The Effects of an Active Pain Management with Structured Physiotherapy on Postoperative Pulmonary Complications and Pain among Children
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(2) ੲࠜ ճߙ ധஹւࠤண୍ԧ ২ บ ੰܛଭ ඍࣦஹ ࢳ ധஹ ੲ ࢠ౿ ۀตր. ۗ. ࣑ଭ थܑ ׆ԩ ࢫ ࢺ࣑ଡ ֜ฃਏಯ ୡ ฅੰଭ ඍ ࣦஹ ࢳ ധஹ ࢫ ੲ࣡ฃ ࢠ౿ ۀઽේଡ คճୀ . ֜ฃࠤࢄऀฺ ܤ૬࣑. ઼ۗ ଲࠜ ֽՋߦ ֽՋணਕଭ ԩண୍ ඹߦഠଡ Թࢳ. ୀপ࣡լր ฺऀ࣑ QFSDVTTJPO ଡ ଲ ฺऀࢄࠤ૬࣑ ࢺ. ਓࡿ ୡ ۀՓଠ ହঃਓࡿ ࢳୢଡ ැ ࠻ ଭࢠ ଼ۀ. ࣑ր ෘਏԩඝࠜ ಅ۩ િ ऀచճ ࣪ୀ՚ ෘ ਏ ค. ଵଲޭ ॷ߹ۗܤ. ඝਏࠜ ܑߧ ۀՓଡ ࠱ۗ ২ บ ਏԩ ܛੲ ୍ บ ࣪ୀ՚ ฺऀࢄࠤ૬࣑ଡ ෘܑߧ ճ ଲบ ਏԩࠬ. ֜ࡧୡ. ۗ ฎ ਏԩࠬۗ ฎ ଲบऀഉ ۀਏԩࠬۗ ෘ ܣଵ ܛੲ ծু ฎं ۀଡ ొր ੴܑߧ ۗ. ࣭ ֜ଭ ࡧୡଠ ੲࠜ ճߙ ২ บ ܛۇୡ ധஹւࠤ ඍࣦஹ. ࢫ ֜ฃࠤࢄऀฺ ܤ૬࣑ଲ ฅੰଭ ඍࣦஹ ࢳ ࢫ ധஹ ੲ࣡ฃ ࢠ౿ ۀઽේଡ ค ۀՓଲۗ. ඍࣦஹଠ ฺऀࢺॷট ઽ ঃ ಅଗ ݊ଭ ण୨ঃୡ ীեଲ ࣪ଲճ ෯ઁ Ցॷ ঃ ࢽ෯֜ ౿ԧ ঃ ହঃୡଞ. ֜ԧড. ߦ ۀճવ ׆ಅ ԧԧ ܤࢱܛլߦ ۡۥଭॷ ଭැ ඍߝ ࢫ ࡿ׆ඍߦ ౖஂ ۚ ܤլࠜ ࠱ۗ. ԧড ੲࠜ ճߙ ധஹւࠤண୍ࠜ ୪վࢲଠ ਓ֞ր ২ บ ୢധୡ ඍࣦஹ ુࢺԩࠜ ୪վࢲଠ ۩֞ଠ ২ บ ඍࣦஹ ࢳ थܑ ఙଲԧ ଼ଡ Փଲۗ. Ⅱ. 문헌고찰. ԧড ੲࠜ ճߙ ധஹւࠤண୍ࠜ ୪վࢲଠ ਓ֞ଲ ২ บ ୢധୡ ඍࣦஹ ુࢺԩࠜ ୪վࢲଠ ۩֞ णැ ২ บ ധஹ୨ܑԧ ٗଡ Փଲۗ. ২ บ ඍࣦஹր ฺऀࢄࠤ૬࣑. ԧড ੲࠜ ճߙ ധஹւࠤண୍ࠜ ୪վࢲଠ ਓ֞ଲ ২ บ ୢധୡ ඍࣦஹ ુࢺԩࠜ ୪վࢲଠ ۩֞. ২ ଭ ඍ࣡ ۇ׆ฃ ۀசߦ ധஹ ଭ ࢭ ۀඍฆ߆. णැ ২ บ ੲ୨ܑԧ ڔଡ Փଲۗ. WJUBM DBQBDJUZ ଭ Ԯীԧ ਕۗ ඍฆ߆ Ԯী ۀ২ บ _ਏԩ ౖ۩ߦ Ԯীճ ଵג ছছํ ฎ࣫ޭݗ ۗܤ. ઘ୨ଭ. ছ ହঃୡଞߦ ค ԧ׆ࡿ ۇඍ ݊ଭ ඍࣦஹଠ ২ บ _ଵ ԧୋ ࢳۗ ඍฆ߆ଠ ঃ࣫ऀ ২ଲฺ يշୣ. ২ บ ୢധୡ ඍࣦஹ ુࢺԩ. Թ২ଡ ࢱ Թฺ২ଭ լ ਏԩ ੲ ২ ୢ ଭ. ׁג ਏෘܣઘ ࢭ۩ߦ ฅੰԧ ২ บ ࣦܛ ૈୀࠬ. _ג Ԯী ฺऀ ऀ࣫ ي২ ଲଭ ২ছۀ. ୀ ฅੰࠜ ࠤճ ԧଡ ࠤ݁ܪେଡ ୀ՚ ۀמՓଡ. ඍฆ߆ଲ Ջଭ Ԯী ੴ ۀՓଞߦ ࣪ճܣճ ଼ۗ ২ บ. ࠱ۗ ଲ ۀਏԩ ณ ׆ԩଲ ୨ැ୲ ଼ ੴճ ଭ߹ଲ. ඍࣦஹଡ ஹԧਏ೬ ۀ૬ଞߦ ۀ২ ୢ ׆ਕඍாฅ ण. ணۚޭճ ් גݡ ծুۗܤ. ஹ լֽாฅ ࢫ ୢઊր Ԯસଲ ଼Ջ ي২ ணۀ ౸ ଵ౸ඍฅ ׆ր߆ଭ ใઙ୪୪ ঃ࣫ऀ ࢫ ฺऀ২. ܛۇୡ ധஹւࠤ. ֻࠤճ ୋਏԩଭ ২ଲ ઽේଡ ࢠ౿ ২ บ ۀใୡ. ฅੰԧ ২ บ ࣦܛ ૈ ԩॷԧ ২ บ ܛۇୡ ധஹւ. Ԯী ౸ ധஹ ࢫ ճॺ ܑړীԧ ଼ۗ ࣫ऀ২. ࠤ ֜ฃࠤࢄऀฺ ܤ૬࣑ ւ କࢄଡ ଲ ऀࡦ. ଲऀฺ ي২ଡ ࢲଠ ฅୀ՚ ധஹଲ ਕ ࣫ऀ ࢫ ฺऀࠜ. ՚ ֗ଖճ ଲࠜ ਏෘ ۀՓଡ ࠱ۗ ԩॷ ۀট ധஹॷ. ॷಧ ׆ ۀಅଠ ตրୡ ԧਆ֗ฅߚۇଭ Թটଡ ܑࡦ. ୨ܑ֜ '-"$$ ੲॷ୨ܑ֜ $0.'035 #FIBWJPS 4DBMF ࠜ. ۗ ૈํߙ ധஹଲ ઢ ۀਕใਐ ใଲ ୀࢳୡ ৩৸׆. ଲ ധஹଡ ॷ୨ճ ֻ ۗଣ ฅୀଭ ઑ௬ ඍଣଡ . TJHI ଭ ตրࠜ ּ۩ฃճ ۇ׆ୡ ୂࠑ߆ '3$ ଡ Թট. ୨ঃଲ ऀࡦ ฅੰԧ ं ܛੲ ଼ ״՚ ճ ଲบ . ඍคୋ ܑૺଲ ޭݗ ۗܤছ ୀࢳୡ ਕใଡ ࣪ ׆. ਏԩ ܛੲ ඇੲ՚ ୍ܑߧ ۗ ֻ ۗଣ ਏԩࠬۗ ധஹଡ. ැ ใઙ୪ࠜ ొ ੴ ۀୡ ۥധ୪ଭ ॷଲ ࢭޱ. ॷ୨ ԧ ଲঃଲ ԩॷ ۀധ୪ࠜ റճ ധ. ۗ ন۴ ஂনր ็ . ஹॷ୨ ਏԩ ଲܑ ऀࡦଭ ധ୪ ૬֜ԧ ଼ଞ റۀ. 5PSSJOUPO 4PSFOTPOր 4IFSXPPE ଭ ֜ ࠙ݗ. ଵߛଭ ୡּୡ ധஹւࠤ ෘࠜ ܛۇୡ ധஹւࠤߦ ୨ଭ. ฎ২ 3PVYFO: HBTUSJD CZQBTT ২ଡ ࢲଠ ࡣଭ. - 48 -.
