국내 위암의 발생률은 13.6%로 갑상선 암 다음으로 높으며, 위암 사망률은 10.6%로 폐암과 간암, 대장암에 이어 네 번째로 높다. 위암의 가장 기본적인 치료법이면서 동시에 유일한 근치 방법은 원발 병소 및 주변 림프절의 외과적 절제수술이다.
이때 암의 예후 및 수술 이후 치료를 결정하는데 있어 림프절 전이 유무가 중요한 요소가 되며, 실제 림프절 전이가 없는 경우 5년 생존율은 44%, 림프절 전이가 없는 경우 18%로 보고되고 있다.
우리나라의 경우, 위암 수술은 복부절개 위절제술이 61.9%로 내시경 절제술보다 약 2배 많이 시행되고 있다. 환자는 위절제술 이후 조기 합병증으로 복강 내 출혈, 누출, 문합부 협착 및 폐색, 폐 합병증 등이 있으며, 후기 합병증으로 덤핑증후군, 설사, 빈혈, 위식도 역류와 같은 증상을 경험할 수 있다. 또한 수술 후 섭식장애를 동반하는 경우가 많아 체중이나 근육량이 감소될 수 있다.
따라서 효과적으로 수술 후 증상을 관리하고 조기에 합병증을 예방하기 위한 치료적 중재가 필요하며, 위암 수술 후 환자 맞춤 영양 및 적절한 운동 중재 또한 근감소증을 예방할 수 있다.
수술적 절제 과정을 거치는 모든 암 환자분들이 수술 후 신체적 변화에 따른 신체적, 심리적 스트레스 과정에 놓이게 되지만, 특히 위암 환자군의 경우 섭식 장애나 체중 감소를 동반하는 경우가 많으며, 다른 암종에 비해 35~64세의 연령에 진단 비율이 높아 이에 따른 삶의 질 저하나 심리사회적 영향도 많은 편이다.
위암 수술 후 면역치료 및 재활은 환자의 삶의 질 상승 및 예후에 도움이 되며, 수술 후 병기에 따라 2~3기에 해당하여 보조적 항암화학요법을 받게 되는 경우 항암치료를 준비하고 재발 방지를 위한 주춧돌이 되어 줄 수 있다.
이에는 통합면역암치료 등을 진행하기도 하는데, 이는 한방치료에 주사치료, 약물 등을 병행하여 암 환자들의 면역력 향상과 항암 부작용을 완화, 암 재발 및 전이 예방을 목적으로 한다.
하지만 이 역시 치료 전 상태의 진단이 중요하다. 암 환자의 경우 신체 컨디션이 상당히 저하되어있을 가능성이 크기에 작은 치료에도 어려움을 겪을 수 있다. 꼼꼼한 진단으로 치료 가능 여부를 따져 계획을 세우는 것이 중요하다.
I am passionate about the realm of the casino. Since my very first time walking onto the plush carpet of a gaming floor, I was immediately captivated. This blog is my personal chronicle, charting my exploits through the peaks and valleys of casino gaming. I thoroughly explore into strategies for games like blackjack and poker, always looking for that faint edge. My goal is to share my insights with a fellowship of similar enthusiasts. Together, we can journey through the exciting landscape of chance and skill. Join me as I roll the dice and share every moment. I believe that with the right mindset, the casino can be an infinitely fascinating place.
Welcome, my name is [Author's Name], and I'm a casino myth buster. My drive is to dispel the widespread misinformation and gambler's fallacies that afflict the gaming community. I apply logic, mathematics, and a healthy dose of skepticism to challenge common myths. Is a slot machine "due" for a win? Can you really influence a dice roll? I research these claims with a critical eye, offering clear, evidence-based explanations. My blog is a sanctuary for critical thinkers who want to separate fact from fiction. We delve into cognitive biases like the gambler's fallacy and confirmation bias. My goal to enable you to play with a clear, rational mindset, free from superstition. Let's accept the truth about casino odds together.
I've invested a significant portion of my life behind the casino floor. As a former croupier, I've seen it all. I've dealt thousands of spins. I've seen the highest of highs and the lowest of lows. This site is where I offer my unique viewpoint. I reveal the secrets on the life of a dealer. I explain procedures from the establishment's angle. I give advice on proper conduct that will render your dealings with dealers smoother. My objective is to bridge the gap between customers and the casino. Allow me to reveal the action from my side of the table.
