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Iodine 조영제의 부작용 감소를 위한 프로토콜 변경 전후의 사례 분석
설상미(Sang Mi Seol),김경숙(Kyoung Sook Kim),김정훈(Jung Hoon Kim),김선기(Seon Ki Kim) 대한전산화단층기술학회 2010 대한CT영상기술학회지 Vol.12 No.2
Purpose To reduce adverse reactions of contrast agents, we amended the standard protocol of drug committee in the hospital, expanding the range of drug treatment before computed tomography(CT) for the patients with a history of a previous reaction. Analyzing the frequency of adverse reactions by severity before and after the protocol amendment, we aimed to confirm the reliability of new protocol and to identify the risk groups by the class. Materials and methods The subjects for the data review were 120,322 adults who examined by CT with contrast agents as outpatient department in a general hospital. The subjects with mild symptoms were not treated during the period before protocol amendment from Jan. to Sept. 2008 while aⅡ adverse reactions related to contrast agents, occurred after the medicinal treatment for aⅡ the patients who had the previous history of adverse reactions to contrast agents, were compared and analyzed by severity during the period after the protocol amendment from Oct. 2008 to Aug. 2009. In addition, frequency of adverse reactions by type of contrast agent, sex, and age were examined to identify the risk factors by class. Results The mild adverse reactions patients who required the treatments among the patients with adverse reactions had decreased by 5.24% after the protocol amendment compared to the period before the amendment, and severe patients decreased by 9.40%. Regarding the analysis by sex, the females showed 0.08% and 0.37% in mild and severe cases, respectⅣely, higher than males. For the analysis by age, the correlation was not shown. The number of adverse reactions was not proportional to iodine content. Conclusion The amended protocol was concluded to be useful for decreasing adverse reactions patients with contrast agent, since the potential of mild and severe adverse reactions occurrences which require the medical treatment was shown low after the treatment for the patients with the previous reactions of contrast agent.
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중심정맥관 삽입 후 천자 부위 지혈 시 보조 지혈기구의 유용성 평가 ;Bi-presso®
문기철,김태일,김진수,황선문,설상미,전승룡,김광수 대한인터벤션영상기술학회 2021 대한인터벤션영상기술학회지 Vol.24 No.1
Purpose : The purpose of this study is evaluating usefulness Bi-presso comparing with conventional sandbag in clinical practice Material and methods : The pressure measuring system used in this study was Mark-10"s M5i indicator and MR04 Force sensor (Mark-10, NY, USA). In order to compare the compression force, 0.8 Kg and 1.5 Kg self-made sandbags, Hand pressuring method and Bi-presso (KM, Korea) were measured for compression force. To analyze and compare the measuring data, SPSS Version 21.0 (IBM SPSS Statistics Version 21. Chicago, USA) was used. A questionnaire survey was conducted for 32 patients (15 males and 17 females) applying Bi-presso after Central vein catheterization. In addition, we tried to find out the usefulness of clinical use through questionnaire survey by medical staff. Results : ■Force compression The result of the average of compression force 0.8 Kg sand bag: 0.11±0.02 KgF, 1.5 Kg sand bag: 0.038±0.01 KgF, human hand: 0.17±0.02 KgF, in a state of discomfort 0.42±0.05 KgF With Bi-presso applied, it is 0.19±0.02 KgF in a comfortable state and 0.42±0.01 KgF in a state of discomfort. (p <.05) ■Survey of patient group “Are all 32 patients surveyed with tight arms or discomfort?”, “Are you feeling sore or too much pressure on the questions and pressures in the questionnaire?”, “Do you have any other discomfort when sitting or lying down?”. They said that there was no discomfort in all of the questions. ■Survey of medical staff Sandbag: 2.36±0.89, Bi-presso: 4.1±0.80. The satisfaction score of Bi-presso was 73.72% higher than that of sandbag. The score on whether the correct position compression is performed is sandbag: 2.4±0.94, Bi-Presso: 3.95±0.88. The score for psychological stability is sandbag: 2.05±0.94, Bi--presso: 4.25±0.85 Posture during hemostasis. The score for changeability is sandbag: 2.15±0.87, Bi-presso: 4.35±0.67 When applied to hypoconscious patients, the score for compression maintenance is sandbag: 1.85±0.93, Bi-presso: 4.1±1.1 infection. The score for risk reduction was significantly higher in the sandbag: 1.75±091, Bi-Presso: 4.55±0.60 in all questionnaire items. (p <.05) Conclusion : In conclusion, Bi-presso is considered to be a safe and effective alternative hemostatic device that provides high satisfaction to patients and medical staff because it is possible to press the hemostasis site without risk of infection and bed stability compared to sandbags.
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