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- 저자 : 최광민 ( Goang Min Choi ) (검색결과 3 건)
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최기훈 ( Gi Hoon Choi ),최광민 ( Goang Min Choi ),김형수 ( Hyoung Soo Kim ),조성준 ( Seong Joon Cho ),류세민 ( Se Min Ryu ),안희철 ( Hee Cheol Ahn ),서정열 ( Jeong Yeol Seo ) 대한결핵 및 호흡기학회 2006 Tuberculosis and Respiratory Diseases Vol.61 No.5
연구배경: 농흉을 치료하는데 VATS가 도입된 후 VATS의 유용성에 대해 많은 연구의 결과들이 보고 되고 있으며 실제로 치료 프로토콜에도 변화를 가져 왔으나 아직까지는 문헌상의 보고가 양적으로 충분하지 못하며 기존의 치료방법에 비해 VATS의 장점 역시 명확하게 검증되어 있지 못한 상태이다. 방법: 의무기록과 흉부 방사선 사진을 검토하여 기존의 치료 환자 군과 VATS 환자 군을 비교하였다. 2001년 1월부터 2003년 12월까지 한림대학교 춘천성심병원에 농흉으로 입원하여 기존의 방법으로 치료받은 환자들을 A군으로 하고 2003년 12월부터 2006년 8월까지 농흉으로 흉강경 수술을 받은 환자들을 B군으로 나누어 입원기간, 흉관 유지 기간, 백혈구증가증이 있던 기간, 발열이 있던 기간, 항생제 사용기간을 비교하였다. 그리고 흉막비후, 갈비가로막각이 각각 치료 전후 어떻게 변하였는지 비교하여 보았다. 결과: A군은 15명으로 남자가 11명 여자가 4명이었고, 평균 나이는 58.2±15.7세 이었고, B군은 11명으로 남자가 9명, 여자가 2명이었으며 평균 나이는 51.6±9.5세 이었다. B군에서 입원 기간(16.6±7.4일, A군은 33.7±22.6일; p=0.014)과 흉관 유지 기간 (10.5±5.7일, A군은 19.5±14.4; p=0.039), 백혈구증가 기간(6.7±6.5일, A군은 18.8±13.2일; p=0.008), 발열 기간(0.8±1.8일, A군은 9.4±9.2일; p=0.004), 항생제 사용기간 (B군 14.9±6.4일, A군 25.4±13.9일; p=0.018)이 A군에서보다 통계적으로 유의하게 감소하였다. 그러나 흉막비후, 갈비가로막의 둔함의 정도는 통계적으로 유의한 변화는 없었다. 결론: 농흉에서 흉강경을 이용한 치료를 하면 기존의 방법에 비해 입원 기간, 흉관 유지기간, 백혈구증가증 기간, 발열 기간, 항생제 사용기간을 단축시킬수 있어 환자의 증상을 더 빨리 개선시키며, 흉관을 조기에 제거할 수 있고 입원기간을 단축시킨다. Background: Since video-assisted thoracoscopic surgery (VATS) was introduced as a new treatment modality for empyema thoracis, numerous reports have suggested that VATS is a more effective treatment method than the traditional methods that mainly use antibiotics and drainage apparatus. However, no confirmative evidence of the superiority of VATS over the traditional method has been provided yet. Methods: We attempted to evaluate the efficacy of VATS for the treatment of empyema thoracis by reviewing past medical records and simple chest films. First, we divided the patients into two groups based on the treatment method: group A of 15 patients who were treated with the traditional method between January 2001 and December 2003, and group B of 9 patients who were treated with VATS between December 2003 and August 2006. The final outcomes used in this study were the number of days of hospital stay, chest tube duration, leukocytosis duration, febrile duration, and intravenous antibiotics usage duration. In addition, radiological improvements were compared. Results: The mean age(±standard deviation) of 11 men and 4 women in group A was 58.2±15.7 years, and of 9 men and 2 women in group B was 51.6±9.5 years. Group B had a significantly shorter hospital stay (16.6±7.4 vs. 33.7±22.6 days; p=0.014), shorter chest tube duration (10.5±5.7 vs. 19.5±14.4 days; p=0.039), shorter leukocytosis duration (6.7±6.5 vs. 18.8±13.2 days; p=0.008), shorter febrile duration (0.8±1.8 vs. 9.4±9.2 days; p=0.004), and shorter duration of intravenous antibiotics usage (14.9±6.4 vs. 25.4±13.9 days; p=0.018). However, radiological improvements did not show any statistical differences. Conclusion: Early application of VATS for empyema thoracis treatment reduced hospital stay, thoracostomy tube duration, leukocytosis duration, febrile duration, and antibiotics usage duration in comparison with the traditional methods. The early performing of VATS might be an effective treatment modality for empyema thoracis. (Tuberc Respir Dis 2006; 61: 463-472)
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안희철,서정열,정재봉,최영미,최정태,유기철,안무업,최광민,김홍기,김성환,조준휘 대한응급의학회 2002 대한응급의학회지 Vol.13 No.1
Purpose: This study was conducted to examine various clinical factors for their ablity to predict mortality in geriatric patients following trauma. Methods: In this retrospective study, medical records from Chun Cheon Sacred Heart hospital were reviewed for patients 65 years and older who sustained trauma. The following variables were extracted and examined, independently and in combination, for their ablity to predict death: age, gender, mechanism of injury, blood pressure, and respiration, pulse rate, as well as Glasgow Coma Score, Revised Trauma Score, and Injury Severity Score. These patients had entered the hospital following trauma during a 2-year period (1999-2000). Results: The Injury Severity Score (more than 28), the Glasgow Coma Score (less than 9), and the Revised Trauma Score (less than 9), were variables that correlated with mortality. Mortality rates were higher for men than for women. Admission variables associated with the highest risks of death included hypotension (mean blood pressure <78 mmHg); pedestrian and motorcycle traffic accident; skull fracture, subdural hemorrhage, and diffuse axonal injury; and hemothorax and lung contusion. Conclusion: Admission variables in geriatric trauma patients can be used to predict the outcome and may also be useful in making decisions about triage, and treatment of the patient.
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