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[Asymptomatic esophageal candidiasis]

°ÇÁø¿¡¼­ ¿ì¿¬È÷ ¹ß°ßµÈ ½Äµµ ĵµð´Ù¿¡ ´ëÇÏ¿© ¿©·¯ºÐµéÀº ¾î¶»°Ô »ý°¢ÇÏ°í °è½Ê´Ï´Ù. ÀÏ´Ü ÃÖ±Ù Èï¹Ì·Î¿î ±â»ç¸¦ ¼Ò°³ÇÕ´Ï´Ù.

[½ºÅ¸Åõµ¥ÀÌ. 2013-10.4] ±èÇý¿¬, »ýü³ªÀÌ 39¼¼..ÇÏÁö¸¸ À§³»½Ã°æ °á°ú´Â?

°¡¼ö ±èÇý¿¬ÀÇ »ýü³ªÀÌ¿Í °Ç°­ºñ°áÀÌ ¹àÇôÁø´Ù. ¿À´Â 5ÀÏ ¹æ¼ÛµÇ´Â SBS ¡®Àß ¸Ô°í Àß»ç´Â ¹ý¡¯¿¡´Â °¡¼ö ±èÇý¿¬ÀÇ »ýü³ªÀÌ°¡ °ø°³µÈ´Ù. ¹æ¼Û¿¡ ¾Õ¼­ ÁøÇàµÈ ³ìÈ­¿¡¼­ ±èÇý¿¬ÀÇ ½Åü ³ªÀÌ´Â ½ÇÁ¦ ³ªÀ̺¸´Ù 4»ì ÀþÀº 39¼¼·Î ³ª¿Ô´Ù. ÀÌÀ¯´Â ¹Ù·Î ¾ÆħÀ» ²À ì°Ü ¸Ô´Â ½Ä½À°ü ¶§¹®À̶ó°í.

±èÇý¿¬Àº ¾ÆħÀº ¿Õºñó·³ ǪÁüÇÏ°Ô Â÷·Á¼­ ±ÕÇü ÀâÈù ¿µ¾çÀ» ¼·ÃëÇÏ°í, ÇÏ·ç ÇÑ ¹ø ÀÌ»ó ì°Ü ¸Ô´Â ÀϺ»½Ä »ýû±¹ÀåÀº ³× ¹øÀÇ ÀӽŰú Ãâ»êÀ» °ÞÀº ±èÇý¿¬ÀÇ »À °Ç°­À» ÁöÄÑÁÖ¾ú´Ù°í ¹àÇû´Ù. ÇÏÁö¸¸ ºÒ±ÔÄ¢ÇÑ »ýÈ°ÆÐÅÏ ¶§¹®¿¡ °Ç°­»ó¿¡ ¹®Á¦Á¡ÀÌ ¹ß°ßµÇ¾ú´Ù´Â ÈĹ®ÀÌ ÀüÇØÁ® ´«±æÀ» ¸ðÀº´Ù. ±èÇý¿¬ÀÇ À§³»½Ã°æ °á°ú ½Äµµ ºÎºÐ¿¡ 'Ä­µð´Ù'¶ó´Â °õÆÎÀÌ°¡ »ý±ä °Í. ÀÌ·± ¿¹»óÄ¡ ¸øÇß´ø °á°ú¿¡ ±èÇý¿¬ ¿ª½Ã Ãæ°ÝÀ» ±ÝÄ¡ ¸øÇß´Ù´Â ÈĹ®ÀÌ´Ù. ÇÑÆí, À̳¯ ¹æ¼Û¿¡´Â »õ º¸±ÝÀÚ¸®¸¦ ¸¶·ÃÇÑ ±èÇý¿¬ÀÇ Áýµµ °ø°³µÈ´Ù.


¹«Áõ»ó ½Äµµ ĵµð´ÙÁõÀº ¹«Ã´ ÈçÇÕ´Ï´Ù. ¿ÃÇØ °ÇÁø ³»½Ã°æ¿¡¼­ ½Äµµ ĵµð´ÙÁõÀÌ ³ª¿Í fluconazoleÀ» ÀÏÁÖÀÏ Á¤µµ ó¹æÇÑ È¯ÀÚ°¡ ³»³â °ÇÁø ³»½Ã°æ¿¡¼­ ¶Ç ½Äµµ ĵµð´ÙÁõÀÌ ³ª¿À´Â °æ¿ì°¡ ¸¹½À´Ï´Ù. ¹«Ã´ ¸¹½À´Ï´Ù.

