1996.4.7

Ȱ ̴.

OT 3ð ̳ 10ñ Ƿ ̱ Ǿ ־.

ڸ NS op. ߰  Ǿ.

¥ ¥ ٷ ʾҴٰ ̴ּ.

ù ̰ ϴ ģϰ ָ ٵ ϸ ٸ DZ

ȴ.

ڵ ԰ ,ᵵ ԰ ޽ ̾߱ϴ ð .

׸ ̳ emergency ʾҴ.׷ ̰ ƴ ˰ Ǵ...

 

1996.4.8

ħ ʵ  ˾ƺ ԰ 9 濡  ־.

Ǽ 6.

ϵ ְ ĩϴ ׷....

.  Ȱ ־.

( )

ϴ 9 濡 ̹ ־ٴ --ʰ  ȴ.

ϴ ̿ TIVA ϰ Ǵ ó . ó ϴ 뿡 TIVA.......

general µ......׷ ø ޾Ҵ.

Ͻôµ ˾Ƶ ! ߴٰ ϳĴ Ҹ .

pk ٸ ٴ ̾߱⸦ ó ϼ̴.( ƴ ʹ ٸ

̴̼. . ι  .......)

ϴ 4¥ ̴ vital bp ʴ´ٴ 𸣰 ־.(

ٰ ¥ ̴.--- ϴٴ .)

intubationȿ ִ ־. þ

̴. ִ ٰ  ߴ. ̷ ϵ ſ Ȳϰ

. ϰ ´ٴ ԿԴ ̱⵵ ߴ.

϶ ϼ̴. κ ϰ ִµ Ÿ Դ.

vital ʰ ϳĴ ̴. ´ . ϰ

ֽø ȵdzĿ.....

׸ ϰ . ϴ ⿡ ϴ

 Ÿε ׷ Ⱑ ̹  ǾȰ 䵵 ϰ Ǿ.

chart ã ϴ....... ϴ ó ؼ ̴ּ.

߿  extubation mask ġ ̾߱⸦ ڵ غǷ

پ ϴ ϱ .

mask ĥ ũ ٰ Ͻô Ҵµ װ ƴϰ mask

޶ ƴѰ..........

ù op ι ̿ ƹ ϰ Ѵ.

뵵 ʾҰ bite  block . ballooning ߴ..

ϴµ 1CC ̾߱⿡ 1cc ʰ ξµ ( ̰ ̿

ε........) ֻ⿡   ʴ ٴ ̶ ̾߱⸦ .

ȭ ̸ ߰ ̿Ա ȭ ƴ.

ÿ  ñ̴µ ENDING϶

ϰ ־ EXTUBATION̶ ȭǥ ǥø  ϴµ ߸ ؼ ٸ ĭ

ϰ Ǿ Ӹ ¾Ҵ. ̋ ؾ 𸣰

̾.

ó غǷ پ . ؿ ִ .

̸ ٰ ٰ ȣ翡 ...... ׳ 濡 ְ ; ٰ Ĵ ܿ

ó Դ. ؿ ִٰ  ٵ.......

϶ ϼ̴µ ӽð ߴ. 1ð 15 o2 ͵

ǥø ̴. ̶ ̼   ó . Ѵ Ѵ ϸ ϰ

̴ ̴. ׷ Ǿ ............

  Ҹ . ڱ پ ־ Ѵٰ,,,,

̰ ȣ鵵 " ´° ..." Ÿ Ҹ ߰ Ȱ Ե

༮........̶  .

ҳİ ̴. ޽ 8ֶ ޽ǿ ġ

Ⱥ....ϰ ̾߱ߴ.

° ۵DZ Ļ縦 ϰ ϼ̴.

Ļ縦 ߴ. ̸   ʾҴ.

Ļ ڿ ־. Դĸ ϴ ִ

  ׷ Ŷ ϼ̴.

׸ ñ ĻϷ .ĻϷ οԴ.

Ļϴ غ ڽ ൿ ߴٴ ̴. Ļ

̿ ׷ ƴ϶   ߴ. г ٿ...........

̋ 5濡 ٰ ϼ̴. ⻵ϸ

.

