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우상복부 통증을 주소로 내원한 10세 남아의 대망 경색 1예
박재용,유리타,김도중,유지형,Park, Jae-Yong,Yu, Ri-Ta Miyoung,Kim, Do-Joong,Yoo, Jee-Hyoung 대한소아소화기영양학회 2009 Pediatric gastroenterology, hepatology & nutrition Vol.12 No.1
저자들은 급성 복통을 주소로 내원한 10세 남아에서 복부 초음파와 복부 전산화단층촬영을 통하여 대망 경색을 진단하였으며 항생제 및 진통제 등의 보존적인 치료로 증상의 완화를 경험하였기에 문헌고찰과 함께 보고하는 바이다. An omental infarctions is an uncommon cause of an acute abdomen and a rare entity in children. The etiology is still unclear and the symptoms mimic acute appendicitis. We recently encountered a case of a 10-year-old boy who had a previous surgical history of a manual reduction for intussusception. He complained of abdominal pain and right upper quadrant tenderness without fever or anorexia. An abdominal ultrasonography suggested an omental infarction and computed tomography confirmed the diagnosis. Conservative management was adopted with a rapid and uneventful recovery. Non-operative treatment is a safe and effective treatment of choice for omental infarction.
영양불량환자의 중증도 적용 향상을 위한 영양지원팀 협의진료체계 개선활동의 중요성
권국환 ( Kuk Hwan Kwon ),이형순 ( Hyung Soon Lee ),유지형 ( Jee Hyoung Yoo ),지수나 ( Soo Na Chi ),박현희 ( Hyun Hee Park ),김소원 ( So Won Kim ),김경란 ( Kyung Ran Kim ),윤난희 ( Nan Hee Yun ),라경택 ( Kyoung Taek Ra ),송현정 ( H 한국정맥경장영양학회 2018 한국정맥경장영양학회지 Vol.10 No.1
Purpose: The grade of complexity in the diagnosis related group (DRG) payment system is influenced by the secondary diagnosis of specific complication and comorbidity level, in which moderate or severe malnutrition is included. This study examined an existing proportion of patients with malnutrition who were supposed to be qualified for the complexity level and devised quality improvement measures to increase the proportion of qualifying complexity payments. Methods: The goal of the activities was to increase the rate of complexity payment claims for patients with malnutrition (%). Cases ineligible for the DRG payment system and cases with no diagnosis of malnutrition were excluded. We established a collaborative system between the nutrition support team and departments related to each improvement factor (i.e., patient care, medical records, insurance review, and medical information). Results: Before implementing the activities, this study investigated the current level of complexity payment claims for malnutrition patients who were discharged within a specific period (June 1, 2015∼August 31, 2015). The results showed that complexity payment claims were filed in 10.00% (2 of the 20 malnutrition cases). After the activities, the rate of complexity payment claims for the patients with malnutrition within the study period (June 1, 2016∼August 31, 2016) was 46.43% (26 out of 56), showing an approximately 364% increase from the pre activity rate. This change was statistically significant according to the chi-square test on Microsoft Excel 2010 (P<0.01). Conclusion: Collaborative efforts by the related departments enabled the smooth implementation of each activity. In addition, moderate or severe malnutrition was revealed to be a variable in the complexity-specific payment system. In the future, hospital-wide awareness and effort are crucial to promot the steady practice of these activities and expand their implementation.