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RISS 인기검색어
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- 저자 : 이순배(SB Rhee) (검색결과 2 건)
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강신명(SM Kang),이순배(SB Rhee),박기영(KY Park),김인숙(IS Kim) 대한산부인과학회 1967 Obstetrics & Gynecology Science Vol.10 No.3
Aseptic technique or reduction of the bacterial flora on the pudendal area in delevery preparation still requires constant re-evaluation. In this paper a new class of disinfectant, the amphoteric surface active agent, hygiene(TEGO 1 03 G) is applied to prepare the perineal area and it`s effects were compared with other varies con- ventional agents and were evaluated clinically by the incidence of transient episotomy fever or sub- clinical infection of clean surgical incision-episiotomy(Showing transient elevation of body tempe- rature orally up to 37`c. or more, lasting less than 4 hours any time in postpartum 3 days period but excluding all othe febrile sources) as well as in vitro study. The data to be presented are based on 169 primiparas deliveried in Ewha Womans University Hospital, Seoul, Korea(33 suing Hygiene, 15 with Mercurochrome, 13 with Cresol, 30 soap and water, 29 soap and water plus prophylactic systemic antibiotics). From this study following conclusions have been reached. 1.The effect of pudendal perineal aseptic technic or disinfectant best can sharply be compared and evaluated clinically by the incidence of transient episiotomy fever or subclinical infection of clean incision-episiotomy(Showing transient fever of 37`c. or more orally in any time of postpart- um 3 days period, but excluding all other febrile sources) rather than by gross episiotomy wound infection which is often encontering many different criterias or even by in vitro biocides effect alone which is also proven to be incorrect unless using serial basin bethod or neutralizing, reducing age- nts. 2.The transient episiotomy fever(Subclinical infection) is strongly correlated with quantitative bacterial innoculation as well as it`s types. It suggested that the most responsible pathogens were staphylococcus aureus and some Streptococcus. On the other hand E. coli appeared to be relatively non-causeative one in the pudendal perineal area; probably female perneum resistant particularly to the normally inhabiting enteric microorganisms. 3.1% Hygiene(TEGO 103G) was superior to a rapid physol wash, Mercurochrome or Cresol wa- sh in reducing subclinical infection of clean episiotomy(tranisent fever) mostly acused by Staphyloc- occus aureus. It seemed also sensitive to Streptococcus. 4.Routine prophylactic antibiotics reduced some transient dpisiotomy fever, but not all of the inc- idence of higher temperatures presumably caused by massive bacterial innoculations. Proper aseptic perineal technic will prevent the clinicl infection of episiotomy wound and subclinical transient episiotomy fever as well. The corection of low hemoglobin level should also be considered in this aspect.
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전춘혜(CH Chun),이순배(SB Rhee),안정례(CR Ahn),조면호(MH Cho) 대한산부인과학회 1967 Obstetrics & Gynecology Science Vol.10 No.10
The data presented here are based on 19 cases of hospital maternal death and 15 cases of maternal D.O.A. among total live births of 10290 in Ewha Woman`s University Hospital, Seoul during 6 years period from 1961 to 1966. The following results have been obtained. 1. For past 6 years from 1961 to 1966 the hospital maternal mortality has greately been lowered, the rate dropping from 29 to 9 per 10,000 live births. However the maternal D.O.A. mostely due to immediate postpartum hemorrhage(89%) from the home the home delivery (63%) or other clinics showed an increasing tendency. 2.The leading causes of maternal deaths in Ewha at present (1964-1966. 9) are toxemia (28.6%), hemorrhage(28.6%) and some others such as post cesarean section sepsis, choriocarcinoma, leukemia,(14.3% respecively). Until 4 years ago(1961-1963) toxemia deaths were exactly 100% of all maternal death. 3. It is interestiong to compare the maternal mortality and it`s significant difference between 2 group or ears; chloropromazine(1961-1962) and Magnesium sulfate(1963-1966) used for treating toxemias, the mortalit rate during MgSo4 era was reduced to 5 per 10,000 live births, or 1/5 of former eras`(26). Its was our experience that chloropromazine tent to develop or aggrivate dyspnea or pulmonary edema(83%) and to increase the inc- idence of failure of uterine contraction or of spontaneous delivery(67%) which sugestive of potent depression of all the important vital organs that consist of involuntary muscles. 4. Hemorrhagic death constituted the highest incidence of physician responsivility(50%) or preventable death and D.O.A. Showed even higher incidence of preventable death (78%). More than half or 63% of D.O.A. happened right after delivered at the home with or without midwife and 25% of them at general practioners clinic. Toxemia death in Ewha showed relatively less incidence of physicians responsibility (1/3 of cases) because more in patient responsibility due to the delayed visit(71%) or no single visit(86% no prenatal care). Infection death was only a case of Ceserean section-sepsis that operated on by a trained obstetrician, but at a general practioner`s clinic without regular sterilizing facilities, aseptic surgical suites or regular nurses. 5. In order to prevent maternal death every expectant mother should be deliveried at hosital or at movile car facilities supporting by special fund. Every general practioners should be educated regularly and at least familiar with managing the immediate post- partum hemorrhage and aseptic delivery. The post graduate educaton program is urgently required. Inteligent prenatal care and nurtritional support for pregnant woman are import socio-ecomonical measures to nation free of toxemic death.
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