척추측만증 수술 후 환자의 복부불편감 실태조사
A Descriptive Study on Abdominal Discomfort after Scoliosis Corrective Surgery
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
목적:본 연구는 척추측만증 교정수술 후 환자의 복부불편감 발생률, 발생시기, 중재방법, 관련요인을 조사하기 위함이다. 방법:2012년 1월부터 2014년 12월 사이 청소년기 특발성 측만증을 진단받고 후방유합술을 받은 420명 환자의 의무기록을 이용한 후향적 조사연구로 복부불편감 발생에 대한 독립적인 발생요인을 확인하기 위해 로지스틱 회귀분석을 사용하였다. 결과:연구 대상자 중 185명(44%)에서 복부불편감이 발생(AD-group)했고, 수술 후 2일(31.4%)과 3일(27%)째 가장 많이 발생했다. 복부불편감 발생한 환자 중 97명(52.4%)이 중재방법으로 글리세린관장을 사용했다. 복부불편감을 발생시키는 최종관련요인은 마지막유합부위(OR=2.43, p<.006), 증가된 수술 중 실혈량(OR=1.03, p<.001)이었다. 결론:본 연구에서 측만증 수술 후 환자의 복부불편감 발생률은 44%로 복부불편감은 측만증 수술 후 환자와 간호사 모두에게 해결요구도가 높은 문제임에 틀림없다.
Abstract
Purpose: The specific aims of this study were to investigate the incidence, time of occurrence, intervention methods and related causes of abdominal discomfort after scoliosis corrective surgery. Methods: A retrospective review was carried out on all patients with diagnosis of adolescent idiopathic scoliosis (n=420) who received a posterior spinal fusion between January 2012 and December 2014. Logistic regression analysis was used to identify significant related factors. Results:One hundred eighty five of the patients in the study (44.0%) reported abdominal discomfort (AD group). The discomfort was worst on 2nd days after operation (31.4%), and 3rd days (27.0%). Ninety seven patients (52.4%) in the AD group received enema treatment. Significant related factors for developing abdominal discomfort were distal fusion levels (OR=2.43, p<.006) and increased operative blood loss (OR=1.03, p<.001). Conclusion: The incidence of abdominal discomfort after scoliosis corrective surgery in this study was 44%. Abdominal discomfort, therefore, is a main concern in reference to scoliosis corrective surgery, and solutions need to be searched and reported in future research.
참고문헌 (19)
- Edward R. Westrick, "Adolescent Idiopathic Scoliosis", Journal of Pediatric Orthopaedics, 31, pp.S61~S68 (2011), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Suk SI, "Textbook of Spinal Surgery", pp.419~453 (2011), Newest Medical Publishing Company
- Seung-Woo Suh, "Idiopathic scoliosis in Korean schoolchildren: a prospective screening study of over 1 million children", European Spine Journal, 20(7), pp.1087~1094 (2011), Springer Nature[DOI]
- "2010-2014 scoliosis surgery statistics for Korea" (2016)[URL]
- Lee CS, "Analysis of scoliosis surgeries: Experience ofmore than 1,000cases at a single center", Journal of Korean Society of Spine Surgery Specials, 22(Suppl 1), pp.s103~s104 (2015), Korean Society of Spine Surgery (KAMJE)[DOI]
- Jane S. Hoashi, "Adolescent Scoliosis Classification and Treatment", Neurosurgery Clinics of North America, 24(2), pp.173~183 (2013), Elsevier BV[DOI]
- Marios G. Lykissas, "Complications of Surgical Treatment of Pediatric Spinal Deformities", Orthopedic Clinics of North America, 44(3), pp.357~370 (2013), Elsevier BV[DOI]
- Leah Y. Carreon, "Non-Neurologic Complications Following Surgery for Adolescent Idiopathic Scoliosis", The Journal of Bone and Joint Surgery (American), 89(11), pp.2427~ (2007), Ovid Technologies (Wolters Kluwer Health)[DOI]
- John T. Smith, "Does a Preoperative Bowel Preparation Reduce Bowel Morbidity and Length of Stay After Scoliosis Surgery? A Randomized Prospective Study", Journal of Pediatric Orthopaedics, 33(8), pp.e69~e71 (2013), Ovid Technologies (Wolters Kluwer Health)[DOI]
- Jun SJ, "Adult Health Nursing", pp.419~ (2000), Hyunmoonsa
- CorreiaMI, "The impact of early nutrition onmetabolic response and postoperative ileus", Current Opinion in Clinical Nutrition andMetabolic Care, 7(5), pp.577~583 (2004)
- 방설영, "껌씹기가 개복수술 환자의 장운동 회복과 구강불편감에 미치는 효과", 임상간호연구, 14(3), pp.15~25 (2008), 병원간호사회
- CrawfordHA, "Gastrointestinal morbidity following spinal surgery in children", The Journal of Bone & Joint Surgery, 87-B(SUPP III), pp.403~ (2005)
- Lee CS, "Thoracic pedicle screw insertion in scoliosis using posteroanterior C-arm rotation method", Journal of Spinal Disorders and Techniques, 20(1), pp.66~71 (2007)
- Se-Il Suk, "Pedicle Screw Instrumentation for Adolescent Idiopathic Scoliosis: The Insertion Technique, the Fusion Levels and Direct Vertebral Rotation", Clinics in Orthopedic Surgery, 3(2), pp.89~100 (2011), 대한정형외과학회
- Yang JH, "The comparative analysis of axial rotation correction rate between titanium-alloy and cobalt-chrome-alloy rod after surgical correction and fusion using posterior only pedicle screw construct in idiopathic scoliosis with double curve", Journal of Korean Society of Spine Surgery Specials, 22(Suppl 1), pp.s104~s105 (2015), Korean Society of Spine Surgery (KAMJE)[DOI]
- Johnson JE, "Effects of structuring patients’s expectations on their reactions to threatening events", Nursing Research, 21(6), pp.499~504 (1972)
- 서은지, "아로마 흡입요법이 대장내시경 검사 대상자의 오심, 구토, 복부 불편감, 순응도 및 대장 정결도에 미치는 효과", 임상간호연구, 18(3), pp.391~401 (2012), 병원간호사회
- Kim JK, "Treatment of chronic constipation", Korean Journal of FamilyMedicine, 18(11), pp.1226~1237 (1997)