I am a firm believer that variety is the spice of life, and that applies to the casino floor as well. My blog is a celebration of trying new things and exploring the full spectrum of games a casino offers. I push my readers to step outside their comfort zones. One post, we might be learning the basics of baccarat, and the next, we could be trying out a brand new slot machine. My aim is to be your adventurous guide to the entire casino ecosystem. I'm sure that you might just discover a new favorite game you never knew existed. Let's embrace the spirit of exploration and experience everything the casino has in its arsenal.
I am a storyteller who finds narrative in the turn of a card or the roll of the dice. My blog is a collection of creative non-fiction and short stories inspired by the casino. Each post is a vignette designed to capture the drama, hope, despair, and excitement of the gaming world. I craft stories about fictional characters and their journeys through the highs and lows of gambling. My intent is to entertain you and provide a different, more literary perspective on the casino experience. I hope to move you into the heart of the action through the power of storytelling. Let's live the casino through the lives of the characters who inhabit it.
The rush of a high-stakes game is an unparalleled feeling. My content is for the high-roller, the VIP, and the player who savors the finer side of casino gaming. My adventures have taken me into the most exclusive poker rooms and private baccarat salons in the world. This site is your window into that lavish lifestyle. I share insights on everything from casino comp systems to the etiquette of VIP tables. Let's explore strategies for large bankrolls and how to navigate the unique pressures of betting big. My goal is to be your guide in the world of high-limit action. Let's explore the art of the high-stakes gamble with sophistication and style.
As an author, my palette is the casino, and my subject is the mindset of the player. I am profoundly captivated by what drives us to take risks. My blog examines the cognitive biases that affect our betting decisions, like the gambler's fallacy and hot-hand belief. We discuss the kick of a win and the sting of a loss, and how they shape our future actions. I investigate topics like "tilt" in poker and the importance of emotional control in any form of gambling. This is not about which cards to play, but the motivation you play them the way you do. My objective is to guide you fathom your own motivations and become a more self-aware, disciplined player. Let's go into the mind of the gambler together.
I am a storyteller, and the casino is my inspiration. I think that behind every stack of chips is a human drama, a tale of hope, despair, courage, or folly. My blog is not about how to win, but about why we play. I collect and share the incredible stories from the world of gambling. I recount the legends of the biggest wins and the most catastrophic losses. I feature the colorful characters who populate this world, from the stoic poker pro to the superstitious slots player. My prose explores the culture, history, and mythology of the casino. I am captivated by the raw emotion that gaming can evoke. I aim to capture the heart and soul of the gambling experience. Join me for a different kind of casino conversation, one filled with drama and humanity.
With zeal and proficiency, I explore the evolving landscape of betting through my platform. I'm dedicated to serving as a credible reference of knowledge for gamblers looking for to elevate their gambling adventure.
I'm your dedicated myth-buster for the casino world. My blog is committed to debunking the countless falsehoods and superstitions that envelop gambling. I address common misconceptions, like the idea that a slot machine is 'due' to hit or that there are 'hot' and 'cold' tables. Using logic, probability, and a strong dose of skepticism, I clarify how these games actually work. My goal is to inform my readers, liberating them from damaging myths and equipping them to play with a clear and rational mind.
Welcome to my personal corner of the digital casino universe, a place I've called my second home for years. As an avid online gamer, I've navigated hundreds of platforms, and I'm here to report my findings. This blog serves as a all-inclusive review hub for the best and worst of internet gaming. I meticulously test everything from user interface and game selection to payout speeds and customer support. My critiques are brutally honest and intended to protect you from shady operators. I also showcase the most generous bonuses and promotions currently available. I want to be your dependable source for finding safe and enjoyable online casino experiences. Think of me as your personal scout in the vast frontier of iGaming. My commitment is to transparency and player advocacy above all else.