ߴ.

ű⼭ 6ñ ־. ű ִ ʹ ſ.

ű⼭ ǥ ̳ ȣǥ ȣ   ٸ Ư

迵, , ȣ   ̴ּ.

 ֳ ;............( д å Ҵ.

ġϽô ϳ................  Ⱑ Ŵ. ٽ ԰ 븦

ؾ߰ڴ.)

ð Ǿ ù Դ..........

ٽ ϱ Ϸ翴. ׸ ̷ . θ ؼ п

ƾ߰ڴ. ׸ ϴ ̶   ڴٴ ӿ

ö.

 

 

1996.4.9.ȭ

ϴ°ɱ?

ƴ ʹ ؼ ⺻ ϴ°.

Ŀ 5 ļ ȯ ⺻ Ż ǥø س Ͱ ǻ

̸ źΰ  . ׷ ͵ µ ʹ Ű ʴ

........ ؼ ϴ ϴ° .

輱 ׸ ׸ ־ ٽ ȯ

͸ ʰ ٸ ϴٰ   ִ ǰ Ҵ.

ȣǥ  ˾Ұ ٵ  δ ٰ

Ѵ.

̶ 4 ġ Ϳ Դ...............

θ ϴ ̷ ϵ ؾ ϴµ.........

ϴ Ϳ ɰϰ ̾.

Ե ַ Ͻô ̴.

ģ Ҵٰ õ Ϸ翴.

ʴ´..... Ǹ ʴ´. ǻ簡 Ǿ ̴ϱ...............

 

 

1996.4.10

õ ԰ Բ 濡 .

õ ֻ⸦ lidocaine ȴ Ǽ Բ ֻ⿡ protection ʾҴٰ

. ð  ̶ µ .............

Բ ȥ ϶ ñð ѷ ̴.

ȭҸ ޶ Ȱ Ź Ҹ 4 ø Ҹ ٰ ߿ Բ

Ҹ ⵵ ߴ.

2ð ....... 3 ۿ ù

ִٰ ߴ.

밡 , ñ Ǯ ̾߱⸦ ϼ̴.

"........ ׸ ϴ ٸ ˵ ׷ ....... ϴ´ٰ ޴ ٴ

󸶳  Ƴ.........." ̷ ̾߱⿴..

ġϽô ϳ ִ ð ̾߱⵵

ɰ ̻ ϴ ϴ   濡 Ǿ ׷ ׵

̴.

ƴϲ ̴. ƴϸ ٸ ô.....

Ǽ ͵ ߸Ǿ. Ҿ ϴµ....... ó ϴ

Ͽ ݿ  ־ڴ°........

· 2 ޾Ҵ. ޼ ڰ 6ñ ϸ鼭

 


1. ϴ źΰ ִٴ ǰ

2. ̷ ϰ ʴ´ٴ ̴......̷

   䱸ϴ Ͽ ̴.

     û ϴ Ǽ........ ¦ ¦ ̷ ....... ٷ

    ǻ簡 ɼ ........

ȸ ִ ̶ ԰ ϵ 󱼵 ־.

߰ ڸ 48ð ׸

Ҵ.

 

1996.4.11

15 ȸǿ Ű ִ .

Ҵ. ϴõ Ǫ Ÿ ɵҴ.

̷ ̴. .......

R/O panperitonitis explo-lapa ޼ TV ־ٰ

ᵵ .

ʾҴ. ֱ ̱⵵ ߰ ʹ ִ

Ǯ ϵ   ΰ .

 

1996.4.12

9濡 Ÿ밡 2 ۿ 嵵 . ׸ ؾ..........

ʹ . Ե ̶ .

ϰ Ѵٰ   .

 ڷ 䳪 η 鼭

ġ ִ.

 

1996.4.13

8 ݱ DZ ȴ. conferenceĿ ϰ Ϸ ϰ

̴.

ó C/S غϰ Ǿ. F-T oligohydramnios Ӻο ε ȸ

ȣ غ϶ ϼ̴.

׸ ó epidural غ϶ ϼ̴. ߸ ó ٸ

Ǿ.

