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임신성 고혈압 산모에서 태어난 조산아의 임상적 및 예후적 고찰
한승표,박상기,송창훈,박종,김경심,최영륜 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.1
Purpose : This study was undertaken to review the clinical and hematologic findings of the preterm infants delivered from pregnancy induced hypertension(PIH) mothers. Methods : The data were collected by reviewing the medical records on the current prognosis of preterm birth and sending questionnaires on the status of NICU. We reviewed the medical records from two university hospitals and two resident training hospitals in Gwangju-Chonnam to evaluate the neonatal prognosis of preterm birth from Jan. 1, 1995 to Dec. 31, 1997. Results : The average survival rate of total preterm babies was 79.6%. According to birth weights, survival rate from less than 1,000 gm was 10%, 1,000-1,499 gm was 55.3%, 1,500-1,999 gm was 82.2%. Maternal risk factors were pretmature rupture of membrane(42.2%), preterm labor (21.3%), PIH(10.7%), multiple pregnancy(8.2%) and incompetent internal os of cervix(4.2%). The average gestational age and birth weight were 34.2■2.3 weeks and 1,940■620 gm in the preterm infants born to mothers with PIH. The death rate was 12.9% in the preterm infants born to mothers with PIH. There were no significant differences in the incidence of RDS, use of assisted ventilation and surfactant, and frequency of the blood transfusion between the preterm infants born to normotensive mothers and those to mothers with PIH. There were significant differences in the total WBC count, platelet count and the concentration of the Mg, Ca and P between the preterm infants born to normotensive mothers and those to mothers with PIH. Conclusion : Our results may be helpful to predict the perinatal complications and manage the preterm infants by considering the clinical and hematologic findings of preterm infants born to mothers with PIH. 목 적 : 임신성 고혈압은 자궁내 성장 지연, 조산, 가사, 또는 혈액학적 변화 등으로 인해 주산기 질병 이환률과 치명률이 높은 것으로 알려져 있다. 저자들은 임신성 고혈압 산모에서 태어난 조산아와 정상 혈압을 갖는 산모에서 태어난 조산아를 비교하여 임신성 고혈압 산모에서 태어난 조산아의 처치에 도움이 되고자 하였다.방 법 : 연구 대상은 1995년부터 1997년까지의 최근 3년 동안 광주·전남 지역의 2개 대학병원과 2개 종합병원의 신생아실에 입원한 재태연령 37주 미만인 조산아 2,360명과 이들 중 879명을 대상으로 의무기록을 조사 분석하였으며, 또한 본원에서 신생아실에 입원한 328명(임신성 고혈압 40명, 정상 고혈압 288명)을 대상으로 혈액학적검사를 비교 분석하였다.결 과 : 전체 조산아의 생존율은 79.6%이었으며, 재태연령이 증가할수록 또는 출생 체중이 증가할수록 생존율이 통계적으로 유의하게 증가하는 경향을 보였다. 임신성 고혈압 산모에서 태어난 조산아의 재태연령은 34.2±2.3주, 출생체중은 1,940±620 gm이었으며, 정상 혈압 산모에서 태어난 조산아는 재태연령은 33.2±3.2주, 출생체중은 2,060±610 gm이었다. 임신성 고혈압 산모에서 태어난 조산아 평균 Apgar 점수는 1분에 7.29±2.51점, 5분에 8.45±1.69점이었으며, 정상 혈압 산모에서 태어난 조산아의 평균 Apgar 점수는 1분에 750±2.47점, 5분에 8.36±2.00점이었다. 임신성 고혈압 산모에서 태어난 조산아에서 총 입원기간은 20.71±18.51일로 정상 혈압 산모에서 태어난 조산아와 비교시 통계학적으로 유의한 차이를 보였다. 임신성 고혈압 산모에서 태어난 조산아와 정상 혈압 산모에서 태어난 조산아에서 사망률, 심폐소생술 시행 여부, 인공호흡기 사용, 표면활성제 사용 및 수혈의 여부는 두 군간의 통계학적인 차이는 없었다. 임신성 고혈압 산모에서 태어난 조산아와 정상 혈압 산모에서 태어난 조산아에서 뇌실내 출혈, 뇌실주위연화증, 신생아 호흡 곤란 증후군, 미숙아 망막증과 패혈증 발생 빈도는 두 군간의 유의한 차이는 없었다. 분만 양식에서는 임신성 고혈압군에서는 제왕절개가 62%로 많은 빈도를 보이고 있었다. 임신성 고혈압 산모에서 태어난 조산아와 정상 혈압 산모에서 태어난 조산아에서 혈액학적 및 혈청학적 검사에서 총 백혈구에서의 과립구와 림프구의 비율, 총 혈소판 수, 혈중 칼슘, 인과 마그네슘의 농도가 두 군간의 통계학적으로 유의한 차이를 보이고 있었다.
