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.