(3) ହঃԩ֜ ଁ ڂ. ন णฅୀࠜ ۩ঃଞߦ ਏԩࠬۗ ԩෞୡ ઑใ࣑ *11#. લઙ୪ࠜ ଵଞ೮ۗ. ր Գฃඍฆ߆ծ *4 ԧߦ ฺऀࢄࠤ૬࣑ଡ ୡଡ ݡ. ށฃܣ ੴଠ ധஹଠ ਆൈߑਆ ࢱଦଡ ୋਏ೬ճ ฅ. ฺऀࢄࠤ૬࣑ଡ ԧߦ ୡ ੴଡ ܪࡦ ݡଭ լছ. ୀ݅ଭ ਕใր Զଠ ২ บ ண૬ ฎ࣫ ฆܛଡ ࢺැଞߦ. ઊ ԧ එଣଲ ܣતճ ଲঃଭ ฅୀԧ Ժۡଡ ࢼ. ছ ୠॺীஹ ๅं ֻࠤճ ୢনଡ ଵଞ೯ ଼ۗ ,JFDPMU. ౢଞ ۩ऀंଠ ୠॺী෯ஹଞߦ ॺী૬࣑ଡ ࢲ՚ ܣતۗ. (MBTFS (MBTFS (SBWFOTUFJO .BMBSLFZ 4IFSJE . ܪࡦ ֞ ܪ ށছ ଲ ฺऀࢺॷট ઽ ঃ ୨ঃীեଡ. .BOXPSSFO ݊ ฅੰଭ ധஹଡ ੱฃਏ೬ ۀٛୡ૬. ઼࣪ճ ଲঃଠ ౖ۩ඍฆ߆ '7$ ଲ Ԯীۗ )PGGNBO. ଞߦ ۀऄੲ վඑ ऀୡୣ՚ ւࠤ ܤଲୢଭ ധஹլ. .B[[PDDP 3PUI ׆ ۀಅ ԧԧ ুୡଞߦ ଼ ۀฅୀ. ࢱܛஹঃ ૈਕ ֜ഠ ใյޯ ଭ ऄೆ լ ঃจ. ՚ ฺऀࢄࠤ૬࣑ଡ ୡଡ ݡඍ࠼ܛ ۇ׆෯ॺীं ࢫ. ۩ ऀ୨ୡ ැজ ݊ଲ ୡ૬ଞߦࡦऀ ۀଭ ऄੲ . ԧଭ ઑঃ ࣡ฃԧ କଭ ੴۗճ ࣪ճ઼ۗ. ऀࡦଭ րী ۀށրଽࢱଦ ଭ߹ଭ ऀୡୣ ւࠤ ฅլ. ଲ߇ ֜էր݅ଠ ฺऀࢄࠤ૬࣑ଲ ୢୡଞߦ ২ บ ඍ. ۩ ऀୡଦଲۗ .D(SBUI ݊ ୪Ջܣ ੴଠ ധ. ࣦஹଡ ુࢺ් ଼ ۀକଵ ࢺ࣑ଠ ੰ ۍധஹଲ ઢۀ. ஹଠ ઽੰ՚ ऀ୨ୡ ఼ୡ ୨ୡ ऀ୨ୡ ෘ࣡ܛฃࠜ. ঃԧ ૈํߙ ୀࢳୡ ਕใଡ କࢳ් ଼ઘ ඍคୋ କଳ. ొۗ ޭݗছ ২ บ ي ۀيധஹଡ ୡּୡଞߦ ુࢺ. ۗ ۀଡ ୪ਏැசճ ଼ۗ. ճ ୣ ୋ ⋅ۚ׆ୡ ଲଳଡ જଡ ଼ۗ 4UBSHBUU. ඇ ඍࣦஹଭ ஹঃଞߦ ହঃছ ۀํ ࢳવଡ சࡧճ. ݊ . ଼ۗ "OHFM #MBTJFS "MMJTPO ଭ ֜ ࠙ݗ. ઽੰԧ ২ บ ധஹւࠤࠜ ࢲ ۀୋ૬ଞߦ ۀଭ߹ଭ. ୨෴ր ࣦܛ ২ ฅੰ ࡣ ண ැۀۥ. ฅੰ ധஹ ۩ ਐऀ ധ୪ ۩ ਐऀ ଳ. ࡣଲ ২ บ ܑ ଲঃଭ ࢳવଲ ଼તଞ ଲண ۚ ࡣ. ੴଠ ੰܛଭ ധஹॷ୨ܑ֜ ݊ଲ ࣪ճܣճ ଼ճ $VNNJOHT. ଲ ඍߝଞߦ ۚଡ ࢲۗ ֻࠤճ ଲ߇ ࢳવଠ ২ บ ొ. 3FJE 'JOMFZ .D(SBUI 3JUDIJF )BNFST "CV. ׆ਏԩ ੲ يٕଞ ২ਏԩր ࠬ౫ਏԩ ࢫ ෯ଲ . 4BBE )BMGFOT 4DIVNBDIFS +BDPC 1VOUJMMP. ২ บ ࢳવր ւߛଲ ଼તճ ා୪ ࠬ౫୪ଭ ஂࠑ ࢼઁւ ঀ. 1FEFSTPO .BUUJFT .D%POBME ֻ ট০. କࡿ ۀւߛଲ ઢતۗճ ࣪ճ઼ۗ ହঃছ ۀ২ บ. ছ ฆߚบ ܑ׆କ ं ࢫ ୢැா ऄֹ෴ ౢ෯ ݊ ۗ. ਏԩ ଲٛ ࢳવଲ ඍࣦஹր ւߛ ଼ۗճ ۩ऀं ࢣճ ଼ଞ. ࠛ ହঃୡ Թڄ ࢤࠤճ ଼ ۀՓଞߦ ୡܣતۗ জࢢ෮ ଗઽ. يඍࣦஹଭ ુ౸ୀߦ ࣪ճ ܤ֜ ۀణੰ࣮ ԧ ઢۗ. ࢠ ૈૉր ࢮଠ . ২ บ ੰܛଭ ധஹࢱଦր ധஹւࠤ. ২ บ ੰܛଭ ੲ DPNGPSU ԩ. ন՚ ധஹଡ قھ՚ ۀઘ ݬՓଲ݃ ઽੰ՚ܑ ധஹ. ੲଲߨ $PNGPSU 5IFPSZ ଠ ఼ୡ ୨ઽୡ ॷฎࢂฃ. ଡ ச ۀՓଲ ੰܑ ധஹଡ ් լୡଞߦ ౦ंํ. ୡ ֻࠤճ ฅլୡ ౸ଡ Գ ԩ ਏ ܛۇୡଲ ۗԨ. ࢳۜܣઘ ଼ۗ "OBOE )JDLFZ ധஹଭ ۚ׆ୡ ઽේ. ୡ ౸ଞߦ ୦්ֽ ଼ܑߧ ܁ۀํ ੰܛԩ ਓࡿ. ଠ ࠤୡ ࣡ ෘܛୡ ࣡ߦ ࢱઽ ܁ۀܣෘܛୡ ࣡ߦۀ. ֜ ंઉছ ଲ ଲߨଡ ଲැճ ୡ׆ԧ ଲۗ. ଣ ઝ֠ඝ୨ ఼ૺହଲ ଼ۗ "OBOE )JDLFZ . ܛੰ ށԧ ԩॷ ֻࠤճ ැ׆ ۥւ ࡦ ࠜܪԳ՚. 4IBQJSP ઽੰছ ଲ߇ ധஹଭ णચઘୡ ۀ୨. ճ ਏ೮ۗ ,PMDBCB .BHWBSZ ࠙ݗ. ค՚ ැজ් ෂ૬ԧ ଼ۗ ઽੰଭ ෘܛୡ ࠤୡ ࣡ฃܪ ۀ. ܛۇୡ ԩ ֜ޭ ଠ ധஹ ऄੲր Զଠ ாࣦଭ. ߙૺր ऄੲր Զଠ Ԯ୨ଭ ඝ෮ଵ ଼ଞ ധஹ࣪ۗࠛۗ ۀ. ऀ୨ୡ ౸ଡ ౖীฃ ۀՓ ॣ ੰ ޭۍੲ ็࠷ ฎ࣫ր. ࣡ ள ࢼճ ੲୢ ॷ ੲ୨ ੲୢ ۩ ૬֜ԧ ઽੰࠜ. Զଠ ଵঃۇ׆ଭ ׄ୨ୡ ۇ׆ଡ Գฃਏ೬ׄ ۀ୨ୡ էր. ճധਆߌ՚ ් ܑ ଼ઘ ැজଡ ઘߞ՚ ࢂݡ ׆ଲۗ. ԧ౿ࠜ ۗܬ. &MBOEFS )FMMTUSPN 2WBSOTUSPN ઽੰ ۀധஹլ. ੲண୍ ۀාঃন କ ധஹଡ ୣ ۀඝஜண୍ ऄ. ଡ ׆ઙ් ଼ଞ ऀ୨ୡ ׆ઙ݅ଠ ૈ ু ܥ ଼ۗ. ੲଡ ୪Ջճ คր ୨࣪ࠜ ୪վ ็࠷ր լ ฎ࣫ଡ . .D$SPSZ . ծฏଡ পܑߧ ۀܙಸಈ ֻࠤճ ੰܛր ԧଲ ԩࠜ. ২ บ ധஹଠ ฎ࣫ଡ ਏ೯ ଼ ܁ۀധஹଠ ਆൈߑਆ. ࢲճ ଼ۗճ ۀ݁ ߧܑقھઽଭ ੲઑਐ প ԧ ෴ԧ. ࠙ࡩଭ ࢺౢ ࢫ റ୕ ܑச ࢱଦ ଡ କࢳ ఼ ۩ॷଘଡ. ଼ۗ ,PMDBCB ֽౖ ࢂෝଡ ॼආ࣪ ಅୡ ୣఙࠜ . ஹԧਏ೬ճ ਕࢮ ࢫ ܛ෯ଭ ஹԧ ୋܛଭ ୠ ֻࠤճ . ෘՋܛੰ ݡ ܑ يଭ ੲ࣪ۗ ۀധஹ լԮ ۳ ւਕଡ ࣪ - 49 -.
