복식 및 질식자궁절제술의 비교관찰

정석준(SJ Chung),신경철(KC Shin) 대한산부인과학회 1976 Obstetrics & Gynecology Science Vol.19 No.2

Two hundred patients who had undergone hysterctomy by the Department of Obsterics and Gyunecology, Seoul Eulgi General Hospital during the three years of 1970-1972, have been made subject of observation and study for indication, complications and choice of operational methods. the study has proved much helpful in determing the merits and demerits involved in each different way of operation as well as in deciding if the operation is optional or not. Out of 200, 100 were for abdominal hysterectomy while the other 100 for vaginal hysterectomy. These two groups were subjected to a observation. The age ranging from 31 to 49 formed the largest group in both case ; the youngest being 26 and the oldest 66. For both groups, Myoma was the biggest cause of the operational indication, whereas that of abdominal hysterctomy was found to be the chronic PID, ectopic pregnancy, meaometrorrhagia in this order. The cause of vaginal hysterectomy, on the other hand, was found to be the chronic cervicitis, and uterine bleeding in this order. Of the total operations that are made subject of this study, 14 are the cases of operation for sterilization. The abdominal hysterectomy patients were generally worse in their condition than those patients who underwent the vaginal hysterectomy, requiring more emergency operations than what wa required for vaginal hysterectomy. However those patients of vaginal hysterectomy showed relatively better general conditions, rendering the operation optional in greater number of cases. In most cases, abdominal hystercetomy was performed under general anesthesia, while vaginal hysterectomy under spinal anesthesis. As to the complications, fever was 50% for both group and urinary tract complications 34% the two most outstanding complications observed. Other complications include wound infections hematomas, intestinal obstruction, thrombophlebitis. etc One patients of abdominal hystercetomy had died of the acute renal failure.

사지단지증아의 1예

정석준(SJ Chung) 대한산부인과학회 1974 Obstetrics & Gynecology Science Vol.17 No.4

사지단지증아의 분만 1예를 경험하였기에 문헌적 고찰과 함께 보고하는 바이다. 본증례는 분만전 X선 소견으로 양수과다를 동반한 사지단지증으로 진단하고 또 분만 후 신생아가 특 징적인 사지단지증의 모양을 가지고 있었으며 원인은 규명할 수 없었다. A case of achondroplasis associated with hydramnios is presented, and the literatures are briefly reviewed.

측자궁마취의 임상적 고찰

정석준(SJ Chung),박영하(YH Park) 대한산부인과학회 1973 Obstetrics & Gynecology Science Vol.16 No.4

Paracervical block is effective in relieving painful uterine contractions in the first and second stages of labor, as was introduced by Rosenfeld in 1945. Paracervical block anesthesia is obtained by the deposition of the local anesthetic solution into the paracervical tissue. 92 patients were undergone paracervical block for clinical observation of anesthetic method, effect, duration, fetal heart rate, maternal complication and Apgar scores of neonates. The method used was multiple injections given into four paracervical areas, namely at 3, 4, 8 and 9 c`clock positions, The needle was inserted approximately 1 or 1.2cm., and 1% lidocaine was then injected. Complete relief of pain was obtained in 84 per cent and duration of action was average 30 or 40 minutes. Ten patients developed fetal bradycardia after paracervical block, but all neonates who had bradycardia were discovered to be in good condition, Apgar score being 7 or above in 5 minutes. Maternal complication involved were of littel significance. Paracervical block is simple, and it is safe for the mother and/or for the neonate.

완전자궁내번증의 1예

정석준(SJ Chung),임인호(IH Lim),박광선(KS Park),박영하(YH Park) 대한산부인과학회 1974 Obstetrics & Gynecology Science Vol.17 No.2

저자들은 최근 치험한 산욕기 급성완전자궁내번증 2예 중 1예를 보고하고 문헌적 고찰을 하 였다. 모두 응급으로 내원한 환자로 발생원인은 미상이나 Eastman의 주장대로 shock 치료 와 동시 Johnson씨 용수정복술로 별 합병증 없이 치료 퇴원하였다. Inversion of the uterus occurs very rarely but the mortality is high unless its recognized and treated promtly. We present a case of complete inversion of the uterus with a brief review of literatures.

질식난관결찰술의 임상적 고찰

이동경(TK Lee),정석준(SJ Chung),박영하(YH Park) 대한산부인과학회 1972 Obstetrics & Gynecology Science Vol.15 No.4

질식난관결찰술의 임상적 고찰을 시행하여 보고하는 바이다. Vaginal tubal ligation is one of the most simple, practical and effective methods of permanent conception control for women who want to conclude their childbearing during not only a nonpregnant period but also an early trimester of pregnancy. The authors performed 72 tubal sterilizations during the period from September 1970 to December 1971, while in one case of those her medical record was lost. There were 8 abdominal tubal ligations performed on non-pregnants, 73 on women in the immediate postpartum period, and 27 vaginal hysterectomies with various surgical indications, during the same 16-month review period. Reviewing morbidities and complications of the 71 vaginal tubal ligations, the vaginal approach was associated with very little risk, and was better accepted by most patients dut to absence of the visible surgical scar and easier attitude toward the surgery than was the abdominal approach. Furthermore, the vaginal could be conveniently combined with the other vaginal surgeries such as interruption of early pregnancy, perineal repair, and so forth. It also seemed to be in any means economic benefit due to performance at once within shorter surgical duration of various combinations of several vaginal surgeries and shortened hospital stay. The vaginal, moreover, was found to be superior to the adbominal in the viewpoint of unwanted postoperative secondary psychologic gain. Comparison of vaginal tubal ligation vs. vaginal hysterectomy performed for permanent conception control was beyond the socpe of this review.