¹«Áõ»ó ½Äµµ ĵµð´ÙÁõ¿¡¼­ ²À Ä¡·á°¡ ÇÊ¿äÇÒ±î¿ä? Àú´Â ¾Æ´Ï¶ó°í »ý°¢ÇÕ´Ï´Ù. ¾ÆÁÖ ½ÉÇÑ °æ¿ì¾ß HIV °Ë»ç ȤÀº fluconazole Ä¡·á µîÀ» ±ÇÇÏ°ÚÁö¸¸, °æÁõ ¹«Áõ»ó ĵµð´ÙÁõ±îÁö ¸ðµÎ °Ë»çÇÏ°í ¸ðµÎ Ä¡·áÇÒ ÇÊ¿ä´Â ¾ø´Ù°í º¾´Ï´Ù. ¼ÒÀ§ evidence-based medicine ½Ã´ë¿¡ ±Ù°Åµµ ¾øÀÌ Ä¡·á¸¦ ÇÏÁö ¾ÊÀ» ¹æ¹ýÀÌ ¾ø½À´Ï´Ù. ¾î¿ ¼ö ¾øÀÌ Ä¡·áÇÏ´Â ¿¹°¡ ¸¹Áö¸¸ ´ëºÎºÐ °úÀ×Áø·áÀÔ´Ï´Ù. ¸ðµç ¹«Á»À» ´Ù Ä¡·áÇÏ´Â °ÍÀÌ ¾Æ´Ñ °Í°ú °°½À´Ï´Ù.

Àú´Â evidence-based medicineÀ» ¹ÏÁö ¾Ê½À´Ï´Ù. Evidence°¡ ¾ø´Â ºÎºÐÀÌ ³Ê¹« ¸¹±â ¶§¹®¿¡ evidence¸¦ ÀÇ·áÀÇ ±âÃÊ·Î »ïÀ» ¼ö ¾ø½À´Ï´Ù. °æÇè ¸¹Àº ÀÇ»çÀÇ Á߸³ÀûÀÎ ÆÇ´ÜÀÌ ÈξÀ Áß¿äÇÕ´Ï´Ù. Evidence¸¸ °­Á¶ÇÏ¸é ¹è°¡ »êÀ¸·Î °©´Ï´Ù. Áø´Ü¿¡¼­´Â evidence¸¦ ¹«½ÃÇÏ°í Ä¡·á¿¡¼­¸¸ evidence¸¦ °­Á¶ÇÏ¸é °úÀ×À¸·Î ¿¬°áµÉ ¼ö ¹Û¿¡ ¾ø½À´Ï´Ù. ¹«Áõ»ó ¼ºÀο¡¼­ ³»½Ã°æÀ» ÅëÇÏ¿© ½Äµµ ĵµð´ÙÁõÀ» ¿©ºÎ¸¦ È®ÀÎÇØ¾ß ÇÑ´Ù´Â evidence°¡ ÀÖ½À´Ï±î? ¹«Áõ»ó ¼ºÀÎÀÇ ½Äµµ ĵµð´ÙÁõÀ» ²À Ä¡·áÇØ¾ß ÇÑ´Ù´Â evidence´Â ÀÖ½À´Ï±î? ¹«Áõ»ó ¼ºÀÎÀÇ ½Äµµ ĵµð´ÙÁõ¿¡¼­ ÃÖ¼±ÀÇ Åõ¾àÀÌ ¹«¾ùÀÎÁö ¹àÈù randomized controlled clinical trialÀ» º¸½Å ÀûÀÌ ÀÖ½À´Ï±î? ¹«Áõ»ó ¼ºÀÎÀÇ ½Äµµ ĵµð´ÙÁõ Ä¡·á ÈÄ ³»½Ã°æ ÃßÀû°Ë»ç°¡ ÇÊ¿äÇÏ´Ù´Â evidence°¡ ÀÖ½À´Ï±î? 'Ä¡·á°¡ ºÒÇÊ¿äÇÏ´Ù´Â evidence°¡ ¾øÀ¸¹Ç·Î Ä¡·áÇÑ´Ù'°¡ ¸ÂÀ»±î¿ä, ¾Æ´Ï¸é 'Ä¡·á°¡ ÇÊ¿äÇÏ´Ù´Â evidence°¡ ¾øÀ¸¹Ç·Î Ä¡·áÇÏÁö ¾Ê´Â´Ù'°¡ ¸ÂÀ»±î¿ä?