(4) ੲࠜ ճߙ ധஹւࠤண୍ԧ ২ บ ੰܛଭ ඍࣦஹ ࢳ ധஹ ੲ ࢠ౿ ۀตր. ଲ ۀՓଲ ॷਓଲ يఙ ੰܛԩ ࢂෝছ ੲୢ߃ DPNGPSU. ଡ ౖ۩ฃ ׆ැ ۗଣր Զଠ ׆ஜଞߦ ֜۩ঃଡ ট୨. TUSBUFHJFT ۩ ւਕଲ ஹԧճ ଼ ۀլේଡ ࣪ଲճ ଼ۗ. ઼ۗ ∙ ২ ୢ լֽாฅ ࢫ ୢઊր ඍߝஹঃଲ ઢଞ ෯. ੲ ۀඇੲ ఼ ઠৃԧޮ ऱ׆ Զଠ ୀ ׆ ւ ۡ૬ߦ ਚச ׆݅ઘ சࠤֻ ׆ճ ऀࡦ ੰܛଲ ״. ઁଦճ ୋ ݊ଭ ாฅଲ ઢ ۀฅੰ ∙ ২ऀ ߦऀ࣫ ۀ୪઼ଞ ୢࠬ౫ ২ଡ ࢲ. ଼ ۀՓ ݊ଲ එ ۗܤ,PMDBCB %J.BSDP ڂ ࢠ֝ࠬ౫ԩॷฎছ ୪վ ԧଲ݁ޭ ࠬ ࠙ݗ౫ୢบ. ଠ ฅੰ. ฅୀଭ ധஹ ࢫ ੲւࠤԧ ԧୋ ண૬ ࢂ୪ହଡ يٛճ ଼ ۗ ,SFO[JTDIFL 8JMTPO ,PMDBCBଭ ੲଲߨ Թڄ. ׆ஜ ऀ۩ ܤঃୀ ࠜ ౦ ׆ැ ฎ Տౄ. ր ୢ߃݅ଠ ੰܛԩ ਓࡿ ண ํ ২ บ ԩਓࡿ ඝஜଡ. ୀ߹ ுଲ ਓਏܣતۗ ఙ ୀ߹ு ׆ԩଠ ଁ_ ڂ. ۜন ׆ ୢ߃݅ր କॷࢂݡ ׆ ੲଲߨଡ ਓࡿ. ఙגଁ_ ڂ ۀ઼ଞ ఙ ਓ֞ ࡣ ۩֞ . ୡ׆ԧ ଲۗ. ࡣ ఙ ਓ֞ ࡣ ۩֞ ࡣ ۩ ୀ߹ԧ ுܣતۗ ֜۩ঃ ট୨׆ஜ ऀ ীੰր ࣦ ܛฅੰ ண ֜ࡧୡଡ ଲැճ ֜ଭ ఞ ছ ܛଭ ࣪ୀଭ ੰܛ. Ⅲ. 연구방법. ଡ ট ۩֞ ହଭ ්ۥ ୀ߹ࠜ ு઼ଞ ଲบ ண୍ଭ คॺଡ ࢺ ׆ැ ۩֞ଭ ฅੰԧ ࡦ ܪബ บ Զଠ ࢺ࣑ଞߦ ֜۩ঃୀࠜ ඝౢճ ਓ֞ ହଭ ්ۥ. ֜ ডծ. ധஹւࠤண୍ࠜ ୪վճ ୀ߹ࠜ ு઼ۗ ਓ֞ր ۩֞ ࣭ ֜ܛۇ ۀୡ ധஹւࠤ ࢫ ֜ฃࠤࢄ ऀฺ ܤ૬࣑ ݊ଞ. ԨԨ ୣܛ ׆ୣܛ ׆ੲ ฅੰࠜ ճ߿ එਏಯ ծ. ߦ ੲࠜ ճߙ ധஹւࠤண୍ࠜ ୪վࢲଠ ਓ֞ր ২ บ. ୣୡ ఙଲߦ ઽේଡ ౖীฃ් ଼તۗ. ୢധୡ ඍࣦஹ ુࢺԩࠜ ୪վࢲଠ ۩֞ ԩ ২ บ ඍࣦஹ ࢳ ധஹ ࢫ ੲ୨ܑࠜ ण֗ ण݊ܛন ۩֞. ֜ୣఙ. ୢบ ਏఙডծଲۗ<ֻࠨ >. ହঃছ ਓ୪ ২ଡ ࢲଠ ฅୀࠜ ۩ঃଞߦ ਖ ܛ ڂੲ ଁ_ ڂఙ. ଁ_ ڂఙ. ୨ডߦ ࢲੰ઼݅۶ ׆ଭ ২ บ ඍࣦஹ ુࢺࢺ࣑ ۩ অ. ଁ_ ڂఙ. ଁ_ ڂఙ. ߦ ண୍ࢺ࣑ଡ ୡ ۀ֜ଲࢂݡ ׆ ॷୢ ฅୀ౿߹. ਓ֞. ۩֞. ఞ ݃ࡦ ۀଭ߹ ԩ ଭԧ ෂ૬ۗ ޭݗছ ֜ࠜ. :F. 9. :F. :D. ਏୁ ׆ୢ ীੰր ֗ ীੰࠬ౫ր ֗՚ ֜ࡧୡ. :D. ր ࢺ࣑ ࢫ অߦ ඍࣦஹ ુࢺԩ ۩ැ ౦ंํ ডࡣ઼ ճ ଲ ۩ැ ࠜ ֜ճ ֜ࠜ ෘ઼ۗ. 9 ੲࠜ ճߙ ധஹւࠤண୍ :F ਓ֞ଭ ଵࢱୡ ন వਐ କࡿ ऀࡦଭ ऄੲ :F ਓ֞ଭ ২ บ ඍࣦஹ ࢳ ധஹ ੲ :D ۩֞ଭ ଵࢱୡ ন వਐ କࡿ ऀࡦଭ ऄੲ :D ۩֞ଭ ২ บ ඍࣦஹ ࢳ ധஹ ੲ. ট ુणॷߦ ࣦ ܛୢ఼ ԩॷ ࡣଲ ࡣ ܪ੩ ைଡ ଲ ߿ઘ ࡣଭ ฅੰࠜ ܛਏ ւఝճ ٛୡܑ߲ࠜ ౸୨઼ ۗ ധஹր ੲ౸୨ܑ֜ ॷ ۩ැ ॷୢ ֗ଖଡ ਓਏ บ ֽࡿਏԩଲ Զଠ ԩॷԧ ࡣ੩ ைଡ ଲ߿ઘ ୢ఼ ਢଲ . <ֻࠨ > ֜ ডծ. DBTFࠜ ւఝଞ ଲ ݡւఝୀԩ ܑ߲ ,BQQB JOEFY _ ଵ౿ଘ _ ଲતۗ ֜۩ঃୀԧ ট୨ ܤบ ۡ ۥԩॷ֞۩ ۀଭ ऀࡦ՚. ֜۩ঃୀ ট୨ր ୀ߹ுࢺ࣑. ׆ ۀ ැ۶ ࢺਐ۩ߦ କࢄଡ ଲැ ୢധୡ ඍ. ֜ଭ ۩ঃୀ ۀছ ী୍ 4۩ࣦ ীੰր ࣦܛ . ࣦஹ ુࢺԩࠜ ডࡣ઼ճ ਓ֞ଭ ऀࡦ՚ ࣭ ۀ֜ଭ. প ଲଭ ฅੰߦ ܪுۚ ԩଭ ఙଲࠜ ࣪ճୀ ් ݡ. ࡧୡ ࠸՚ ୍୨׆ ܤଭ କࢄଡ ଲ ܛۇୡ ധ. ॷ ۀ$PIFO ଭ վਐ ޭݗധஹւࠤண୍ࠜ ୪վࢲ. ஹւࠤ ֜ฃࠤࢄऀฺ ܤ૬࣑ଡ ডࡣॷ ۀୢ֗ଖଡ ਓ. ۀਓ֞ ࡣ ୪վࢲ ੴࡣ ֞۩ ۀଡ ֜۩ঃଞߦ. ਏ઼ۗ ২ր ւߛ ࣡ଭ ܛாনଡ ැ ২ଠ ীੰր ֗. ઼ۗ କଭஜ ɷ E ɸ ֞ ܪԩଭ ܛாন. - 50 -.
