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RISS 인기검색어
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- 저자 : 안영옥(YO Ahn) (검색결과 2 건)
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안영옥(YO Ahn),이재옥(JO Lee),조의경(EK Cho),안정자(JJ Ahn),강신명(SM Kang) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.11
The data presented are based on 28 cases of pelvic tubercu1osis among 4830 cases of gynecologic patients admitted into Ewha Womans University Hospital, Seoul for past 12 years (197l~1982). The incidence of pelvic tuberculosis was 0.58%, l: l72 cases which was consi dered fairly high In the past history, the most cases of pelvic tuberculosis (61%, l7 cases) revealed one or more extra pelvic tuberculous lesions including pulmonary tuberculosis(46%, 13 cases), peritonitis {7%, 2 cases), lymphadenitis in neck (3.6%, 1 case) or sal pingitis (3.6%, 1 case). In family history, some 18% of cases with pelvic tuberculosis have had pulmonary tuberculosis in their family members. It was an important finding that majority (86%, 24 cases) of the cases with pelvic tuberculosis were in febrile and 66% of them had mild fever (36.8뫌~ 37.4뫌) which is likely to be overlooked in the diagnosis. The remaining associated findings of abdominal distension (43%, 12 cases) and infertility (39%, 11 cases} were also important from the diagnostic points of view Palpable mass was noticed in 50% of the pelvic tuberculosis, however certain percents (11%) of the cases were symptomless or negative findings. Preoperatively or postoperatively, only 25% of the patient were able to be susp ected as pelvie tuberculosis. There was ll% or 4 cases with pelvic tuberculosis were unrecognized or missed even in the surgery simply because majority of them (3 cases) were infertile pati ents associated with other disease masked such as adenomyosis, pseudocyst or serous ovarian cyst. In the surgery, the operator should be familiar and expert with operative findings and the final diagnosis should be based on meticulous and multipte or repeated hist opathologic studies. The most important points of treatment is considered to be early diagnosis as well as understanding of basic concepts on the tuberculosis. Primary antituberculous medication is considered to be choice of treatment. However it failed, surgical approach by skilled hand of gynecologist is imperative
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이제옥(JO Lee),안영옥(YO Ahn),이남희(NH Lee),우복희(BH Woo),강신명(SM Kang) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.10
2년간 제왕절개술(1980~81) 936예를 대상으로 관찰 분석한 결과 다음과 갈은 결론을 얻었다. 1. 전체적인 제왕절개술의 빈도는 최근 80년대 초에 와서 27.3% 그 중 첫제왕절개술의 빈도는 18.5%로서 10년전(1961~63)에 비하여 각각 2배로 증가된 추세에 있었다. 2.. 첫제 왕절개술의 적응증은 난산을 위한 것이 75% 즉 대부분을 점하였고 그 증 특히 둔위를 위한 제왕절개술이 최근 11% 즉 상당히 증가된 추세로 포함되었다. 3. 제왕절개술후 모체측 합병증은 적었으며 보통 볼 수 있는 자궁내막감염(2.9%) 창상감염(2.2%)등 이었다. 4 모성사망은 자간발작환자 제왕절개술후에 1예(0.075%)있었는데 이것은 비교적 적은 빈도이었다. 5. 분만방법 개선과 신생아사망 감소. 1) 첫둔위분만방법을 과거 1961-63년대의 질실분만 위주 즉 소극적인 제왕절개 분만방법(15%)에서 최근 2년간(1980~81) 둔위제왕절개분만 위주(79%, 140예)로 둔위분만방법을 개선한 결과 둔위분만손상에 의한 태아장애빈도가 1/10로 현저히 감소(29%→1.5%)되었고 둔위 신생아 사망도 0으로 모두 예방되었다. 2) 선택적 진통없는 제왕절개술 338예에 대하여 술전 Oxytocin 자극방법 적용으로서 초자막질환 이환에 의한 사망을 전부 예방할 수 있었다(대조군 596예 중 1예 사망). 전체 주산사망은 평균 1000분만당 22.5였다. 특히 신생아 사망은 전체 제왕절개술의 0.9%로서 과거 10년전 2.4%)에 비하여 감소되었다. This study was an analysis of 936 cesarean sections done among 4830 cases of deliveries at Ewha Womans University Hospital, Seoul during 1980 to 1981. In recent years, the indications for cesarean section has been changed. The purpose of this paper is to discuss the change of indications for or increased incidence of cesarean section, the end result for both maternal and perinatal morbidity and mortality. The results obtained were as follows; 1. Overall incidence of cesarean section was 27.3% or 1319 cases of 4830 deliveries, while primary cesarean section rate was 18.5% or 895 cases of cases of 4830 cases. 2. In 614 cases of primary cesarean section, the dystocia was the most frequent indication (75% or 463 cases). Among the dystocia, primary breech cesarean sections were markedly incerased(11% or 69 cases) in recent 2 years. The other frequent indications were antepartum bleedings (6.5% or 40 cases) .including placenta previa (5.4%) and abruptio placente (1.1%), and fetal distress (5.7% or 35 cases) in order. 3. The maternal complications in cesarean sections in this series were relatively low. There was only 2% or 27 cases of 936 cases with endometritis and a few cases of wound infections (2.2% or 21 cases). 4. We have encounterd with 1 case or 0.075%(1:1319) maternal death among 1319 cesarean sections. The cause of death was cerebral homorrhage due to eclamptic convulsion 5. The policy of primary breech cesarean section and perinatal death; (1) Since we have established policy starting from 1980 to 1981 that almost all (79% or 140 cases) primary breech presentation has been delivered by cesarean section, the perinatal death or traumatic delivery was reduced completely or down to 0. It was compared with 10 cases or 6% of higher perinatal deaths (corrected) during the era of early 1960s (1963~68) with conservative delivery method or 85% of primary breech presentation has been delivered vaginally. (2) Neonatal mortality due to hyaline membrane disease 338 cases of elective (without labor) cesarean section has
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