ÀÇ·á´Â öÇÐÀÌ°í ¿¹¼úÀÔ´Ï´Ù. Evidecne°¡ ¾ø´Â »óȲ¿¡¼­ ¾î¶»°Ô ÃÖ¼±ÀÇ ¼±ÅÃÀ» ÇÒ °ÍÀΰ¡¸¦ °í¹ÎÇØ¾ß ÇÕ´Ï´Ù. °á±¹ ³»½Ã°æ °Ë»çÀÚÀÇ ÀûÀýÇÑ Ã³½ÅÀÌ Áß¿äÇÕ´Ï´Ù. ±Û·Î ¾µ ¼ö´Â ¾øÁö¸¸... (»óȲÀ» Àß ÀÌÇØÇÏ´Â ÀÇ»çµé¸¸ ÀÌ ±ÛÀ» º¸°í ÀÖ´Â °ÍÀº ¾Æ´Ï±â ¶§¹®ÀÔ´Ï´Ù) ¿©·¯ ¼±»ý´ÔµéÀÌ Àú¿Í °°Àº ÀÔÀåÀ» °¡Áö°í °è½Å °ÍÀ¸·Î ¾Ð´Ï´Ù. ±Û·Î ¾µ ¼ö ¾ø´Â Áø½Çµµ ÀÖ½À´Ï´Ù.

°ÇÁø¿¡¼­ ³»½Ã°æÀ» ÇϽô ¼±»ý´ÔµéÀÇ Ã¶ÇÐÀû ÆÇ´ÜÀÌ Áß¿äÇÏ´Ù°í º¾´Ï´Ù. °úÇÐÀû ÆǴܺ¸´Ù´Â öÇÐÀû ÆÇ´Ü ¸»ÀÔ´Ï´Ù. »ç½Ç °úÇеµ öÇÐÀ̱â´Â ÇÏÁö¸¸......


°ÇÁø ¹«Áõ»ó ½Äµµ ĵµð´ÙÁõ. Ä¡·á°¡ ÇÊ¿äÇÒ±î¿ä?


°ÇÁø ¹«Áõ»ó ½Äµµ ĵµð´ÙÁõ. Ä¡·á°¡ ÇÊ¿äÇÒ±î¿ä?


±â°üÁö õ½ÄÀ¸·Î inhaler¸¦ »ç¿ëÇϴ ȯÀÚ¿¡¼­ ¹ß°ßµÈ ¹«Áõ»ó ½Äµµ ĵµð´ÙÁõ. FluconazoleÀ» ó¹æÇÒ ¼öµµ ÀÖ°í ¾È ÇÒ ¼öµµ ÀÖ°ÚÀ¸³ª... Àû¾îµµ inhaler »ç¿ë¹ý Àç±³À°Àº ÇÊ¿äÇÏ´Ù°í º¾´Ï´Ù.


2013³â 11¿ù 18ÀÏ SGEA¿¡¼­ »ï¼º¼­¿ïº´¿ø ³ªÀ±ÁÖ ¼±»ý´Ô²²¼­ Candida ½Äµµ¿° ºÐ·ù¸¦ ¼³¸íÇØ Áּ̽À´Ï´Ù. °¨»çÇÕ´Ï´Ù.


[¾Öµ¶ÀÚ (C´ë K±³¼ö) ÆíÁö] ±³¼ö´ÔÀÇ Endo-Today¿¡¼­ ¸Å¹ø »õ·Î¿î Áö½Ä°ú ÇÔ²² ±ÕÇü ÀÖ´Â ½Ã¾ß¸¦ ¹è¿ì°í ÀÖ½À´Ï´Ù. ¿À´Ã ¸»¾¸ÇϽŠ³»¿ë°ú ºñ½ÁÇÑ ³»¿ëµéÀ» ±³¼ö´ÔÀÇ ±Û¿¡¼­ ¸¹ÀÌ º¸°Ô µÇ´Âµ¥¿ä. ÀÌ·± ºÎºÐÀº ÇâÈÄ Clinical trialÀÌ ÀÖ¾î¾ß µÉ °ÍÀ̶ó°í »ý°¢ÇÕ´Ï´Ù. ¹°·Ð ÀÌ·± ¾ÆÀÌÅÛÀÌ ¿¬±¸ÀÚ Ãø¸é¿¡¼­ º¼ ¶§ º°·Î Àα⠾ø´Â ¾ÆÀÌÅÛÀÏ ¼öµµ ÀÖ½À´Ï´Ù. ±×·¯³ª ÀÓ»óÁø·áÀÇ °¡À̵带 Á¦½ÃÇÏ¿© ÁÖ´Â °ÍÀº ¹«Ã´ Áß¿äÇÏ´Ù°í »ý°¢ÇÕ´Ï´Ù.