(5) ହঃԩ֜ ଁ ڂ. $SPOCBDIT ɷ ଲતۗ. ଭැ ෘ ܤՓଞߦ ୪઼ۗ ֻࠤճ էր࣡ ২ บ ඍࣦஹ ധஹ ࢫ ੲ ઽේଡ ࢠಃ ଼ ࡦऀ ۀऄ. ੲෘॷܛ୨ܑ֜ $0.'035 #FIBWJPS 4DBMF. ੲ వਐ ২ր ࠬ౫ਏԩ ২ ண ୀপ ෯ କࡿ ணਕ୨ ࠼ւ ী࣡ ࢫ ւ ঀକࡿ ২ บ హী࣡ ࢼౢਏԩ. վใۜ ࠜ׆ճ ଼_ ۀপ ணฅୀਓ ฅੰଭ ਆൈߑਆ. ւ ୪Ջਏԩ ԧਆࢼౢ ਏԩ ਐଲ ෘ ਏԩ ݊ଭ ࣡. ੲࠜ ౸୨ ׆ැ Թࢳ ܤ$0.'035 4DBMF "NCVFM. ۩ැ ॷୢॷࠜ ਓਏ઼ۗ ऀࡦଭ ऄੲ ۩ ॷୢॷ. )BNMFUU .BSY #MVNFS ଡ _প ২ บ ฅੰࠜ. ۀ4QJFMCFSHFS ଭ ঃऄੲ౸୨ܑ֜ࠜ ଲ઼ճ ଵࢱ. ۩ঃଞߦ ॷ ׆ැ 7BO %JKL ݊ ଲ ୍୨ ੲ. ୡ ॷා ۩ැছ ۀாࢂࠜ ୁনܑߧ ઼ۗ ২ บۀ. ॷ୨ܑ֜ $0.'035 #FIBWJPS 4DBMF ࠜ ଲ઼ۗ ଲ ܑ֜. ਏԩඝࠜ ଲැ ଵ ܛੲ ധஹෘܛ౸୨ ܑ֜ '-"$$ ੲ. ۀԹଭ ාࡧଞߦ ֜নܣઘ ଼ଞ يվใۜ ࠜ׆ճ ଼. ෘ ܑ֜ܛ$0.'035 #FIBWJPS 4DBMF ࠜ ଲ ധஹր ੲ. ۀլ ැ ۀܣۥාࡧ Թࠜ ୪ճ Թଭ ාࡧ ࣭ . ୨ܑࠜ ਏԩࠬۗ ඌԧ઼ۗ ২ บ ฅੰԧ ࣦܛ ܑచ. ֜ ॷ઼ۗ Ԩ ࣐ச_ ۀଭ ߦ ࠻բճ ଠ. ฆߚบࠜ ౸୨઼ճ ২ บ ਏԩ ܛੲଠ ਏԩࠬ. _ଲ ܣԧ ڔଡߧ ੲ୨ܑԧ ٗଣଡ ଭࢠۗ. ۗ ଲบ ۀਏԩࠬۗ ఼ଡ ౸୨ ଵԩ ఼ଭ ࣡ฃࠜ. ܑ֜ॷ ۩ැ ୠୀଭ ෛޮଡ ࢲଞ ୠୀԧ ୪ୁ ଲ. ౸୨઼ۗ. ࣑ ۩ $%30.ଡ ࢲճ ֜ୀԧ ࡋୠ ܑ֜ॷ࣑ଡ ଳํ ճ يছ ԩॷ՚ ֗ଖଡ ਓਏ઼ۗ ܑ֜ ۀ֜ୀԧ ֿ ߦ ࣌લଡ ܶ ઽઘ ֝ઘ ۇധ ୢࢂԧଭ લ࣌લଡ. ਓళ౿. ࢲੰ ୨ ॷ઼ۗ ܑ֜ Թࢳ ۥਏ ܑ߲ $SPOCBDIT ɷ ઼ଞ ࣭ ֜ছଭ $SPOCBDIT ɷ ଲતۗ. ۩֞ଭ ऀࡦ՚׆ ۀଭ ࢺਐ۩ߦ ฅੰԧ ২ บ ࣦܛ ૈୀࠬୀ ඍࣦஹଡ ુࢺ ׆ැ ऀࡦ՚ ฅੰࠜ ࠤ. ২ ୢ ऀࡦଭ ऄੲ౸୨ ܑ֜ 45"*. ճ ԧଡ ࠤ݁ܪେଡ ୀ՚ ޭמճ ֗ଖ઼ճ ୨ැ ਏԩ ณ ׆ԩ ઢଲ ଭ߹ଲ ணۚޭճ ් גݡ ෘ. ऀࡦଭ ऄੲଡ ౸୨ ׆ැ ୨ր ֹܛଲ ඝஜ. ՚ ઼ۗ ਓ֞ଭ ऀࡦ՚ ۀฅੰԧ ২ บ ࣦܛ ૈ. ฃ ঃ׆ாऄੲ౸୨ܑ֜ 4QJFMCFSHFS ࠜ ଲ઼ۗ. ট ऀࡦ ฅੰԧ ं ߧ଼ܑ ״ճ ଲบ ਏԩ ܛੲ. ঃऄੲ ׆ாऄੲଲ ԨԨ Թ ࢂාଞߦ ֜নܣઘ ଼ճ Ԩ. ୍ܑߧ ઼ۗ ֻ ۗଣ ਏԩࠬۗ ฎ ਏԩࠬۗ ฎ ଲ. ࢂාଠ _ଭ ߦ ࠻բճ ଠ _ଲ ۗܤ. บऀഉ ۀਏԩࠬۗ ଵԩ ฺऀࢄࠤ૬࣑ ෘਏԩඝࠜ ಅ۩. ԧ ڔଡߧ ऄੲ୨ܑԧ ڔଣଡ ଭࢠۗ ܑ֜ Թࢳ ۥਏ. િ ऀచճ ऀࡦ՚ ෘ՚ บ ค ඝਏࠜ ܑߧ. ܑ߲ $SPOCBDIT ɷ ଲતଞ ࣭ ֜ছଭ ܑ߲. ઼ۗ ඇ ԩॷ ۀധஹॷ୨ܑ֜ '-"$$ ੲॷ୨ܑ֜. $SPOCBDIT ɷ ଲતۗ. $0.'035 #FIBWJPS 4DBMF ଲ ਏԩ ࠬۗ ധஹր ੲ ࠜ ॷ୨઼ճ ധஹԧ ଲঃ ࡦऀ ۀށଭ ૬֜ԧ ଼ଡ. ୀ߹ंজࢺ࣑. ۀݡധ୪ࠜ റ઼ۗ ு ܤୀ߹ ۀ4144 ඹߦֻଡ ଲැছ କଭஜଡ Q ߦ ড୨ ۗଣր Զଲ ंজ઼ۗ. ܑ֜֜. ֜ ۩ঃୀ ऀࡦଭ ଵࢱୡ ॷාଠ ਓ ࢽंଘ ඌֹ ր ඝஜඇఙߦ ֜ճ ਓ֞ր ۩֞ ܪுۚ ԩ ܛா. ധஹॷ୨ܑ֜ '-"$$. ন Ցஹଠ ಉଲ୪ռUFTU 'JTIFST FYBDU UFTU UUFTU. .FSLFM 7FPQFM-FXJT 4IBZFWJU[ .BMWJZB ԧ Թࢳ. ࠜ ଲۗ. ധஹෘܛ౸୨ ܑ֜ '-"$$ࠜ ଲۗ '-"$$ ۀധஹଡ. ֜ԧড Ց୨ଡ ැ ധஹ୨ܑ ੲஜଠ ऀࡦଭ ঃ. ࠱ߦ ඝ෮් ઢ ۀԹଁ_প ੰܛଭ ധஹॷ୨ܑ֜ߦ ઝ֠. ऄੲଡ. ۗࠤ ฆ ܛଣ ୨ଭ Թଭ ࣐சߦ ֜নܣઘ ଼ճ Ԩ ࣐ச. "/07"ࠜ ଲճ ඍࣦஹ ࢳଠ 'JTIFST FYBDU. _ ۀଭ ߦ ࠻բ ଠ _ଲ ۗܤԧ. UFTUߦ ण઼֗ۗ. ڔଡߧ ധஹଭ ୨ܑԧ ڔଣଡ ଭࢠۗ ܑ֜ Թࢳ ۥਏ ܑ߲. $SPOCBDIT. ɷ ઼ଞ. ࣭. ֜ছଭ. վ࣡ߦ. ళࠤ. SFQFBUFE. NFBTVSFT. ౸୨ܑ֜ଭ ܑ߲ ۀ$SPOCBDI BMQIB DPFGGJDJFOUߦ Ցஹ. ܑ߲ۀ. ઼ۗ. - 51 -.
