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RISS 인기검색어
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- 저자 : 김규태(Kyou Tae Kim) (검색결과 6 건)
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개심술후의 Ventilator Weaning 에 관한 임상적 고찰
김규태,한승세,이종태,Kim, Kyou-Tae,Han, Sung-Sae,Lee, Chong-Tae 대한흉부심장혈관외과학회 1981 Journal of Chest Surgery (J Chest Surg) Vol.14 No.3
Cardiac surgery is generally followed by a period of routine ventilator support. When the patient seems hemodynamically stable and relatively alert following surgery, respiratory adequacy is tested by the weaning trial. In this study, physiological and clinical prediction of postoperative respiratory adequacy, including values of pulmonary function tests, were examined in an attempt to identity those few variables which predicted the outcome of the ventilator weaning trial following surgery. Our series comprised 27 patients who underwent elective open intracardiac operations at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, from October 1979 to July, 1980. The pulmonary function tests performed on all patients included the following; forced vital capacity [FVC], forced expiratory volume [FEV1.0], forced expiratory flow [FEF 25--75~], residual volume [RV], and functional residual capacity [FRC], measured with a helium dilution technique. Of our 27 patients, 8 were successfully weaned within 20 hours of operation. All patients with cyanotic heart diseases or acquired heart diseases were unsuccessfully weaned. The bypass time in the successful weaning group was shorter in the mean value [82.8 minutes]than in the unsuccessful weaning group [120.5 minutes]. There was a relatively significant difference in the mean values for the two groups in arterial pressure, bleeding amounts and FiO2 among the postoperative monitoring variables, and in forced vital capacity [FVC]. The postoperative clinical assessments appeared vague but corresponded reasonably well to appraisal of success in weaning, especially in variables of cough and self-respiration efforts.
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心內膜炎이 倂發한 開存動脈管 3例의 手術經驗 : 3 cases report
金圭太 慶北大學校 醫科大學 1976 慶北醫大誌 Vol.17 No.2
慶北醫大 附屬病院 胸部外科에서 수술치험한 開存動脈管에 倂發한 心內膜炎 3例를 문헌고찰과 함께 報告하였다. Three cases of PDA associated with SBE were experienced and surgically corrected with satisfactory results. For a intractably febrile case during the course of chemotherapy of 104 days, the ductus was doubly ligated. The others were treated by division and suture technique. Clinical symptoms, signs and hospital course were presented. Antibiotic treatment before and after surgery was discussed in detail.
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농흉에 대한 임상적 관찰 : A review of 48 cases
김규태,이성행 慶北大學校 醫科大學 1976 慶北醫大誌 Vol.17 No.2
1972년 1월부터 1975년 9월까지 3년 9개월 동안 부산 침례병원에서 입원한 48예의 농흉환자에 대한 임상적 관찰을 실시하여 다음과 같은 결과를 얻었다. (1) 년령별 분포는 15세이하 12명(25%), 15세∼30세 9명, 30세이상 27명(56.3%)이였다. 소아대 성인비는 1:3이였다. (2) 성별 분포는 남녀비가 약 1.3:1이였으며, 원인 질환에 따른 남녀비도 별차이가 없었다. (3) 농흉의 발병은 첫1주일에 발병한 것이 19예, 2주일에 발병한 것이 13예로서, 전체 환자의 약(66.7%)에서 2주 이내에 발병하였다. (4) 증상으로는 기침(68.8%), 발열 및 흉통(각각 50.0%), 호흡곤란(45.8%)등의 순위였다. (5) 병원균은 34예(70.8%)에서 확진되었고, 세균학전 분포는 Unspecified Gram (+) cocci 및 Gram (-) baccilli가 각각 10예(각각 25.0%)로 가장 많았으며 그외의 원인균으로는 연쇄상구균 8예, 포도상구균 7예, 결핵균 3예 등으로 포도상구균과 결핵균이 비교적 낮은 비율을 보였다. (6) 늑막액 검사상으로 Pyogenic농흉과 결핵성 농흉간에 큰 차이를 볼수 없으나 Cell different count상 결핵성 농흉에서 Lymphocytosis(80%)룰 보였다. (7) 기흉이 동반되었던 것은 7예(14.3%)이였으며, 그중 4예(59%)가 Pyogenic 농흉이였다. (8) 입원 기간은 1주일간 입원이 18예(37.5%), 2주일간 입원이 15예(31.3%)로, 2주일 이내 입원이 전체의 68.8%를 차지하였으며, 4주이상 입원예 7명(14.5%)은 전예가 Pyogenic농흉이였다. (9) 치료는 Chemotherapy만으로 치료한 것이 12예(25%), 반복된 늑막강 천자에 의한 것이 25예(52.1%), 폐쇄성 배농법 8예(16.7%), 개방성 배농법 3예(6.2%) 등이였다. (10) 농흉 48예중 Klebsiella균 감염을 보인 농흉 흉이 성인 1명이 사망하였으며, 퇴원할때 임상적 증상의 호전을 보인 경우가 37예(77.1%)이 ?? Clinical observations on 48 cases of empyema patients treated at Busan Wallace Memorial Baptist Hospital were made in period from 1972 to 1975. 1) Twenty-five per cent was under the age of 15 years, and 56.3% was above the the age of 30 years. A proportion of child and adult was 1:3. 2) Male and famal ratio was 1.3:1. 3) The duration of illness prior to admission varied in each case. Ninetten cases visited the hospital had less than a week of illness, 13 cases less than 2 weeks, thses counted 66.7% of total cases. 4) Most frequently encountered symptoms were cough (68.8%), fever and chest pain (50%) and dyspnea (45.8%). 5) Etiologic organisms were confermed in 34 cases (70.8%), Unspecified Gram positive cocci and Gram negative bacilli were found in 20 cases, and staphylococci in 7 cases and mycobacterium tuberculosis in 3 cases. 6) Dominant lymphocyte was found in tuberculos pleural effusion. 7) Pneumothorax was associated with empyema of seven cases (14.3%), among those four cases were pyogenic in nature. 8) The length of hospitalization seemed to be related the disease process and time interval between the disease onset and treatment. Eighteen cases (37.5%) stayed at hospital less than a week and 15 cases (31.3%) less than two week. All of pyogenic empyema cases were admitted fo rmore than tour weeks. 9) Twelve cases (25%) were treated with chemotherapy alone, 25 cases (52.1%) with repeated thoracentesis, 8 cases (16.7%) with closed thoracotomy and 3 cases with open drainage. 10) Twenty-four cases (50%) were discharged with recovery, 13 case (27.%) with improvement, and 10 cases without improvement or against advice. One death occured in the patient with Klebsiella empyema.
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