구강악안면 손상 후 과도한 출혈을 보인 정신지체 응급환자에서 신속지혈 예: 증례보고
Emergency bleeding control in a mentally retarded patient with active oral and maxillofacial bleeding injuries: report of a case
모동엽, 김하랑, 최병호, 이천의, 설성한, 유재하,
소속 상세정보
모동엽 ( Mo Dong-Yub ) - 연세대학교 원주의과대학 치과학교실
김하랑 ( Kim Ha-Rang ) - 연세대학교 치과대학 구강악안면외과학교실
최병호 ( Choi Byung-Ho ) - 연세대학교 치과대학 구강악안면외과학교실
이천의 ( Lee Chun-Ui ) - 연세대학교 원주기독병원 구강악안면외과학교실
설성한 ( Sul Sung-Han ) - 연세대학교 치과대학 구강악안면외과학교실
유재하 ( Yoo Jae-Ha ) - 연세대학교 치과대학 원주기독병원 구강악안면외과
KMID : 0355620100360040303
Abstract
Excessive oral and maxillofacial bleeding causes upper airway obstruction, bronchotracheal and gastric aspiration and hypovolemic shock. Therefore, the rapid and correct bleeding control is very important for saving lives in the emergency room. Despite the conventional bleeding control methods of wiring (jaw fracture, wound suture and direct pressure), continuous bleeding can occur due to the presence of various bleeding disorders. There are five main causes for excessive bleeding disorders in the clinical phase; (1) vascular wall alteration (infection, scurvy etc.), (2) disorders of platelet function (3) thrombocytopenic purpura (4) inherited disorders of coagulation, and (5) acquired disorders of coagulation (liver disease, anticoagulant drug etc.). In particular, infections can alter the structure and function of the vascular wall to a point at which the patient may have a clinical bleeding problem due to vessel engorgement and erosion. Wound infection is a frequent cause of postoperative active bleeding. To prevent postoperative bleeding, early infection control using a wound suture with proper drainage establishment is very important, particularly in the active bleeding sites in a contaminated emergency room. This is a case report of a rational bleeding control method by rapid wiring, wound suture with drainage of a rubber strip & iodoform gauze and wet gauze packing, in a 26-year-old male cerebral palsy patient with active oral and maxillofacial bleeding injuries caused by a traffic accident.
키워드
Active oral hemorrhage; Shock; Mentally disabled patient; Wound drainage; Emergency hemorrhage control
원문 및 링크아웃 정보
등재저널 정보