(6) ੲࠜ ճߙ ധஹւࠤண୍ԧ ২ บ ੰܛଭ ඍࣦஹ ࢳ ധஹ ੲ ࢠ౿ ۀตր. Ⅳ. 연구결과. ࢫ ২ւߛ ন ۩ঃୀଭ ࢫ ২ւߛ নছ ֞ ܪԩ ۀକଭ. ֜۩ঃୀଭ ଵࢱୡ ন ࢫ ܛாন Ցஹ. ఙଲԧ ઢતۗ ඝ . ۩ঃୀଭ ଵࢱୡ ন. ࣡ଭ ܛாন Ցஹ. ۩ঃୀଭ ଵࢱୡ নছ ֞ ܪԩ ۀକଭ ఙଲԧ ઢત. ฅੰଭ ധஹ ઽේଡ ࢠಃ ଼ࡦऀ ۀଭ ऄੲଠ ֞ ܪԩ. ۗ ඝ ඝ ۩ঃୀଭ ଵࢱୡ ন ଵࢱୡ ন. ন. ֜ं. ԧஂ֗. ੰ࣊ડ. PS U. Q. . . . . . . . . . . Ü. Ü. హ. . . ܭ. . . র ଲঃ. . . Ü. Ü. . . . . . . . . . . . . . . . . ઘࡉۍߡ প. ઘࡉ֗ۍଖஜ. ۩֞ O . . ੰ࣊ߡ প. ੰ࣊֗ଖஜ. ਓ֞ O . ْ. ߡ Թଁ. ౢ০. O PS .Ü4%. Ü. Ü. ճ ଲ. . . ۩ ଲঃ. . . ճ ଲ. . . ۩ ଲঃ. . . ଼ۗ. . . ઢۗ. . . ฎॷ. . . ୀઽડ. . . ୢࢂ. . . վࡿ. . . ׆. . . சऀ. . . ฎॷ. . . ୢࢂ. . . վࡿ. . . ׆. . . ଼ۗ. . . ઢۗ. . . ณ. Ü. Ü. . . ২ณ. Ü. Ü. . . . . . . . . ઘࡉۍડ. ઘࡉۍડକࡿ. ଲୢଵ ଵ. ୢࠬ౫լ. ۚࡣ. Ü. Ü. ઢۗ. . . ଼ۗ. . . )JSTDITQSVOH EJTFBTF. . . *NQFSGPSBUF BOVT. . . ׆. . . - 52 -.
(7) ହঃԩ֜ ଁ ڂ. କଭ ఙଲԧ ଼ ۀՓଞߦ يٕଞ Q ২ บ ඍࣦஹ. ઽේଡ ࢠಃ ଼ ۀใ ׆ாฅ వਐଠ ఙଲԧ ઢતۗ ඝ . ඝ ۩ঃୀଭ ࢫ ২ւߛ ন. ࣡. ֜ं. O PS .Ü4% ਓ֞ O . ۩֞ O . PS U. Q. ২ਏԩ ं. Ü. Ü. . . ࠬ౫ਏԩ ं. Ü. Ü. . . ୍׆ԩ ଵ. Ü. Ü. . . ౠ׆෯ NN)H. Ü. Ü. . . ଲ׆෯ NN)H. Ü. Ü. . . ࠼ࢮ ฎं. Ü. Ü. . . ใ ฎं. Ü. Ü. . . କ. . . ࡿ. . . . . റ. . . റ ੴଣ. . . . . କ. . . ࡿ. . . . . TVQJOF. . . ,OFFDIFTU ׆. . . . . କ. . . ࡿ. . . . . ২ บ హী࣡ ਏԩ. Ü. Ü. . . լւൃज୪Ջ ਏԩ. Ü. Ü. . . ২ บ ԧਆࢼౢਏԩ ਏԩ. Ü. Ü. . . ਐଲ ਏୁਏԩ ਏԩ. Ü. Ü. . . କ. . . ࡿ. . . . . ࢳવ ç ฎ ଲঃ. ധ୪റ. ணਕ୨࠼ւঀւ. ২ ண ୀপ. କ౿ ܑڠ. ෯. ඝ ࣡ଭ ন ࢫ ܛாন Ցஹ. ࣡. ֜ं. O PS .Ü4% ਓ֞ O . ۩֞ O . PS U. Q. ঃऄੲ. Ü. Ü. . . ׆ாऄੲ. Ü. Ü. . . ઢۗ. . . . . ଼ۗ. . . ऀࡦऄੲ. వਐକࡿ Q . - 53 -.
(8) ੲࠜ ճߙ ധஹւࠤண୍ԧ ২ บ ੰܛଭ ඍࣦஹ ࢳ ധஹ ੲ ࢠ౿ ۀตր. ԩ ২ บ ധஹ ۀఙଲԧ ઢતճ Q ౸୨ਏܑߦ׆. ֜ԧড Ցஹ. ఙଲԧ ઢતଞ يQ ౸୨ਏ׆ ுۚ ԩ ঃୁଠ କ ԧড ੲࠜ ճߙ ധஹւࠤண୍ࠜ ୪վࢲଠ ਓ֞ր. ଭ઼ۗ Q ඝ <ֻࠨ > ޭݗছ ԧড ۀܣતۗ. ২ บ ୢധୡ ඍࣦஹ ુࢺԩࠜ ୪վࢲଠ ۩֞ ଠ ২ บ ඍࣦஹ ࢳ थܑ ఙଲԧ ଼ଡ Փଲۗ ২ บ ඍࣦஹଲ ଭਕܣઘ ฺऀ ࢺॷট ઽଡ ՚ ܤ. 6. լԧ ਓ֞ছ ۀՍ ۩֞ছ ۀՍଲ ଼તଞ۩ ي. 5. ֞ছ ࡣଲ ඍߝ ۚଡ ࢲۗ ധծୡଞߦ ۀକ. 통 4 대조군. 3. ଭ ੴੰছ ԧডଠ ׆Ԩܣતۗ ඝ . 실험군 증 2. ԧড ੲࠜ ճߙ ധஹւࠤண୍ࠜ ୪վࢲଠ ਓ֞ଲ. 1. ২ บ ୢധୡ ඍࣦஹ ુࢺԩࠜ ୪վࢲଠ ۩֞. 0 0 4 8 12 16 20 24 28 32 36 40 44 48 수술 후 시간. णැ ২ บ ധஹ୨ܑԧ ٗଡ Փଲۗ ࣡ Ցஹছ ܛா ੴଠ Փଞߦ يٍ ऀࡦଭ ঃ <ֻࠨ > ২ บ ധஹ ࣡ฃ. ऄੲଡ վ࣡ߦ ళࠤ ࢱ࣫ ౸୨ ंॺंজ էր ுۚ. ඝ ২ บ ฺऀ ࢺॷট ઽ ীե. ন. O . ֜ं. ਓ֞ O . ۩֞ O . ඍߝ. . . ଲঃ ઢଣ. . . ฺऀ ࢺॷট ઽ ীե. . Q. . . ඝ ২ บ ധஹ ण֗ .Ü4%. ন. ਓ֞ O . ധஹ. Ü. ઝ֠. ۗࠤ. ฆܛ. ଣ. ୨. Ü. Ü. Ü. Ü. Ü. '. ۩֞ O . Ü. Ü. Ü. Ü. Ü. Ü. Q Q Q . - 54 -. Q. ுۚԩ. . . ౸୨ਏ׆. . . ౸୨ਏ ׆Y ுۚ. . . ுۚԩ. . . ౸୨ਏ׆. . . ౸୨ਏ ׆Y ுۚ. . . ுۚԩ. . . ౸୨ਏ׆. . . ౸୨ਏ ׆Y ுۚ. . . ுۚԩ. . . ౸୨ਏ׆. . . ౸୨ਏ ׆Y ுۚ. . . ுۚԩ. . . ౸୨ਏ׆. . . ౸୨ਏ ׆Y ுۚ. . . ுۚԩ. . . ౸୨ਏ׆. . . ౸୨ਏ ׆Y ுۚ. . .
