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RISS 인기검색어
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- 저자 : 김선휴 ( Seon Hyu Kim ) (검색결과 2 건)
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외상환자의 초기 사망 예측 지표로서의 내원 초기의 염기 결핍, 젖산 및 강이온 차이의 유용성 비교
박경혜 ( Kyung Hye Park ),이강현 ( Kang Hyun Lee ),김선휴 ( Seon Hyu Kim ),오성범 ( Sung Bum Oh ),문중범 ( Joong Bum Moon ),김현 ( Hyun Kim ),황성오 ( Sung Oh Hwang ),김헌주 ( Heon Ju Kim ) 대한외상학회 2005 大韓外傷學會誌 Vol.18 No.2
Purpose: Currently, there is a variety of systems available for predicting prognosis of trauma patients such as trauma score, Injury severity score (ISS) and acid-base variables. But it is not clear that the initial acid-base variables are predictors of prognosis in trauma patients at the emergency department. The objective of this study is to compare the base deficit, lactate and strong ion gap as an early predictor of mortality in trauma patients. Methods: Retrospective record review of 136 trauma patients needed to admit to intensive care unit via emergency department (June 2004 to February 2005). Data included age, injury mechanism, ISS, Revised trauma score (RTS), Multiple organ dysfunction score (MODS), Acute physiology and chronic health evaluation III (APACHE III), Glasgow coma scale (GCS), laboratory profiles, calculated anion gap and strong ion gap. Patients were divided into survivors and non-survivors, shock group and non-shock group with comparison by t-test; significance was assumed for p<0.05. Correlation between acid-base variables and mean arterial blood pressure (MABP) was evaluated. Results: There was a significant difference between the RTS (p=0.00), APACHE III (p=0.00), MODS (p=0.00), GCS (p=0.00) of survivors and non-survivors. There was no significant difference between the ISS (p=0.082), lactate (p=0.541), base excess (p=0.468) and SIG (p=0.894) of survivors and non-survivors. There was a significant difference between the RTS (p=0.023), APACHE III (p=0.002), lactate (p=0.000), base excess (p=0.000) and SIG (p=0.000) of shock and non-shock group. There was no significant difference between the ISS (p=0.270), MODS (p=0.442) and GCS (p=0.432) of shock and non-shock group. The base excess was most correlated to MABP (r2=0.150). Conclusion: Initial base deficit, serum lactate and SIG are not predictors of mortality in moderate to severe trauma patients. Initial base deficit, serum lactate and SIG are correlated with the mean arterial blood pressure in trauma patients in emergency department.
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비전형적인 급성충수염의 복부 전산화 단층촬영과 임상 소견의 비교
박경혜 ( Kyung Hye Park ),이강현 ( Kang Hyun Lee ),김윤권 ( Yun Kwon Kim ),원호경 ( Ho Kyong Won ),김선휴 ( Seon Hyu Kim ),장용수 ( Yong Soo Jang ),김현 ( Hyun Kim ),황성오 ( Sung Oh Hwang ) 대한응급의학회 2006 대한응급의학회지 Vol.17 No.4
Purpose: The frequency of computerized tomography (CT) for diagnosing of atypical acute appendicitis, as ordered by emergency physicians, was noted. According to abdominal CT findings, the severity of acute appendicitis is divided into six grades that are used for diagnosis and treatment. However, whether or not the laboratory and clinical findings of atypical acute appendicitis have a relation to the grading of abdominal CT scans is unknown. This study was performed to evaluate the correlation between CT grades and symptoms, signs and operative and pathologic findings of atypical acute appendicitis. Methods: This study included 412 patients who were admitted and underwent an appendectomy from January 2004 to June 2005. An abdominal and pelvic CT scan was performed in 114 patients who had atypical presentations in the emergency room. The abdominal and pelvic CT scales were correlated with clinical signs, laboratory findings, and pathology reports. The CT scale for appendicitis is a six-grade scale from normal (grade 0) to periappendiceal abscess (grade 5). Results: Sixty-six patients were male and 48 were female, and the mean age was 50.7±22.0 years old. On the abdominal CT, grade 0 (normal) was 3 patients (2.6%), grade 1 (probable appendicitis) 5 (4.4%), grade 2 (appendicitis) 17 (14.8%), grade 3 (appendicitis with periappendicitis) 47 (40.9%), grade 4 (appendicitis with rupture) 30 (26.1%), and grade 5 (complicated appendicitis) 12 (10.4%). There was no significant difference between CT grades and either local tenderness or rebound tenderness in the right lower quadrant abdomen (p>0.296). However increased body temperature correlated with higher CT grades (p=0.01). There were significant differences in the neutrophil count (p<0.001), but not the white blood cell count (p=0.493). The severity of pathology of acute appendicitis correlated with the CT grade (R=0.468, p=0.004). Conclusion: There was no significant correlation of local and rebound tenderness on right lower quadrant abdomen and of white blood cell count with CT grading in appendicitis, but there was a high correlation of body temperature and of neutrophil counts with the CT grades of appendicitis for patients with atypical appendicitis. The CT grades of appendicitis also correlated with the pathology.
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