[성인간호학] 수술실 케이스 스터디, 보고서

문서 내 토픽

• 1. Unstable angina

  환자는 71세 남성으로 Unstable angina 진단을 받고 Off-pump CABG (coronary artery bypass graft) surgery (two vessel) 수술을 받았습니다. 수술 과정에서 마취 간호사가 환자의 vital sign을 모니터링하고, 수술 중 필요한 기구와 장비를 준비하고 사용하는 것을 관찰할 수 있었습니다. 특히 경식도 초음파(TEE)를 이용해 심장 기능을 확인하고, 관상동맥 내 shunt를 삽입하여 혈류를 유지하는 등의 기술이 사용되었습니다.

• 2. Abnormal findings on diagnostic imaging of liver and biliary tract

  55세 남성 환자가 Abnormal findings on diagnostic imaging of liver and biliary tract 진단을 받고 laparoscopic cholecystectomy 복강경 담낭절제술을 받았습니다. 수술 과정에서 CO2 insufflator를 이용해 복강 내 기복을 만들고, 복강경 기구를 사용하여 담낭을 절제하는 과정을 관찰할 수 있었습니다. 또한 수술 후 회복 과정에 대한 정보도 제공되었습니다.

• 3. Spinal stenosis lumbar region

  74세 남성 환자가 spinal stenosis lumbar region 진단을 받고 posterior decompression lumbar spine : L4-5 ULBD Lt 수술을 받았습니다. 수술 과정에서 Wilson frame을 이용해 환자의 자세를 고정하고, Caspar retractor와 Kerrison rongeur 등의 기구를 사용하여 척추 근육을 박리하고 극돌기와 후방인대를 절제하는 과정을 관찰할 수 있었습니다.

• 4. Acute aortic dissection

  85세 여성 환자가 acute aortic dissection 진단을 받고 pericardial window operation, minithoracotomy with diaphragm plication 수술을 받았습니다. 수술 과정에서 Doppler 초음파를 이용해 혈관을 확인하고, Versajet II Hydrosurgery System을 사용하여 괴사 조직을 제거하는 등의 기술이 사용되었습니다. 또한 수술 중 환자의 혈압 저하로 인한 어려움도 있었습니다.

• 5. Pressure sore of buttock

  64세 남성 환자가 pressure sore of buttock 진단을 받고 local flap 수술을 받았습니다. 수술 과정에서 괴사 조직을 제거하고, 도플러 초음파를 이용해 혈관을 확인한 후 피부 이식술을 시행하는 과정을 관찰할 수 있었습니다. 또한 Versajet II Hydrosurgery System을 사용하여 오염된 조직을 제거하는 것도 확인할 수 있었습니다.

Easy AI와 토픽 톺아보기

• 1. Unstable angina

  Unstable angina is a serious form of coronary artery disease that requires prompt medical attention. It occurs when the heart muscle does not receive enough oxygen-rich blood, often due to a partial blockage or narrowing of the coronary arteries. Symptoms can include chest pain, shortness of breath, and fatigue, and may occur at rest or with minimal exertion. Prompt diagnosis and treatment are crucial to prevent potentially life-threatening complications, such as heart attack. Management typically involves medications to improve blood flow and reduce strain on the heart, as well as lifestyle changes and potentially revascularization procedures. Careful monitoring and follow-up care are essential to manage this condition and reduce the risk of adverse outcomes.

• 2. Abnormal findings on diagnostic imaging of liver and biliary tract

  Abnormal findings on diagnostic imaging of the liver and biliary tract can indicate a wide range of underlying conditions, from benign lesions to serious diseases. These findings may include masses, cysts, calcifications, or changes in the size, shape, or density of the liver or bile ducts. Careful interpretation of the imaging results, along with consideration of the patient's medical history and other clinical factors, is essential to determine the appropriate next steps for diagnosis and treatment. In some cases, further testing such as biopsy or laboratory analysis may be necessary to confirm the nature of the abnormality and guide the management plan. Prompt and accurate diagnosis is crucial, as some liver and biliary tract conditions can be life-threatening if left untreated. Collaboration between radiologists, gastroenterologists, and other healthcare providers is often necessary to ensure comprehensive and effective care for patients with these complex conditions.

• 3. Spinal stenosis lumbar region

  Spinal stenosis in the lumbar region is a common condition that can cause significant pain, disability, and reduced quality of life. It occurs when the spinal canal or neural foramina in the lower back become narrowed, often due to age-related changes, degenerative disc disease, or other underlying conditions. This narrowing can put pressure on the spinal cord and nerve roots, leading to symptoms such as lower back pain, leg pain, numbness, and weakness. Accurate diagnosis through a combination of medical history, physical examination, and imaging studies is crucial to determine the underlying cause and develop an appropriate treatment plan. Conservative management, including physical therapy, medications, and epidural injections, may be effective for some patients. In more severe or refractory cases, surgical intervention, such as decompression or fusion procedures, may be necessary to alleviate symptoms and improve function. Ongoing monitoring and a multidisciplinary approach to care are essential to manage this complex and often chronic condition.

• 4. Acute aortic dissection

  Acute aortic dissection is a life-threatening condition that requires immediate medical attention. It occurs when there is a tear in the inner layer of the aorta, the main artery that carries blood from the heart to the rest of the body. This tear can cause the inner and outer layers of the aorta to separate, leading to a potentially catastrophic loss of blood flow and organ damage. Symptoms may include sudden, severe chest or back pain, shortness of breath, and signs of organ dysfunction. Prompt diagnosis through imaging studies, such as CT angiography or transesophageal echocardiography, is crucial to determine the extent and location of the dissection and guide appropriate treatment. Management typically involves emergency surgical or endovascular repair to prevent further complications, such as aortic rupture or organ ischemia. Careful monitoring and management of underlying risk factors, such as hypertension and connective tissue disorders, are also essential to reduce the risk of recurrence and improve long-term outcomes. Collaboration between cardiologists, vascular surgeons, and other specialists is often necessary to provide comprehensive and effective care for patients with this complex and life-threatening condition.

• 5. Pressure sore of buttock

  Pressure sores, also known as bedsores or decubitus ulcers, are a serious and potentially life-threatening condition that can develop in individuals who are immobilized or have impaired sensation. Pressure sores of the buttock are particularly common, as this area is subject to high levels of pressure and friction, especially in patients who are bedridden or wheelchair-bound. These wounds can range in severity from superficial skin irritation to deep, necrotic tissue damage that can lead to osteomyelitis, sepsis, and other life-threatening complications. Effective prevention and management of pressure sores require a multifaceted approach, including regular skin inspections, pressure redistribution through the use of specialized mattresses and cushions, and prompt treatment of any emerging lesions. Nursing care, wound management, and addressing underlying risk factors, such as malnutrition and poor circulation, are all crucial components of a comprehensive treatment plan. Early intervention and a collaborative, interdisciplinary approach are essential to promote healing, prevent further complications, and improve the overall quality of life for patients with this debilitating condition.