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초등학생들의 의료기관 이용양상 및 선택 기준에 관한 연구
한승표,김은영,노영일,양은석,박상기,박영봉,문경래,Han, Seung Pyo,Kim, Eun Young,Rho, Young Il,Yang, Eun Seok,Park, Sang Kee,Park, Yeong Bong,Moon, Kyung Rye 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.2
Purpose : The aim of this study is to find out the distribution of illness, patterns of medical care utilization and factors determining medical care utilization in elementary school children. Methods : We performed the questionnaires in Gwangju city on 2,036 children of two elementary schools from June 1 to June 30, 1998. Results : The prevalence rate of illness was 32.3%. The distribution of illness was respiratory disease(64.7%), gastrointestinal disease(12.8%), injury & poisoning. The rate of persons having received medical treatment when they were sick, was 89.8%. The selection distribution among various medical facilities was pediatric hospital(46.7%), otolaryngologic hospital(19.8%), pharmacy (13.2%) and internal medicine in the decreasing frequency sequence. The major factors influencing the selection of medical facility were geographic accessibility and good results. The most common reason for the first visit to the pediatric hospital was geographic accessibility. The most common reason for a visit and to otolaryngologic hospital was a good result. The most frequently utilized medical facility for respiratory symptoms and gastrointestinal symptoms was pediatric hospital. The persons influencing the selection of medical facility in the children were mother(73.3%), father( 10.8%), doctor and others in decreasing sequence. The persons answering the questionaire thought that the optimal age of pediatric care was from 0 to 12 years(47.8%), to 10 years(22.4%) and to 15 years(18.5%) in decreasing rate. Conclusion : Other departments instead of pediatrics have treated children. Children have particular growth and development process, which is different to those of adults. So, it is necessary to choose special medical care and adequate medical facilities for children.
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한승표,조규종,조영석,김오현,김이호 대한응급의학회 2023 대한응급의학회지 Vol.34 No.6
Objective: Automated external defibrillators (AEDs) have been installed for use on out-of-hospital cardiac arrest (OHCA) patients in Korea. However, there are very few cases in which the AED was used before the 119 paramedics arrived in cardiac arrest patients. This study investigated whether the locations of the AED in Korea were appropriate. Methods: This study analyzed the locations of OHCA patients, AED installations, and the number of OHCA patients within a 100-m grid around the AEDs in public and residential areas by province. The information on acute cardiac arrest patients was obtained from the original data of the Korea Disease Control and Prevention Agency. The installation of AEDs is registered with the National Emergency Medical Center. Results: The number of OHCA patients in public and residential areas was 28,434 and 95,713, respectively, and the number of installed AEDs in these locations was 15,387 and 11,420, respectively. The number of OHCA patients per AED was 1.8 in public areas and 8.4 in residential areas, and there were significant differences by province (P<0.001). The percentage of OHCA patients within the 100-m grid around the AEDs was 21.9% and 23.1% in public and residential areas, respectively (P<0.001). Conclusion: There were significant differences in the AED placement locations in public and residential areas by province. In addition, the percentage of OHCA patients within a 100-m grid around AED was only 22.9%, indicating that the number of AEDs was insufficient. Efforts to enhance the AED placements and monitoring are needed to resolve the regional deviations.
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