ξ߱ ϴ ̰ 2ú 5 ѰԱ OTְ 㿡 ǫ ߼ ־. Ư

..............

 

 

1996.4.14

׸ ȸ ߴ. ߿ Ͼ ϵ ڷ

ڸ ɾ 踦 帮   Ҵ.

׸ ߰ ȸ ٽ Ҵ.

Ⱑ  .....

̴..

2 ٸ ִ. Ƹ η ذ ٽ DZ .

" ƴϴ ׿..........."

" , ôϱ ׿........."

"  Ծ?......."

 

 

1996.4.15

maintenance fluid

  4cc/kg/hr  ó 10kg

  2cc/kg/hr   10kg

  1cc/kg/hr  

   ex)  60kg -- 40(4*10)+20(2*10)+40(1*40)

maintenance

  10cc/kg/hr  major op.

  8cc/kg/hr   intermediate

  6cc/kg/hr   minor op

 

1ð ־ /4 --->gatt(1д )

ü׾ -- ü 7.5%

 electrolyte -- 1L ָ 300 ´.

 DW      -- 1L ָ 100 ´.

ؿ Կ ͵ . ǰ ǰ Ǵ ĵ............

İ̴߰. ڴ..............................

 

 


1996.4.16 ȭ

޾ ڽŰ Ǿ.

ΰ .

off Ǿ (տ ʱ ) 鼭 õǾ ٴ Ͱ

ð ׸ 󸶳 ߿Ѱ ǻ Ҵ.

 

 

1996.4.17

total thyroidectomy Ͻô 濡 ִٰ Ǹ

л ȸϰ Ǿ.

anti-TG Ab

anti-microsomal Ab

anti-receptor Ab--hashimoto Ab

Goiter

  nodular--hashimoto's thyroiditis ( TSH goiter ߻)

               hashimoto  hypothyroidism ȴ.

  diffuse-- Graves' ds( TSI goiter)

 hypothyroidism

  Ҿ-- ϶, cretinism--Ҿ 'christ' -->ϴ.

  -- ǰϴ. ״´.

׸ EKG ó APC ߴ Ҵ.

P ʴ QRS complex ̴.

APC P Ĵ ⿡ ߻Ǹ PR 0.12 ̸̻ P ̴.

Pİ ʹ ʱ⿡ ߻ϸ պο ɽ ⿡ ־ ڱ ܵǰų

ϰ ȴ.

ɹڵ ʹ ⿡ Ÿ PĴ TĿ Pĸ ϱⰡ 쳪 Tĸ

Ű Ǿ Pĸ  ִ.

ڵ Pİ Ÿ κ Ѵ.

ɹڵ ɹ, ɹ漼,ۼ ɽǻ Ƶ ߻ų ִ.

ġ ɹڵ ְų Ƽ ߻ų 輺 ǽѴ.

,,Ŀǵ ϸ ʿϸ Ѵ.

 

 

1996.4.18

hepatobiliary op.ϳ ϴ ̴.

NS,OS OP ̶ ִ ð ִ.

׸ 4 ޷Ḧ ޾ƺҰ 濡 Ȳ 4ȣ ־.

 

 

1996.4.19

intubation õ ---׷

ϴ epiglottiis Ʒ Ա ĵ Ա .

ĵ Ա ʿ vocal cord ϰ ã Ա ʴ

ϻ̾.

ĵ ʿ larynx Ƹ ʿ vocal cord ϰŶ

̴.

׸ ϴ ȥ ߴ. vocal cord ϰ

⵵ Ա ɱ........

epiglottisƷ vocal cord Ͻô ɱ..........

ǹ 4ð ٸ Ե鿡Լ ĵ ⵵ Ա ̰

exposure vocal cord Ŷ ظ ϰ Ǿ.

׸ â case ϼ̴ ذ Ǿ.

ڿ δٰ ϼ̴.

ϴ ʳ ؾ ׸ ޽ǿ intubation ̳ .

 


1996.4.20

2 ƱⰡ myeolcele ħ 7 ݺ op .

װ ̾.

׸ Ŀ Ű OT ȸ ߴ.