원발성 난관암의 1예

신경철(KC Shin),정석준(SJ Chung),이동경(TK Lee),박영선(YS Park) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.2

원발성 난관암의 1례를 보고한다. 환자는 57세의 1회 출산력을 가진 환자로 3년간에 걸친 질분비와 하복부 포만감과 경한 얍통을 호소하였으며 7일간에 걸친 발열 두통 하복부 압통 그리고 다량의 질분비로 내원 자궁근종과 난관종양이라는 진단하여 개복수술하였으며 수술후 병리 조직학적 진단은 원발성 난관암이었다. Primary carcinoma of the fallopian tube is the rarest tumor of the female reproductive tract . A case of primary carcinoma of the fallopian tube was reported and brief review of literature.

자궁경관 임신의 1예

박영선(YS Park),신경철(KC Shin),정석준(SJ Chung),박영하(YH Park) 대한산부인과학회 1975 Obstetrics & Gynecology Science Vol.18 No.3

자궁경관임신의 1례를 보고하였다. 본례는 22세의 미산부로 타의원에서 인공임신 중절수술을 시도하다 다량의 자궁출혈로 웅급 전원된 환자이며, 자궁전적출술을 하여 병리조직학적으로 자궁경관임신이라는 확지을 얻은 례이다. A case of cervical pregnancy which is in 22 year old nulliparous woman is presented with a brief review of literature.

질식자궁적출술에 대한 임상적 관찰

경광수(KS Kyung),박영선(YS Park),정석준(SJ Chung),박영하(YH Park) 대한산부인과학회 1974 Obstetrics & Gynecology Science Vol.17 No.3

1970년 10월 1일부터 1973년 2월 28일까지 29개월간 을지병원 산부인과에서 불임술을 받은 721예 중 질식자궁척출술 76예에 대한 임상적 관찰을 하여 다음과 같은 결론을 얻었다. 1) 자궁척출술에서 질식 62.7%, 복식 37.3%였다. 2) 년령 분포는 28∼56세로 평균 40.3세이며 40세 이하가 56.6%였다. 3) 평균 분만회수는 4.0회, 평균 유산회수는 2.8회, 평균 생존 자녀수는 3.6인이었다. 4) 질식자궁척출술의 부수적 적응질병은 자궁근종 20예(26.3%), 부정자궁출혈 15예(20.0%), 자궁경부본란예(13.1%)의 순이며 자궁내임신, 난소낭종이 각각 7예로 9.1%를 점하고 있다. 5) 마취는 전신마취 32예, 척수마취 40예, 전신마취와 척수마취를 병행한 예가 4예였다. 국 소마취의 예는 없었다. 6) 수술시간은 자궁척출술 단독에서 98분, 질회음부봉합술을 병행한 예에서 130분이 소요되 었는데 전례에서 자궁내용물 제거 및 소파술을 선행하였으므로 실제 수술시간은 약 15분 단 축되었으리라고 사료된다. 7) 난관난소절제술을 병행한 예는 14예(18.4%)이었고, 질회음봉합술을 병행한 예는 56예였 다. 8) 수술 중 출혈량은 62예(81.6%)에서 400cc 이내였고, 19예에서 수혈없이, 34예에서 1병으 로 충분하였다. 9) 이환률은 31.6%로 수술시간과 수혈량에 따라 증가하였다. 합병증의 대부분은 쉽게 치료되었고 그 예에서 개복하였으며 사망자는 없었다. 10) 유치 catheter는 전례에서 사용되었고 평균 기간은 2.5일이었다. 11) 척출술에 대한 병리조직학적 검사는 42예(53.0%)에서 이상소견을 보였다. 12) 본 수술은 불임술로서 우수하며 양성 및 악성자궁질환을 예방한다는 이점이 있으나 난 관결찰술에 비해 환자들이 잘 응하지 않고 있는 실정이다. The purpose of this study was to analyze the vaginal hysterectomy admitted to Eul-Ji Hospital during 29 months period of Oct. 1, 1970-Feb, 28, 1973. By analysis, 80 cases of vaginal hysterectomy of among 721 sexual sterillization in the same period, the following results were obtained. 1) The incidence of vaginal hysterectomy was 11.1% in total sexual sterillization, and 37.3% in hysterectomy. 2) In the age distribution, the majority was in 31-40 years age group, and 43 cases (56.6%) were under the 40 years old in age. 3) The average of the parity was 4.0. 4) The febrile morbidity was 31.6%, but less serious. 5) The complication was found in 23 cases, and one exploratory laparotomy was done. 6) The hospital stay after operation was 4-14 days. The average was 8.0 days.