°Å½Ã°æÁ¦ÀûÀÎ °üÁ¡¿¡¼­ º¼ ¶§ ¾îÂ¥ÇÇ ÀÚ¿øÀº ÇÑÁ¤µÇ¾î ÀÖ´Ù°í ¿©°Ü Áý´Ï´Ù. ¼³»ç Àý´ëÀû ÀÚ¿øÀÌ Áõ°¡ÇÑ´Ù Çصµ Àηù¿ª»ç¿¡¼­ ÀÚ¿øÀÌ »ó´ëÀûÀ¸·Î dzÁ·ÇÑ ÀûÀº ¾ø¾ú´ø °Í °°½À´Ï´Ù. ÈçÈ÷ ÆÄÀ̸¦ Å°¿ö¾ß ÇÑ´Ù°í À̾߱â ÇÏÁö¸¸.... ÀÌ °Í ¿ª½Ã ´Ù¸¥ ¿µ¿ªÀÇ ÀÚ¿øÀ» ÀÌÂÊ¿¡¼­ »ç¿ëÇÏ°Ú´Ù´Â Àǹ̰¡ ÀüÇô ³»Æ÷µÇÁö ¾Ê¾Ò´Ù°í ÇÒ ¼ö ´Â ¾ø´Â °ÍÀ̶ó°í »ý°¢ÇÕ´Ï´Ù.

°á±¹ ÀÌ·± ³íÀïÀÇ ¿äÁö´Â ºÒÇÊ¿äÇÑ medical practice¿¡ »ç¿ëµÇ´Â ÀÚ¿øÀÌ ÀÖ´Ù¸é À̸¦ ÇâÈÄ ÁÙÀÌ°í ÀÌ ÀÚ¿øÀ» ²À ÇÊ¿äÇÑ È¤Àº µµ¿òÀÌ µÇ´Â medical practice·Î ÀçÆíÇÏ´Â °ÍÀ̸ç ÀÌ °ÍÀº ÀÇÇÐÀû ³í¸®¿¡¼­ º¸³ª »çȸ°æÁ¦Àû ÀÚ¿ø ¹èºÐÀÇ ³í¸®¿¡¼­ º¸³ª Ÿ´çÇÏ´Ù°í »ý°¢ÇÕ´Ï´Ù. ƯÈ÷ Çѱ¹°ú °°ÀÌ ³»½Ã°æÀ» Àü±¹¹ÎÀÌ ÀÚÁÖ ¹Þ´Â ³ª¶ó¿¡¼­´Â Asymptomatic endoscopic findingÀÌ Clinically substantial consequence¿Í ¿¬°üÀÌ ÀÖ´ÂÁö¿¡ ´ëÇÑ ¿¬±¸°¡ ÇÊ¿äÇϸ®¶ó°í »ý°¢ÇÕ´Ï´Ù. Symptom base·Î ȯÀÚ¸¦ Á¢±ÙÇÏ´Â ±¹°¡¿¡¼­´Â ÀÌ·± ¿¬±¸¸¦ ÇÒ ¼öµµ ¾ø°í ÇÒ ÇÊ¿äµµ ¾øÀ» °Í °°½À´Ï´Ù.

