4. 태변착색과 제태기간에 따른 제대동맥혈의 pH, PO2, PCO2의 관계를 보면 40주가 넘을수록 pH와PO2 값은 점차 낮아졌으며, PCO`값은 점차 높아지는 양상을 보였다. 5. IUGR은 16%를 보였는데, IUGR이 있는 군에서 낮은 pH, PO2 높은 PCO2 분압을 나타내었다. 6. 제대동맥혈의 pH는 3840주 사이에 분만한 경우에는 pH가 7.25이상이 60.26%었으며, 43주 이상인 경우는 pH7.25이상인 경우가 50%을 나타내었다. 7. 태아 심박자궁수축 곡선의 이상은 84(38.5%)예로 높은 빈도를 나타내었고, 이들에서 낮은 Apgar 점수를 나타내었다. 8. 분만방법은 흡입분만이 113예(51.8%)로 가장 많았고, 제왕절개에 의한 분만은 정상 태아심박 곡선을 보인 경우는 12예(8.9%)에서 시행되었고, 비정상 태아심박 곡선을 보인 경우에는 39예(46%)에서 시행되었다. 9. 분만시간은 초산부에서 경중등도 태변착색은 11.8시간, 심한 태변착색의 경우 14.9시간, 경산부에서는 경중등도 태변착색은 5.4시간, 심한 태변착색은 7.4시간으로 분만시간이 길수록 태변착색의 정도가 심한 양상을 보였다. 10. 태변착색과 Apgar 점수의 관계를 보면 경한 태변착색순에서 1분/5분 평균 Apgar점수는 9.3/9.6, 중등도 태변착색군에게 평균 Apgar 점수는 8.3/8.8, 심한 태변착색에서 평균 Apgar 점수는 7.6/8.0으로 태변 착색이 심할수록 낮은 Apgar 점수를 나타내었다. 11. 태변착색된 출생아에 서 신생아 이환은 32예(14.6%)로 흡인성 폐염은 6예, 신생아 황달이 16예였다. During the past decase, there has been significant improvement in the obstetrician`s ability to achieve anternatal surveillance. Nevertheless, hypoxia is still a serious danger to the fetus before and during labor even in non high risk groups. And it is wellknown fact that meconium appeared in amniotic fluid under the circumstaces of chronic and acute fetal hypoxic state. Then, cardiotocography alone is insufficient to differentiate whether fetal hypoxia is present or not. This study was performed by retrospective analysis of cardiotocogram, cord arterial blood gas parameters and neonate outcomes in meconium stained 218 cases among 1,749 deliveries which were admitted in St. Mary`s Hospital from July 1,1989 to June 31,1990 The result obtained was as follows; 1. The overall incidence of meconium staining was 12.5% with no sexual difference. 2. The incidence of severe meconium stained case was 46.3%. 3. The severity of meconium staining also increased as the duration of labor. The more incidence rate of meconium staining was noted in primiparous women than multiparous women. 4. The mean value of fetal umbilical arterial pH was shown gradually lower in following order of gestational weeks, 38 weeks(7.37), 39 weeks(7.33), 40 weeks(7.27), 42 weeks(7.24) and 43 weeks (7.23). 5. The incidence of IUGR was 16% in the meconium stained cases, they have lower pH,PO and high PCO2 than in the cases of adequate for gestational age. 6. The acidosis and preacidosis was more ferquently occurred in the cases of over 41 weeks. 7. The incidence of abnormal F.H.R. pattern was 38.5% among the meconium stained cases and abnormal F.H.R. pattern group has lowere Apgar score. 8. The most common mode of delivery in meconium stained group was vaccum extraction(59.7%) to shorten the 2nd stage of labor. 9. Perinatal morbidity rate was 14.6% the most frequent complication was neonatal jaundice. The meconium aspiration pneumonia were 6 cases.
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