http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
직장으로 투여한 Misoprostol 에 의해 조절된 산후 출혈 2 예
한성태(Seong Tae Han),정석희(Seok Hee Jung),나연화(Yeon Hwa La),서정래(Jung Lae Seo),정우철(Woo Chuel Jung),이성원(Sung Won Lee),조용(Yong Cho),노의선(Eu Sun Ro) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.4
Obstetrical hemorrhage is one of the deadly triad, along with hypertensive disorder in pregnancy and infection. Postpartum hemorrhage is the major cause of obstetrical hemorrhage. Uterine atony is the most common cause of postpartum hemorrhage, and resulted from poor uterine contraction after delivery of the fetus and placenta. Initial management to control postpartum uterine atonic bleeding is based on the use of uterotonics such as well known oxytocin and ergot preparations together with uterine massage. Prostaglandin E2 analogue, sulprostone can be used next when these agents are failed to produce uterine contraction. The woman unresponsive to non-surgical managements requires surgical interventions including emergency hysterectomy. Recently prostaglandin E1 analogue, misoprostol, has been known to elicit potent uterine contraction and cervical ripening after oral, vaginal or rectal administration. We have experienced two cases of postpartum uterine atonic bleedings which were unresponsive to oxytocin, ergot, or prostaglandin E2, but were successfully controlled by rectal administration of misoprostols.
자궁탈출증이외의 적응증에 대한 질식전자궁적출술의 임상적 고찰
나연화(Yeon Hwa La),조경철(Gyung Chul Jo),한성태(Sung Tae Han),정석희(Suk Hee Jung),서정래(Jung Rae Seo),정우철(Woo Chul Jung),이성원(Sung Won Lee),조용(Yong Jo),노의선(Eui Sun Ro) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.8
Objective : To analyse the clinical aspects of total vaginal hysterectomy, we evaluated age distribution, parity, previous abdominal operations, indications for hysterectomy, postoperative pathology, combined operations, operation time, bleeding amount, hemoglobin change, weight of uterus, and postoperative complications. Methods : We reviewed the medical records of the 50 patients who underwent total vaginal hysterectomy for the indications other than uterine prolapse from July 1998 to June 1999 at chunchon Sacral Heart Hospital, Hallym University. Results : 1. Age distribution was from 31 to 55 years old and 78% of patients were in 36 to 45 years old group. 2. The most common parity was para 2 (56%) and the next was para 3 (30%). 3. The most common previous abdominal operation was laparoscopic tubal sterilization and followed by appendectomy, cesarean section, and pelvic operation. 4. The most common indication for vaginal hysterectomy was uterine myoma (74%) and followed by cervical intraepithelial neoplasia, atypical endometrial hyperplasia, and dysfunctional uterine bleeding. 5. The most common postoperative pathologic finding was uterine myoma (56%) and followed by adenomyosis, cervical intraepithelial neoplasia, endometrial hyperplasia, endometrial polyp, endometriosis, microinvasive cervical cancer, and endometrial cancer. 6. The concurrent surgical procedures were ovarian cystectomy (6%), parovarian cystectomy (6%), salpingo-oophrectomy (6%), and anterior or posterior vaginal colporrhapy (10%). 7. The operative time was within 2 hour in almost all cases (98%). 8. The bleeding amount was within 500 cc in almost all cases (98%). 9. The hemoglobin change was within 3 g/dl in almost all cases (98%). 10. The weight of hysterectomized specimen was over 300gm in 32% of patients. 11. There were 5 cases (10%) of vaginal cuff hematoma with infection, 3 cases (6%) of upper respiratory infection, and 2 cases (4%) of bladder dysfunction as the postoperative complications. Conclusion : Total vaginal hysterectomy is a safe method for removing uterus even in the absence of prolapse. Recently it's indication is widening to the patient who has larger uterus and history of previous pelvic surgery. Because of it's advantage, total vaginal hysterectomy would be the preferred method of hysterectomy in the future.