¹®Á¦´Â ÀÌ·ÐÀûÀ¸·Î´Â Ÿ´çÇÏ°ÚÁö¸¸, Àΰ£ÀÌ Àΰ£°ú »óÈ£ÀÛ¿ëÇÏ´Â »çȸ¶ó´Â °ø°£ÀÌ Á÷¼±ÀûÀÎ ³í¸®¸¸À¸·Î ¿òÁ÷ÀÌ´Â °ÍÀÌ ¾Æ´Ï¸ç ³í¸®º¸´Ù´Â ¿å¸Á°ú ÀÌ¿¡ ±â¹ÝÇÑ Á¤¼­°¡ ´õ Å« ÀÛ¿ëÀ» ÇÏ´Â ¶§°¡ ¸¹ÀºÁö¶ó ¼²ºÒ¸® ¹¹¶ó°í ¾ð±ÞÇϱ⵵ ¾î·Á¿î °Í °°½À´Ï´Ù. ÀÇÇп¡¼­ ÈçÈ÷ ÀÌ¿ëµÇ´Â Evidence¶õ Åë°èÀû ±Í³³¹ý¿¡ ±â¹ÝÇÑ evidence¸¦ À̾߱â Çϴµ¥ ÀÌ·± Evidence°¡ ¾øÀ» ¶§´Â ±âÁ¸ Áö½Ä¿¡ ±â¹ÝÇÑ ¿¬¿ªÀû »ç°í·Î ¹®Á¦¸¦ Ç® ¼ö ¹Û¿¡ ¾øÀ» °Í °°´Ù´Â »ý°¢À» ÇÕ´Ï´Ù. ¹°·Ð ƯÁ¤ »ç¾È¿¡ ´ëÇÑ Evidence¸¦ ¸¸µé±â À§ÇÑ ³ë·ÂÀ» °ÔÀ»¸® ÇÏÁö ¸»¾Æ¾ß ÇÏ°ÚÁö¸¸¿ä.


[2014-3-12. Ãß°¡] 2013³â ÃÊ µ¿±¹´ëÇб³ Àϻ꺴¿ø ÀÓÀ±Á¤ ±³¼ö²²¼­ ¹«Áõ»ó ½Äµµ ĵµð´ÙÁõ¿¡ ´ëÇÑ ³í¹®À» ¹ßÇ¥ÇÑ °ÍÀ¸·Î ÃÖ±Ù¿¡¾ß º¸¾Ò½À´Ï´Ù. ¼Ò°³ÇÕ´Ï´Ù.

Prevalence and risk factors of esophageal candidiasis in healthy individuals: a single center experience in Korea. (link)

PURPOSE: Esophageal candidiasis (EC) is the most frequent opportunistic fungal infection in immunocompromised host. However, we have found EC in healthy individuals through esophagogastroduodenoscopy (EGD). The aim of this study was to determine the prevalence and risk factors for EC in healthy individuals.

MATERIALS AND METHODS: We retrospectively reviewed the medical records of 281 patients who had been incidentally diagnosed with EC. We also conducted age and sex matched case control study to identify the risk factor for EC.

RESULTS: The prevalence of EC was 0.32% (281/88125). The most common coexisting EGD finding was reflux esophagitis (49/281, 17.4%). An antifungal agent was prescribed in about half of EC, 139 cases (49.5%). Follow-up EGD was undertaken in 83 cases (29.5%) and 20 cases of candidiasis was persistently found. Case control study revealed EC were more often found in user of antibiotics (p=0.015), corticosteroids (p=0.002) and herb medication (p=0.006) as well as heavy drinking (p<0.001).

CONCLUSION: The prevalence of EC was 0.32% (281/88125) in Korea. Use of antibiotics, corticosteroids and herb as well as heavy drinking were significant risk factors for EC in healthy individuals.

¿¬±¸ÀÚµéÀÇ Discussion¿¡ Èï¹Ì·Î¿î ºÎºÐÀÌ ÀÖ¾ú½À´Ï´Ù. "In immunocompetent hosts, chronic alcohol consumption and long-standing gastroesophageal reflux may increase the risk of transmural invasive Candida infection and esophageal perfration."

Àú´Â À§½Äµµ¿ª·ù°¡ "¹«Áõ»ó ½ÄµµÄµµð´ÙÁõ"ÀÇ Áß¿äÇÑ predisposing factorÀÏ °ÍÀ¸·Î ¹Ï½À´Ï´Ù. µ¿±¹´ë ¿¬±¸ÆÀÀÇ ÀÚ·á¿¡¼­µµ ¿ª·ù¼º ½Äµµ¿°ÀÌ ¹«·Á 17.4%³ª µ¿¹ÝµÇ¾î ÀÖ¾ú½À´Ï´Ù. Nonerosive reflux diseaseµµ ¸¹´Ù´Â °ÍÀ» »ý°¢Çغ¸¸é À§½Äµµ¿ª·ù°¡ Áß¿äÇÑ ¿äÀÎÀÏ °Í °°½À´Ï´Ù.



