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EndoTODAY ³»½Ã°æ ±³½Ç


[³»½Ã°æ°ú Ç×»ýÁ¦. õ°øÀÇ Ä¡·á ¹× ¿¹¹æÀû Ç×»ýÁ¦. Antibiotics for perforation and prophylaxis]

1. Ç×»ýÁ¦ Ä¡·á

2. ³»½Ã°æ Àü infective endocarditis ¿¹¹æ - ºÒÇÊ¿äÇÔ

3. ³»½Ã°æ Àü infective endocarditis ÀÌ¿ÜÀÇ °¨¿° ¿¹¹æ - ¼Ò¼öÀÇ ÀûÀÀÁõ¿¡¼­¸¸ ÇÊ¿äÇÔ


1. Ç×»ýÁ¦ Ä¡·á

2022-3-23. EndoTODAY ³»½Ã°æ¼¼¹Ì³ª. ¼ÒÈ­±â Áúȯ¿¡¼­ ¿Ã¹Ù¸¥ Ç×»ýÁ¦ »ç¿ë (°­Ã¶ÀÎ)

2010³â °¡À̵å¶óÀÎÀÌ ¿©ÀüÈ÷ À¯¿ëÇÕ´Ï´Ù. ³»½Ã°æ µî À§Àå°ü ½Ã¼ú ÈÄ ¹ß»ýÇÑ Ãµ°ø¿¡ ´ëÇÑ Ä¡·áµµ 2010³â °¡À̵å¶óÀο¡ µû¶ó Á¢±ÙÇÏ¸é µÇ°Ú½À´Ï´Ù. Ceftriaxone + metronidazoleÀº ÀÌ·¯ÇÑ ¿øÄ¢¿¡ Àß ¸Â´Â Ãʱâ Ä¡·áÀÔ´Ï´Ù.

Multidrug-resistant Gram negative pathogens

Carbapenem

Carbapenem-sparing regimen

Carbapenem-resistance non-fermenter

Carbapenem-resistance Enterobacteriaceas (CRE)

* Âü°í: Diagnosis and management of complicated intra-abdominal infection. Clin Infect Dis 2010;50:133 (PDF)


2. ³»½Ã°æ Àü infective endocarditis ¿¹¹æ - ºÒÇÊ¿äÇÔ

³»½Ã°æ °Ë»ç¿Í °ü·ÃµÇ¾î infective endocarditis ¿¹¹æÀ» À§ÇÑ Ç×»ýÁ¦´Â ¾î¶² °æ¿ì¿¡µµ ÇÊ¿äÇÏÁö ¾Ê½À´Ï´Ù. °ú°Å¿¡´Â ÀϺΠ¼±Ãµ¼º ½ÉÁúȯ, ½ÉÀåÆǸ·Áúȯ, prosthetic valve µî¿¡¼­ Ç×»ýÁ¦ »ç¿ëÀÌ ±ÇÀ¯µÇ°Å³ª Àû¾îµµ optional Á¤µµ·Î ¾ð±ÞµÇ¾î ÀÖ¾ú½À´Ï´Ù (Âü°í). 2015³â ¹Ì±¹ ³»½Ã°æÇÐȸ °¡À̵å¶óÀο¡¼­´Â prosthetic valveÀÇ À¯¹«³ª ½ÉÁúȯÀÇ Á¾·ù¿Í ¹«°üÇÏ°Ô ¸ðµç »óȲ¿¡¼­ infectious endocarditis¸¦ ¿¹¹æÇÒ ¸ñÀûÀÇ Ç×»ýÁ¦¸¦ ³»½Ã°æ °Ë»ç Àü¿¡ Åõ¿©ÇÒ ÇÊ¿ä°¡ ¾ø´Ù°í ÇÕ´Ï´Ù. ÀÌ´Â 2007³â ¹Ì±¹½ÉÀåÇÐȸ(AHA)ÀÇ ÃßõÀ» ±×´ë·Î ¹Þ¾ÆµéÀÎ °á°ú·Î »ý°¢µË´Ï´Ù. ¿©ÇÏÆ° ½ÉÀ嶧¹®¿¡ Ç×»ýÁ¦¸¦ ¾µ ÇÊ¿ä´Â ¾ø´Ù°í ¾Ë¸é µÇ°Ú½À´Ï´Ù.

2015³â 1¿ùÈ£ Gastrointestinal Endoscopy Áö¿¡ ³»½Ã°æ °Ë»çÀÇ ÀÌ ½Ç·È½À´Ï´Ù. °ú°ÅÀÇ Áöħ¿¡ ºñÇØ ¹«Ã´ ´Ü¼øÇØÁ³½À´Ï´Ù. »óºÎÀ§Àå°ü ³»½Ã°æ°ú Á¶Á÷°Ë»ç¸¸ ÇÒ °ÍÀ̶ó¸é ¾î¶² °æ¿ì¿¡µµ Ç×»ýÁ¦¸¦ ¾µ ÇÊ¿ä°¡ ¾ø½À´Ï´Ù. ¾ÕÀ¸·Î´Â 'Ç×»ýÁ¦¸¦ ¾²Áö ¾Ê¾Æ¼­ Á¶Á÷°Ë»ç¸¦ ÇÒ ¼ö ¾ø´Ù'´Â À̾߱⸦ ÇÒ ¼ö ¾ø°Ô µÇ¾ú½À´Ï´Ù.

2022³â 7¿ù »ï¼º¼­¿ïº´¿ø ½ÉÀå³úÇ÷°üº´¿ø ¼Ò½ÄÁö¿¡ ±ÇÇöö ¿øÀå´Ô²²¼­ ±â°íÇÑ ³»¿ëÀ» ¼Ò°³ÇÕ´Ï´Ù.


3. ³»½Ã°æ Àü infective endocarditis ÀÌ¿ÜÀÇ °¨¿° ¿¹¹æ - ¼Ò¼öÀÇ ÀûÀÀÁõ¿¡¼­¸¸ ÇÊ¿äÇÔ

²À Ç×»ýÁ¦¸¦ ¾²µµ·Ï ±ÇÀ¯µÈ ÀûÀÀÁõÀº (1) PEG¿Í (2) '´ã³¶¿°ÀÌ ¾ø´Â ´ãµµ Æó¼â ȯÀÚ¿¡¼­ ERCP¸¦ ÇÏ¿´À¸³ª incomplete drainage°¡ µÈ °æ¿ì', (3) cirrhosis with acute GI bleeding »ÓÀÔ´Ï´Ù. ±×¸®°í ¸î °³ÀÇ suggest Ç׸ñÀÌ ÀÖ½À´Ï´Ù.



© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.