(9) ହঃԩ֜ ଁ ڂ. Ⅴ. 논. ԧড ੲࠜ ճߙ ധஹւࠤண୍ࠜ ୪վࢲଠ ਓ֞ଲ. 의. ২ บ ୢധୡ ඍࣦஹ ુࢺԩࠜ ୪վࢲଠ ۩֞ णැ ২ บ ੲ୨ܑԧ ڔଡ Փଲۗ. ࣭ ֜ ۀ২ บ ඍࣦஹଡ ુࢺ ׆ැ ࣦܛ ૈୀࠬ. ২ บ ੲ ۩ැ ࢱ࣫ ౸୨ ंॺंজ էր ுۚ ԩ ఙଲ. ୀ ฅੰࠜ מճ ࠤ ୨ැ ඹߦഠ ઢଲ ׆ฎԧ ݡ ܥ. ԧ ઢતճ Q ౸୨ਏ ܑߦ׆ఙଲԧ ઢતଞ يQ . ࠬۗ ฺऀࢄࠤ૬࣑ଡ ਏෘছ ฅੰଭ ധஹր ੲࠜ ճߙ. ౸୨ਏ׆ ுۚ ԩ ঃୁଠ କଭ઼ۗ Q ඝ <ֻ. ۀହঃԩண୍ ۩ැ ֜ࢂ୪ࠜ ୪ ۀ׆Փଞߦऀ. ࠨ > ޭݗছ ԧডଠ ܣતۗ. ഉ ਏୁܣતۗ ํ ࢳۜۚծঃ ෘߚۇ ծࠜ ԧճ ଼ ۀপ ଲ ฅੰ ۀඍࣦஹ ુࢺଡ ਕใ JOTQJSPNFUFS ୡ ր ׆ಅଡ ් ԧ ઢۗ ޭݗছ ଭ߹ଠ ੰଲࠜ ࠤճ. 20. מԧଡ ࣑ࢺ ۀࠤ݁ܪଞߦ ඍଭ คୋଡ କܑճ ඍ 안. 15. ࣦஹଡ ુࢺճୀ ଲ߇ ր୨ছ ฅੰ ۀ২ บ ധ 대조군. 10. ஹ ਏۜࠤ՚ ۗܤധஹଡ ચઘߦ ඝ෮ ් ઢ ۀઘࠦ ฅ. 실험군 위. ੰଭ լ ۀଭ߹ଲ࣪ يୀଭ ധஹւࠤ ڄր சւ ݗ. 5. ޭ ઽේଡ ࢲ՚ ܣছ ܛۇୡ ധஹւࠤ ࠻ ౫ઊۗ. 0. ۳ଲ ଭ߹ଠ ઘࠦ ฅੰଭ ധ୪ ۩ ऀୁଡ ߙ. 0 4 8 12 16 20 24 28 32 36 40 44 48 수술 후 시간. ധ୪ ॷଡ ੰ ۀߙقլේଲ ଼ۗ ޭݗছ ࣭ ֜ছ ۀฅੰଭ ੲࠜ ճߙ ധஹւࠤண୍ࠜ ୡ ২ บ ඍࣦஹ ࢳր ധஹ ࢫ ੲ ࢠ౿ ۀต. <ֻࠨ > ২ บ ੲ࣡ฃ. ඝ ২ บ ੲ ण֗. ন. ੲ୨ܑ. ׆. ճ૬ ܛ૬. ଣ. ఼ૺହ. ֽଖୋܑ. ੲୋܑ. .Ü4% ਓ֞ O . ۩֞ O . Ü. Ü. Ü. Ü. Ü. Ü. Ü. Ü. Ü. Ü. Ü. Ü. Ü. Ü. Q . - 55 -. '. 1. ுۚԩ. . . ౸୨ਏ׆. . . ౸୨ਏ׆Ýுۚ. . . ுۚԩ. . . ౸୨ਏ׆. . . ౸୨ਏ׆Ýுۚ. . . ுۚԩ. . . ౸୨ਏ׆. . . ౸୨ਏ׆Ýுۚ. . . ுۚԩ. . . ౸୨ਏ׆. . . ౸୨ਏ׆Ýுۚ. . . ுۚԩ. . . ౸୨ਏ׆. . . ౸୨ਏ׆Ýுۚ. . . ுۚԩ. . . ౸୨ਏ׆. . . ౸୨ਏ׆Ýுۚ. . . ுۚԩ. . . ౸୨ਏ׆. . . ౸୨ਏ׆Ýுۚ. . .
(10) ੲࠜ ճߙ ധஹւࠤண୍ԧ ২ บ ੰܛଭ ඍࣦஹ ࢳ ധஹ ੲ ࢠ౿ ۀตր. րࠜ คճୀ ਏܑܣતଞ ࣭ ֜ଭ էրࠜ ணਕଞߦ ۗ. ߹ళ౿ ࢺැ Զଠ ฅլୡ ࢂ୪ ࢼճր Զଠ ࠤ. ଣր Զଲ ڍଭճୀ ۗ. ୡ ૬֜ࠜ ஂୡଞߦ ճߙැছ ւࠤԧ ଲ߿ઘ୲ઉ ۗ ն. ധஹଠ ࣌ ฆߚบߦ ԩசܣઘઉ ฅୀଭ ԩॷ୨. ੰܛԩ ଼ઘছ ۀ఼ୡ ୨⋅ઽୡ ॷฎࢂฃୡ ࢫ ฅլ. ࢱ݁ਏ එܣճ ண୍ܣઘઉ ۀԩࢂ୪ଲۗ 7BO %JKL. ୡ ౸ଡ Գ ฅੰଭ ੲԧ ճߙ ߧܑܣԩୢ߃ր ண. ݊ ޭݗছ ധஹւࠤࠜ ැছ ۀট ധஹॷ୨ଲ ۥ. ୍ԧ ෂ૬ۗ ,PMDBCB ࣭ ֜ ۀଲ߇ ,PMDBCB. ন ଼՚ ෘܣઘઉ ଭॷীധଲ ୪ܣઘ ଼ ۀઘࠦ ฅ. ଭ ੲଲߨଡ ࢭଞߦ ധஹւࠤண୍ࠜ ֜ন ୡ. ੰ ۀଭ߹ր ऀࡦଭ சւୡ ൡۚ ଭ ۀլԧ ۗ ࣭. ઼ճ ֻ էր ധ୪ റ ఙଲԧ ઢતଣܑ ऄ֜ճ ਓ. ֜ছ ۀ২ บ ฅੰଭ ധஹଡ Ժւୡଞߦ ॷ୨ ׆ැ. ֞ଲ ۩֞ णැ ധஹր ੲ୨ܑছ କଭ ఙଲࠜ ي. ܑ߲ ܑۥԧ Ցஹܛੰ ܤധஹॷ୨ܑ֜ࠜ ଲ ఼ծ. ٢ۗ ੲࠜ ඌԧ ׆ැ ॷ ੲॷ୨ܑ֜. ୡଞߦ ധஹଡ ॷ୨ճ ଲࠜ ֽՋߦ ઊࢄୡ णઊࢄୡ ധஹւ. $0.'035 #FIBWJPS 4DBMF ଭ ऀઽલছ ۀੲ ୋܑ. ࠤࠜ ෘܛۇ ۀୡ ധஹւࠤண୍ࠜ ୡ઼ۗ ֻࠤճ ֻ. GBDJBM UFOTJPO କଭ ఙଲࠜ ઼࣪ۗ ଲ ܑ֜ ࣭ ۀ֜. ܛੲ ֽ ۥՋ ઢଲ ২ଡ ࠬ౿ճ ࣦܛ ੰܕ ฅੰࠜ. ࠜ ැ ୠୀଭ ෛޮଡ જճ ࣌ੲ ॷ Փଞߦ ੰ ֝. ࢭߦ מճ ࠤ ۀւෘ ۩ ਏԩ ܛੲ ౦ं ଡ ౫. ٛଭ ۗࠛ ֜ছ ࠜࢭ ܤॷ ۀణଡ ԧ ઢࢂݡ ׆ ଲ. ՚ ઼ۗ ࣭ ֜էր ଭ ଲ߇ ധஹւࠤண୍࠻ ۀ. ۩ ण֗ंজଲ ઘߙ࢛ߦ บ ֜ԧ ۳ ෂ૬් Փଞߦ. ตրୡ Փଞߦ يٕۗ ੲࠜ ճߙ ധஹւࠤண୍ࠜ ୡ. ࣪ۗ. ࢲଠ ਓ֞ଠ ۩֞ր ण֗ଡ ݡ౸୨ਏ׆ ுۚԩ ঃ. ଲ߇ ੰܛଭ ധஹր ੲ୨ܑ ܑࠜ֜ ۀଲ ԩॷଭ. ୁଲ କଭ ఙଲԧ ଼તۗ ࣭ ֜ছ ധஹଡ. ւఝߦ ౸୨ܣતۗ ޭݗছ ֜ ছ ુणॷࠜ ധැ ԩ. ॷ୨ ׆ැ ॷ ܤധஹॷ୨ܑ֜ '-"$$ ଭ ऀාࡧ ฆ. ॷଭ ֗ଖଡ ਓਏ઼ଞ يւఝୀԩ ܑ߲ۗ ࠻ ۀઑ՚. ܛઽલ "DUJWJUZ ছ ۀକଭ ੴ՚ يٕ ܁ۀଲ ۩ැছ. يٕۗ ଲ ࣭ ۀ֜ଭ নঃ ֜ෘଭ ଲনଡ ැ. ۀധஹଭ ୨ܑԧ ٗۗ ۀՓଲ ୢ෬ ധஹଲ ୢ෬ ઢۀ. ଵԹ ࣦଭ ীੰրࣦܛ ֽࡿࡣ ۀଭ ࡦ݃ ԩॷԧ. ੴۗ ۀր ੰܛଭ নଡ ճߙۗ ডࡣଲ ԧۗۇ. ധஹւࠤண୍ ࢫ ඌԧ ఞ઼ࢂݡ ׆ Փଞߦ ౸ܣ. ԩॷ݅ଭ ฅੰ ധஹ ۩ ਐ ധ୪ ۩ ਐ ੰ. ࣭ ށ֜ଭ ୪ଞߦ ॷ߹ۗܤ. ܛଭ ߡ ࠛݗୡୣ ധஹॷ୨ܑ֜ଭ ॷր ॷ୨ଠ ࠻. ହঃছ ֻܛੲ ਏෘܣઘ ২ บ ୢധୡ ඍࣦஹ ુ. ண૬ۗ $VNNJOHT ݊ )BNFST ݊ +BDPC . ࢺԩ ۀฅੰଭ ധஹր ੲࠜ ճߙ ੴճ ฅੰࠜ ࠤճ. 1VOUJMMP 1FEFSTPO ݊ ੰܛଠ ઘ ھԩ۩ঃୀ. מছ ԧր ݊ଡ ࣑ࢺ ۀࠤ݁ܪଞߦ ෘܣઘ ۗ ࣭. ࣪ۗ ധஹ ౫ઊ ധஹଭ ॷ୨ছऀഉ ւࠤג ࡦ݃. ֜ছ ۀ২ บ ඍࣦஹଡ ુࢺ ׆ ԩண୍ߦ ฅ. ऀंছ নր ण֗ැ ীํ բճ ଼ ۀՓଲ ॷਓଲۗ. ੰ՚ ଵ୨ ր ิਐ ਏԩଡ ச֜ ۀฃࠤࢄऀฺ ܤ૬. ֽౖ ಅୡ ୣఙ ۩ ฅੰଭ ധஹଡ Ԯীਏ೬ճୀ ۗઑ. ࣑ଡ ਏෘ઼ ܁ۀ֜էր ֜ฃࠤࢄऀฺ ܤ૬࣑ଡ ୡ. ԩண୍ԧ ਏܑܣճ଼ ۀଞੰ يג ହঃছ ܛੰ ۀധஹ. ਓ֞ր ୢധୡ ඍࣦஹ ુࢺԩࠜ ୡࢲଠ ۩֞ଭ ඍ. ଭ ॷ୨ր ւࠤԧ ฆߚบ ౸୨ր Զଠ ୨ָୡ ԩડࡿۀ. ࣦஹ ࢳ ۀକଭ ఙଲԧ ઢતۗ ֜ฃऀฺ ܤ. එܣઘ ଼ ੴۗ ധஹ ۩ැ ࣪ճ ܤ߇ ऀ୨ୡ. ࢄࠤ૬࣑ ۩ැছ ۀఞճࢂෝ ॣ ੰ ޭۍઘ ݪඹߦഠܑ. ઽේ ૬ ,JFDPMU(MBTFS ݊ .BOXPSSFO ݊ . ణੰ࣮ ԧ ઢતճ ۗ ࣭ ֜ୀଭ ହঃլ ֽՋ ֜. .D(SBUI ݊ 4UBSHBUU ݊ ݅ଡ ճߙۗ ੰܛ. নܣતࢂݡ ׆ ֜ฃࠤࢄऀฺ ܤ૬࣑ଭ ֜নր ตր ۩ැ. ധஹւࠤԧ ԩડࡿಅ ࢱ݁ਏ එ ܥෂ૬ԧ ଼ଡ Փଞߦ. ছ ۀบ ֜ԧ ծু ܥෂ૬ԧ ଼ۗ. ॷ߹ۗܤ. ۩ऀंଭ ଭ߹݅ଠ ২ บ ਏԩ ଲٛଭ ࢳવଲ ඍࣦ. ඇ ࣭ ֜ছ ۀധஹր ״ฅੰଭ ੲ୨ܑࠜ ण֗ं. ஹր ւߛ ଼ۗճ ࢣճ ଼ۗ ޭݗছ ২ บ ฅੰԧ વଲ ي. জ઼ ܁ۀ֜էր ࣭ ֜ଭ ധஹւࠤண୍ࠜ ୡࢲଠ ਓ. ՚ ܣඍࣦஹଡ ߙ ۳ վգୡଞߦ ฺऀࢄࠤ૬࣑ଡ. ֞ଲ ۩֞ր ण֗ଡ ݡ౸୨ਏ׆ ுۚԩ ঃୁଲ. ਏෘ՚ ۗ ࣭ ֜էրছ ۀଲ߇ ւෘଭ ۥনଡ ణ. କଭ ఙଲԧ ଼તۗ ২ บ ୢധୡ ඍࣦஹ ુࢺԩ. ׆ැ ২ บ ଵ ܛੲ વଡ ౸୨ැ࣪ ֻ ܁ۀէր ২. ࣭ ࠤۜ ۀ֜ছ ۀଵ୨ ԩգଞߦ ָಀୡ ฺऀࢄࠤ૬. บ ࢳવଠ ඍࣦஹଭ ુ౸ୀߦ ऀ ۀՓଞߦ يٕۗ. ࣑ଡ ෘ઼ࠤࢄऀฺ ܁ۀ૬࣑ଲ ୡܣ ੴଠ ਏԩଡ ଲ. "OHFM ݊ ࢳવଲ ࢱ݁ਏ ඍࣦஹଡ يٛ ۀஹঃଠ. ැ ฅੰଭ ր ิਐଡ ౖ۩ ܑࡦ઼۶ Փଲ ตրԧ ଼. ੰ ߦ࢛ۍଭ߹݅ଠ ࢳવ ۩ ਐ࣡ฃࠜ ധැ ෂ૬ଲঃ ฅ. ત۶ Փଞߦ Ԩܛੰ ۗܤଭ ധஹଠ ധஹ ଲଭ ऄੲ ࢫ ଭ. ੰଭ ധஹଡ କࢳ ੴܑߧ ් ෂ૬ԧ ଼ՠۗ. - 56 -.
