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정경석,김중섭,박석철,손태경,신현욱,정봉화 대한외상학회 2000 大韓外傷學會誌 Vol.13 No.1
Background: The Pediatric Trauma Score (PTS) was developed as a means of providing rapid, accurate assessment of an injured child in a manner that would insure a comprehensive initial evaluation. Methods: A total of 69 cases of injured children 0 to 15 years of age who had undergone a laparotomy in the Department of Surgery, Kangnam Sacred Heart Hospital, from January 1994 through December 1998 were retrospectively reviewed. Results: The most common injury mechanism was pedestrian auto accident (n=48, 69.7%), followed by fights (n=10, 14.5%), falls (n=7, 10.1%), and penetrating injuries (n=2, 2.9%). Children whose ISS (injury severity score) was greater than 40, below 20, and greater than 21 had a 100% mortality, a 0% mortality, and 66.7% morbidity, respectively. Children whose PTS was greater than 6, below 2, and below 8 had, a 0% mortality, a 100%mortality, and a 65.5% morbidity, respectively. A decreasing PTS and an increasing ISS were associated with increased morbidity and mortality. This study documents the inverse linear relationship between the PTS and the ISS (Y = -2.514X + 36.338). The overall mortality was 13% (9/69). A comparision between survivors and nonsurvivors showed significant differences in PTS (9.6±1.9 vs. 2.8±2.5, p<0.05), ISS ( 11.7±6.0 vs. 33.0±9.0, p<0.05), and morbidity (77.8% vs. 13.3%, p<0.05). Conclusions: These results suggest that the PTS is a valid predictor of morbidity and mortality in a multiple-trauma child with hemoperitonem or peritonitis and may be useful in conjunction with other indices to assess an injured child.
이영철,정경석,김중섭,손태경,신현욱 대한소화기학회 2000 대한소화기학회지 Vol.35 No.3
Background/Aims: Not rarely, the abdominal surgeon is confronted with the finding of gallstones and cholecystitis while performing a nonbiliary procedure. This study was performed to evaluate the postoperative effects of incidental cholecystectomy in patients who received major non-biliary abdominal surgery. Methods: A total of 63 patients who received incidental cholecystectomy during major abdominal surgery were reviewed. Results: Two major proceding problems for abdominal surgery in this study were intraabdominal malignancies and gastroduodeual diseases. There were no significant differences in the mean hospital days, operating time, morbidity (46.2% vs. 37.5%, p 0.05) and mortality (7.7% vs. 4.2%, p 0.05) between the unplanned cholecystectomy group (39 patients) and planned cholecystectomy group (24 patients). However, there were significant differences in the mean hospital days and morbidity (88.9% vs. 24.4%, p 0.05) between the patients aged over 65 (18) and the patients aged under 65 (45). The mortality showed no statistical difference according to age (16.7% vs. 2.2%, p 0.05). Conclusions: These results suggest that unplanned incidental cholecystectomy for gallstones and cholecystitis during major abdominal surgery is justified if it is easily accessible and the condition of the patient warrants the additional procedure.