[2013-11-9. ¾Öµ¶ÀÚ Áú¹®] ¼±»ý´ÔÀÇ ¿£µµÅõµ¥ÀÌ °¨»çÈ÷ Àß ¹Þ¾Æº¸°í ÀÖ½À´Ï´Ù. ¹Þ±â¸¸ ÇÏ°í º¸´äÀ» ¸øÇØ ´Ã ÇÑ ±¸¼®ÀÌ Âñ¸®´Â º´¾Æ¸® ¼ÒÈ­±âÀÇ»çÀÔ´Ï´Ù.^^ Æò¼Ò ±Ã±ÝÇß´ø Á¡¿¡ ´ëÇØ Áú¹®µå¸³´Ï´Ù. À̹°ÁúÀ» »ïÄ×´Ù°í ¿Â È¯ÀÚ¿¡ ´ëÇØ ¾î¶»°Ô Á¢±ÙÇÏ´Â °ÍÀÌ ÀûÀýÇÑÁö¿ä. ÇÐȸ¿¡¼­´Â ÀÌ·± À̹°ÁúÀÌ ÀÖ¾î ÀÌ·¸°Ô Á¦°ÅÇß´Ù´Â ³»¿ëÀÌ ¸¹Àºµ¥¿ä. ¸ðµç À̹°ÁúÀ» ´Ù Á¦°ÅÇØ¾ß ÇÏ´ÂÁö¿ä. Á¦°ÅÇØ¾ß ÇÏ´Â ±âÁØ, golden time, Á¦°ÅÇϰųª ¶Ç´Â natural passageÈÄ medication, follow upÀÌ ÇÊ¿äÇÑ °æ¿ì¿Í follow up½Ã À¯ÀÇÇؼ­ È®ÀÎÇØ¾ß ÇÒ »çÇ× µîÀÌ ±Ã±ÝÇÕ´Ï´Ù.

[ÀÌÁØÇà ´äº¯] ÁÁÀº Áú¹® °¨»çÇÕ´Ï´Ù. ¿ì¼± 2003³â ³»½Ã°æ ¼¼¹Ì³ª¿¡¼­ ÀÌ»óÇõ ±³¼ö´Ô²²¼­ ¹ßÇ¥ÇϽŠ»óºÎ ¼ÒÈ­°üÀÇ À̹°Á¦°Å (PDF, 0.2M)¸¦ Àо½Ã±â ¹Ù¶ø´Ï´Ù. ÀÌ»óÇõ ±³¼ö´ÔÀÇ ±Û¿¡ µû¸£¸é "»óºÎ¼ÒÈ­°üÀ¸·Î À̹°ÀÇ 80¡­90%´Â ÀúÀý·Î ¹è¼³µÇÁö¸¸, 10¡­20%´Â ³»½Ã°æÀû ½Ã¼úÀÌ ÇÊ¿ä ÇÏ°í, 1% Á¤µµ´Â ¼ö¼úÀû Á¦°Å°¡ ÇÊ¿ä"ÇÕ´Ï´Ù. ÀúÀý·Î ³ª¿À´Â °æ¿ì°¡ ¸¹´Ù´Â À̾߱âÀÔ´Ï´Ù. ±×·¯³ª ³»½Ã°æÀ¸·Î Á¦°ÅÇÏÁö ¾ÊÀ¸¸é ¾ÈµÇ´Â ȯÀÚµµ ¸¹½À´Ï´Ù. ¼±»ý´ÔÀÇ Áú¹®¿¡ ´ëÇÏ¿© Á¦ ÀÇ°ßÀ» ¸»¾¸µå¸³´Ï´Ù.

1) ¸ðµç À̹°ÁúÀ» ´Ù Á¦°ÅÇØ¾ß ÇÏ´ÂÁö (Á¦°Å ±âÁØ): ÀÛ°í µÕ±Û°í ü³»¿¡¼­ ºÐÇصÇÁö ¾Ê´Â À̹°Àº Á¦°ÅÇÒ ÇÊ¿ä°¡ ¾ø½À´Ï´Ù. ÀÌ¿Ü´Â ¸ðµÎ Á¦°ÅÇÏ´Â °ÍÀÌ ÁÁ½À´Ï´Ù. ÆÇ´ÜÀÌ ¾Ö¸ÅÇϸé ÀÏ´Ü Á¦°ÅÇϱ⸦ ±ÇÇÕ´Ï´Ù. Çö½ÇÀûÀ¸·Î Á¢±ÙÇÏÀÚ¸é, º´¿øÀ» ã¾Æ¿Â À̹° ȯÀÚ´Â ¸ðµÎ ³»½Ã°æ À̹°Á¦°Å¼úÀÇ ÀûÀÀÁõÀ̶ó°í º¸½Ã¸é µË´Ï´Ù. º´¿ø±îÁö ã¾Æ¿Â ȯÀÚ¿¡°Ô "¹®Á¦°¡ ¾øÀ» °ÍÀÌ´Ù"°í ´Ü¾ðÇÒ ¼ö ¾ø±â ¶§¹®ÀÔ´Ï´Ù.