(11) ହঃԩ֜ ଁ ڂ. էրୡଞߦ প ଲଭ ฅੰ՚ ୡ ܛۇୡ ധஹւࠤ ࢫ. ॷบॷԧ ਓਏܣતۗ ு ܤୀ߹ ۀ4144 ඹߦֻଡ. ֜ฃࠤࢄऀฺ ܤ૬࣑ଠ ২ บ ฅੰଭ ധஹଠ լԮਏ೬ճ. ଲැছ ंজ઼ଞ ֜ ۩ঃୀ ऀࡦଭ ଵࢱୡ নଠ. ੲڔ ۀ ச ২ บ ඍࣦஹ ુࢺܑ ตրୡ ԩண. ਓ ࢽंଘ ඌֹր ඝஜඇఙߦ ઼֜ճ ਓ֞ր ۩֞. ୍ࢺ࣑ଞߦ Ցஹܣતۗ ޭݗছ ଲ߇ էրࠜ ֽՋߦ ২ บ. ܪுۚ ԩ ܛாনଠ ಉଲ୪ռUFTU 'JTIFST FYBDU UFTU. ฅੰଭ ੲࠜ ճߙ ധஹւࠤண୍ࠜ অߦ ԩ ඹߦഠߦ. UUFTUߦ Ցஹ઼ଞ ֜ԧড Ց୨ଡ ැছܛ ۀா ੴ. ֜ন ਓࡿ ୡ් ଼ଡ Փଞߦ ۗܤ۩׆. ଠ Փଞߦ يٍ ऀࡦଭ ঃऄੲଡ վ࣡߆ଞߦ ళࠤ. ࠤԧ ২ บ ඍࣦஹ ુࢺԩଭ ୨ডߦ ࢲੰ݅ଲճ ଼. SFQFBUFE NFBTVSFT "/07" ಉଲ୪ռUFTUࠜ ଲ઼ۗ. ۀਕใ ׆ಅ ԧ ड़ࠤࢄऀฺ ࢫ ׆૬࣑ଠ ଲࢠ ૈୢऀ. ܑ֜ଭ ܑ߲ ۀ$SPOCBDI BMQIB DPFGGJDJFOUߦ Ցஹ઼ۗ. ഉ ֻ ֽՋ ตଘন ۩ ଭࢂଲ ୪ܣ׆ছ ঃ ํۥଠ. ֜ էրۗ ۀଣր Զۗ. ֜ԧ ࣪ճܣતճ ଲ บ ࠤୡ ֽՋ ొ׆ตଘୡ অߦ. ੲࠜ ճߙ ധஹւࠤண୍ࠜ ୪վࢲଠ ਓ֞ր ২. ׆২ր ࢺ࣑݅ଲ Թࢳܣઘ ୡܣճ ଼ ۀਓ୨ଲੰ يܑ. บ ୢധୡ ඍࣦஹ ુࢺԩࠜ ୪վࢲଠ ۩֞ଠ . ࠤޭيছ ۀํ ੰܛԩ ंઉছ ۀଲ ւߛ݅ࢂڍ ܤ. ২ บ ඍࣦஹ ࢳ थܑ ఙଲԧ ઢતۗ. ଲ ୢࡿ ঃଲۗ ଲ߇ ր ହঃլଡ ഠ۩ߦ ࣭. ੲࠜ ճߙ ധஹւࠤண୍ࠜ ୪վࢲଠ ਓ֞ଲ ২. ֜ছ ۀฅੰଭ ২ บ ඍࣦஹ ુࢺԩߦ ฅੰଭ ധஹ. บ ୢധୡ ඍࣦஹ ુࢺԩࠜ ୪վࢲଠ ۩֞ ण. ր ੲ ొଡ ܬঅߦ ண୍࣑ଡ Թࢳ ਏ઼ܑճ ֻ. ැ ২ บ ധஹ୨ܑԧ ٗۗ. էր ඍࣦஹ ુࢺր ധஹ ੲ ࡦ ܪตրୡ ண୍ହଡ. ੲࠜ ճߙ ധஹւࠤண୍ࠜ ୪վࢲଠ ਓ֞ଲ ২. ค઼ۗ ࣭ ֜ ۀହঃছ ࢳե ԩࢂ୪ ۩ැ ࢂ୪. บ ୢധୡ ඍࣦஹ ુࢺԩࠜ ୪վࢲଠ ۩֞ ण. ࠜ ୪׆ճ ࢂ୪ࠜ ැէ ׆ ਓ֜ࠜ ਏܑ էր. ැ ২ บ ੲ୨ܑԧ ۗڔ ଲঃր Զଲ ੲࠜ ճߙ ധஹւࠤண୍ ۀധஹॣ ੰޭۍ. ࠜ คଞߦਭ অߦ ԩண୍ ۩ ֽՋୀ߹ࠜ ࠬߛճ. ඍࣦஹ ુࢺܑ ตրԧ ଼ ۀՓଞߦ يٕۗ ޭݗছ ׆. ୀ ਏܑܣતۗ܁ ۀ ଭࢠࠜ ऀճୀ ۗ. ଭ ࢺਐ۩ߦ ২ บ ࢭߦ ฅੰࠜ מճ ߙছ ฺऀࢄࠤ૬࣑ ଡ ਏෘ۩ ۀ ր ิਐଡ ౦ंํ ճߙճ ԩෞୡଞߦ. Ⅵ. 결론 및 제언. ฺऀࢄࠤ૬࣑ଡ ਏෘ ࣭ ֜ଭ ண୍ ۀঅߦ ԩண୍ߦ ॷ ܥ ଼ଡ Փଞߦ ॷ߹ ۗܤଲ߇ էրࠜ ഠ۩ߦ ۗଣ ր Զଠ ୪ચଡ ճୀ ۗ. ࣭ ֜ ۀ২ บ ฅੰଭ ੲࠜ ճߙ ധஹւࠤண୍ԧ ඍ. ւఝୀԩ ٛୡଵ౿ܑଭ ේঃਏ೬ ׆ැ ւఝୀࠜ ୨ਏ. ࣦஹ ࢳ ࢫ ധஹ ੲ࣡ฃ ࢠ౿ ۀઽේଡ ָࡣ ׆. ಯ บ ֜ࠜ ෘ් Փଡ ୪ચۗ. ण݊ܛন ۩֞ ୢบਏఙডծߦছ ২ บ ඍࣦஹ ુࢺ. ฺऀࢄࠤ૬࣑ଡ ۗઑ ࢺ࣑ଞߦ ֜ฃճ ୡ ֻ. ԩඹߦഠଡ Թ୨ ׆ැ ֽՋணਕਓࡿ &WJEFODF#BTFE. ตրࠜ ण්֗ ଼ ۀ֜ࠜ ୪ચۗ. 1SBDUJDF ଭ ࢱ׆ଡ ࠬߛճୀ ਏܑܣતۗ ֜ ۩ঃୀ ۀছ. ֜էրଭ ଵࢱฃࠜ ැ บ ֜ ۩ঃୀࠜ ค۩. ী୍ ଵԹ ۩ࣦ ীੰր ࣦܛ ฅੰ ண ֜. ਏෘ් Փଡ ୪ચۗ. ۩ঃୀଭ ট୨׆ஜ ऀ ܤฅੰࠜ ඇଭ ౢ઼ଞ ۩ঃୀ ࡣ ֞۩ ۀਓ֞ ࡣଞߦ ࡣଲતۗ ୀ߹ ு ଠ ऀଁ ڂഉ גଁ ڂ ଲ߿ઘ୷ճ ુणॷࠜ ധ. 참고문헌. ැ ധஹॷ୨ܑ֜ '-"$$ ੲॷ୨ܑ֜ $0.'035 #FIBWJPS 4DBMF ଭ. ւఝୀԩ. ܑ߲ࠜ. ౸୨઼ۗ ,BQQB. JOEFY . _ ੲࠜ ճߙ ധஹւࠤண୍ܛۇ ۀୡ ധஹւࠤ ࢫ ֜. ন۴ ஂন ็ ীੰ ใւࠤ ছ ֞ୀౢൡॷ. ฃࠤࢄऀฺ ܤ૬࣑ଞߦ ֜নܣતۗ ২ บ ฅੰԧ ࣦܛ. ୨ ֹܛ45"*ଭ ֝ඝஜฃ ւ ֜ ౖଭ. . ૈ՚ ܣট ਏԩଡ ୍ճ ଲบ ਏԩ ࠬۗ ധஹଡ ॷ୨ ճ ෂ૬ਏ ധ୪ࠜ റ઼ଞ ׆ଭ ୢധୡ ඍࣦஹ. জࢢ෮ ଗઽࢠ ૈૉ ࢮଠ ԩॷଭ ੰ ܛധஹ ॷ୨. ુࢺ࣑ր ࠤۜ ۀր ิਐଡ ౫් ଼ܑߧ ଵ୨ ԩգଡ. ࢫ ւࠤ ۩ ਓॷ ੰܛԩฎ . ܪճ ฺऀࢄࠤ૬࣑ଡ ୡ઼ۗ էր࣡ ઽේଡ ࢠಃ . Ambuel, B., Hamlett, K. W., Marx, C. M., & Blumer, J. L.. ଼ ࡦऀ ۀऄੲ ࢫ వਐ କࡿ ݊ଭ ࣡ ۩ැ ॷୢ ܛா. (1992). Assessing distress in pediatric intensive care. নଡ Ցஹ઼ଞ ੲࠜ ճߙ ധஹւࠤண୍ଭ ตր ۩. environments: - 57 -. the. COMFORT. scale. Journal of.
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(13) ହঃԩ֜ ଁ ڂ. The Effects of an Active Pain Management with Structured Physiotherapy on Postoperative Pulmonary Complications and Pain among Children 1). 2). Kim, Sun Gu ⋅Kim, Ji Soo 1) HN, Seoul National University Hospital. 2) Full time lecturer, Department of Nursing, Sangji University. Purpose: The purpose of the study was to compare the active pain management (APM) with structured physiotherapy (SPT) with the conservative care on postoperative pulmonary complications, pain, and comfort in children under three year. Method: A non-equivalent control group, non-synchronized design study was used. A total of 64 children participated in the study. The children in the experimental group (n=32) received APM with SPT after surgical operation. After transferred to the general unit, the parents were instructed to hold the child for 30 minutes to relieve anxiety and have him/her sleep comfortably for 2 hours. Scheduled 20 minutes chest percussion was performed by the parents for 2 days: twice every 4 hours, one in 6 hours, then one every 8 hours for the rest of two days. Analgesic was administered as needed. Pain and comfort were observed and recorded by nurses using the FLACC and COMFORT Behavior Scale. Results: One child in the control group was diagnosed with postoperative pneumonia. The children in the experimental group who were received the APM with SPT reported higher scores in comfort and lower scores in pain than those in the control group. Conclusion: The findings suggest that APM with SPT can help prevent postoperative pulmonary complications and pain. ,FZ XPSET 1IZTJPUIFSBQZ 1BJO 0QFSBUJPO 1PTUPQFSBUJWF DPNQMJDBUJPOT $PNGPSU Corresponding author: Kim, Ji Soo Department of Nursing, Sangji University 660, Usandong, Wonjusi, Gangwondo 220-702, Korea Tel: 82-33-738-7624, E-mail: [email protected]. - 59 -.
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