소아 혈액종양 환자의 골수검사 후 침상안정 시간 단축에 따른 출혈에 관한 연구
A Study on Bleeding after Shortening the Bed Rest Time of Pediatric Hemato-oncologic Patients after Bone Marrow Examination
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목적: 본 연구의 목적은 소아 혈액종양 환자의 골수검사 후 침상 안정 시간단축에 따른 출혈여부와 영향요인을 파악하여 그 효과를 검증하기 위함이다. 방법: 2019년 7월부터 2020년 9월까지 총 145명을 대상으로 시행하였다. 단일센터에서 의무 기록을 통한 후향적 서술 조사연구이다. 기술적 통계, x 2 –test, Fisher의 정확한 검정, 로지스틱 회귀분석을 이용하여 자료분석 하였다. 결과: 침상안정 2시간 단축 후 91.7%은 출혈이 관찰되지 않았으며, 8.3%의 대상자에게 경미한 출혈이 관찰 되었다. 혈종(hematoma)이나 후복막 출혈(retroperitoneal hemorrhage)등과 같은 심각한 부작용은 관찰 되지 않았다. 골수검사 부위가 출혈에 유의한 영향을 미치는 것으로 나타났으며(p<.05) 한쪽 전장골능에서 검사를 시행하는 것에 비해 양쪽 전장골능에서 검사를 시행할 때 출혈의 위험성이 높아지는 것으로 나타났다. 결론: 소아 혈액종양 환자 골수 검사 후 2시간 침상안정 단축 시행은 안전한 실무 지침으로 판단된다..
Abstract
Purpose: The purpose of our study was to identify the bleeding risk factors and to validate the safety of shortening the bed rest time after bone marrow examination in pediatric hemato-oncologic patients. Methods: From July 2019 to September 2020, 145 patients were enrolled from a single center. Medical records were reviewed retrospectively. Descriptive statistics were presented, and the data were analyzed using x2-test, Fisher’s exact test, and a logistic regression. Results: After two hours of bed rest, most of the patients (91.7%) did not have bleeding complications, and only 8.3% of the patients had a minor bleeding. The rate of major bleeding complications, including hematoma, retroperitoneal hemorrhage rate was zero. The bleeding complications was frequently found on bilateral procedures than unilateral procedures and the difference were statistically significant (p<.05). Conclusion: Two hours of bed rest time after bone marrow examination could be safe and adequate in pediatric hemato-oncologic patients.
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