2) Golden time: Àú´Â ASASP(as soon as safely possible)¸¦ ±ÇÇÕ´Ï´Ù. ¹®Á¦´Â ±Ý½ÄÀÌ ÃæºÐÇÏÁö ¾ÊÀº °ÍÀä... À½½Ä°ú ÇÔ²² ³»·Á°¡¹ö¸®´Â °æ¿ì°¡ ¸¹À¸¹Ç·Î Àú´Â ÀÏ´Ü ³»½Ã°æÀ» ½ÃµµÇÕ´Ï´Ù. ȯÀÚµµ Èûµé°í Àǻ絵 ÈûµéÁö¸¸ µµ¸®°¡ ¾ø½À´Ï´Ù.

3) Natural passage ÈÄ medication: ÇÊ¿äÇÑ °æ¿ì¸¦ Çѹøµµ °æÇèÇÑ ÀûÀÌ ¾ø½À´Ï´Ù.

4) Follow upÀÌ ÇÊ¿äÇÑ °æ¿ì: ³»½Ã°æ follow upÀÌ ÇÊ¿äÇÑ °æ¿ì´Â °ÅÀÇ ¾ø½À´Ï´Ù. À̹°À» Á¦°ÅÇÏ´Â °úÁ¤¿¡¼­ ȤÀº À̹° Á¦°Å Á÷ÈÄ¿¡ ³»½Ã°æÀ¸·Î À̹° ÀÌ¿ÜÀÇ º´¼Ò°¡ ¾ø´ÂÁö È®ÀÎÇÏ¸é ±×¸¸ÀÔ´Ï´Ù. ´Ù¸¸ ¿Ö À̹°À» »ïÄ×´ÂÁö È®ÀÎÇÏ´Â °ÍÀÌ ÁÁ½À´Ï´Ù. Á¤½Å ÁúȯÀ» °¡Áø ºÐµéÀÌ ÀûÁö ¾Ê±â ¶§¹®ÀÔ´Ï´Ù. ObstructionÀ̳ª motility disease¸¦ °¡Áø ºÐµµ ÀÖ½À´Ï´Ù. »ý¼±°¡½Ã¸¦ Á¦°ÅÇÑ ÈÄ¿¡´Â aortoesophageal fistula(AEF)·Î ÀÎÇÏ¿© ÇâÈÄ ¾ðÁ¦µçÁö ´ë·® ÃâÇ÷·Î »ç¸ÁÇÒ ¼ö ÀÖÀ½À» °æ°íÇØ¾ß ÇÕ´Ï´Ù. AEF ȯÀÚ°¡ ´ë·® ÃâÇ÷ Àü herald bleedingÀ̶ó´Â ¼Ò·®ÀÇ ÃâÇ÷À» º¸ÀÌ´Â °æ¿ì°¡ ÀÖ½À´Ï´Ù. À̶§ »¡¸® º´¿øÀ» ã¾Æ¾ß ÇÑ´Ù°í °­Á¶Çؼ­ ¼³¸íÇØ¾ß ÇÕ´Ï´Ù. º´¿øÀ» ã´Â´Ù°í ´Ù »ý¸íÀ» °ÇÁú ¼ö ÀÖ´Â °ÍÀº ¾Æ´ÏÁö¸¸ ±×·¡µµ ÃÖ¼±À̱⠶§¹®ÀÔ´Ï´Ù. Herald bleedingÀÌ ÀÖ´Ù°í ȯÀÚ¸¦ ¼ö¼úÀåÀ¸·Î ²ø°í°¡±â ¾î·Á¿îµ¥¿ä.... ±×·¡µµ ¼ö¼úÀ» Çؾ߸¸ »ì¸± ¼ö ÀÖ½À´Ï´Ù. Angiographic approach¸¦ Çغ¼ ¼ö ÀÖ´Ù´Â ÀÇ°ßµµ ÀÖÁö¸¸.


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