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자간증에 관한 임상적 고찰

자간증에 관한 임상적 고찰
Other Titles
Clinical study on eclampsia
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연세대학교 대학원
[한글] 모성사망의 3대원인의 하나인 자간증은 모체와 태아에 치명적인 결과를 초래하는 산과 영역에 있어서 매우 중요한 질환으로서, 끊임없는 기초 및 임상적인 연구에도 불구하고, 아직까지 그 원인이 확실치 않으므로 지금까지 역학적 연구의 결과에 따라 철저한 산전관 리만이 그 예방의 첩경이라는 것은 주지의 사실이다. 지금까지 알려진 추정된 생성기전을 바탕으로 대중적인 치료의 한계를 벗어나지 못한 치료방법의 향상 및 그 예방을 위해, 1 965년 1월부터 1976년 12월까지 만12년간 본 연세대하교 의과대학 부속 세브란스병원 산 부인과에 입원, 분만하였던 산모 총21,704명중 224예의 자간증환자의 기록부를 임상통계 적으로 다각적인 면에서 분석 고찰하였으며, 연구기간중 본 의료원에서 사용하였던 치료 방법의 변천과정을 문헌고찰과 더불어 간략히 서술하였다.
[영문] In order to study a variety of epidemiological and clinical aspects of eclamptic patients a retrospective survey of obstetric records of 224 eclamptic patients, who were admitted between 1965 and 1976, was carried out in the Yonsei University Medical Center. The results were as follows: 1. The incidence of eclampsia was 10.3 per 1.000 deliveries. 2. The distribution of antepartal, intrapartal and postpartal eclampsia was 70.1%, 19.2%, and 10.7% respectively. 3. 38.9% of the patients were in the age 25 - 29, which was most prevalent childbirth group. 4. 66.5% of the patients were primigravids. 5. 29.4% of the patients occurred in winter which was followed by spring, autumn, and summer in order. 6. 66.5% were in the gestational period 37 - 40 weeks. The average duration of gestation was 37.7 weeks. 7. 86.1% of the patients received no antenatal care. 8. 29.5% of the patients convulsed one time, which was most frequent number of convulsion. 38.5% of the patients convulsed within 25 - 72 hours before and after delivery. 9. Among the associated diseases, the incidence of SPRM was 27.1% and anemia, twins, chronic hypertensive vascular disease were 22.9%, 14.3%, 14.3% respectively. 10. 88.9% of the patients were delivered vaginally, 11.1% were performed cesarean section. Among the vaginal delivery, 49.1% delivered spontaneonsly. The most frequent indication for cesarean section was CPD (6.2%). 11. 52.2% of the patients received pudendal blocks. In case of cesarean section the majority had general anesthesia. 12. The maternal mortality from eclampsia managed in YUMC was 19 per 100,000 live births. 13. The stillbirth rate was 48.2 per 1,000 births and the neonatal mortality rate 36.9 per 1,000 live births. The overall perinatal mortality rate was 83.3 per 1,000 births. 14. 41.7% of the patients were in the placental weight 600 -699 grams. 15. 48.3% of the patients were in the systolic BP 160 - 199mmHg on admission and 49.5% the diastolic BP 110-- 129muHg. 16. 49.1% of the patients were in the hemoglobin level 12.0 -13.9gm% and 7.1% below 10.0gm%, 48.7% of the patients were in the hematocrit level 36.0 - 41.9%. 17. The average value of Na, K, Cl, BUN, and protein was within normal range. The bicarbonate value appeared to be increased, bet the uric acid and creatinine decreased. 18. 35.2% of the patients were in the degree of proteinuria ++++ on admission, but 2.3% discharge. 19. 36.6% of the patients were in the degree of pretibial pitting edema ++ on admission. 20. The most common blood type were A**+ and 0**+ (36.6% respectively). 21. 69.6% of the patients were in the normal fundoscopic findings. 22. The average duration of hospitalization after delivery and cesarean section were 7.6 days and 9.8 days.
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2. 학위논문 > 1. College of Medicine (의과대학) > 석사
Yonsei Authors
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