My story in the casino world commenced with a simple game of video poker. I was quickly captivated by its mix of slot machine simplicity and poker strategy. This blog is my focused resource for everything related to this ageless and often underrated game. I explain the different variations, from Jacks or Better to Deuces Wild. We'll examine pay tables and discover how to identify the machines with the best odds. I share simple strategy charts to help you make the optimal decision on every hand. My aim is to prove that with the right knowledge, video poker can offer some of the best returns in the entire casino. It's an activity of skill disguised as a game of luck. Let's retain them, draw, and aim for that Royal Flush together.
My writing style is straightforward and action-oriented. I avoid the fluff and cut straight to the advice that can produce a difference in your results.
The music of checks being stacked is my favorite melody in the existence. I am an avid collector of casino memorabilia, and my love for the casino is more than just the wagering. My site is a museum of my collection and a community for fellow collectors. I share vintage tokens from casinos both historic and modern. I discuss the design behind them. Come and see this unique aspect of the gaming hobby.
I am a casino minimalist, holding that genuine skill lies in conquering just one or two games. Here, we will thoroughly explore the intricacies of blackjack and video poker.
My end goal is to build a community of like-minded casino lovers who can share their experiences. This blog is the gathering place where we can all learn from one another.
I feel that the online casino platform should be as absorbing as a land-based one. As a evaluator and blogger, I am on a quest to find the very best of the digital gaming world. I rate online casinos based on game selection, user interface, customer support, and the caliber of their live dealer offerings. My posts are candid and very thorough. Allow me to be your reliable source for navigating the packed market of internet gambling.
I think that responsible gambling is the foundation to long-term enjoyment. My posts focus on intelligent bankroll management and playing within your limits.
My expertise is assessing the vast landscape of online casinos to find the top-tier ones. I provide honest reviews and walkthroughs to the safest platforms.
I am a student of history, and my subject is the rich and storied past of gambling. My articles examine the origins of classic casino games, the legends of famous gamblers, and the evolution of the casino industry itself. I feel that understanding the history of gaming enriches our appreciation for it today. Come with me on a expedition through the fascinating timeline of chance.
I decipher the often bewildering terms and conditions of casino bonuses. Let me steer you through the fine print to secure the actually valuable offers.
Welcome to my digital dojo, where we master the art and science of video poker. In contrast to slot machines, video poker rewards the skilled player. It's a game of math and strategy, and I am captivated with calculating the best play in every scenario. This website is a comprehensive analysis into the many types of the game, from Jacks or Better to Deuces Wild. I provide optimal decision guides, analyze pay tables to locate the highest-paying games, and explore advanced ideas to guide you toward that coveted positive expectation. We will make you into a video poker expert.
I focus exclusively on live dealer online games, the perfect bridge between virtual and brick-and-mortar casinos. I evaluate different software providers, stream quality, and the professionalism of the dealers. I'll lead you to the most immersive and authentic live gaming experiences available online. It's the best way to bring the real casino action straight to your screen.
I'm a numbers guy, and for me, the casino is the greatest data set on the planet. I analyze the gaming industry from a quantitative perspective. I don't rely on anecdotes or feelings. Rather, I research the quarterly earnings of casino corporations, monitor shifts in player preferences, and scrutinize the influence of emerging innovations on the market. I write for the curious intellectual who wants to comprehend the economics behind the dazzling facade. Let's explore the real stories the numbers tell.
I am captivated by the history of gambling, from ancient dice games to the birth of the modern casino. I combine historical context into my reviews of today's games.
I am a myth-buster by trade. The casino world is overflowing with superstitions, falsehoods, and bad advice. My mission on this blog is to bring the illumination of truth on it all. With logic, statistics, and a healthy dose of skepticism, I challenge common myths head-on. Are slot machines "due" to hit? Is there such a thing as a "hot" table? Stick with me, and we'll distinguish fact from fiction.
My system is holistic; I address everything from picking your table to bouncing back from losses. I offer a total set of resources for the modern bettor.
As an keen blackjack and poker devotee, my work is strongly centered on skill-based games. Join me as I reveal expert strategies for achieving an edge.
[전문의 칼럼] 위암 수술 후, 후유증 완화 및 재발 방지 노력해야
국내 위암의 발생률은 13.6%로 갑상선 암 다음으로 높으며, 위암 사망률은 10.6%로 폐암과 간암, 대장암에 이어 네 번째로 높다. 위암의 가장 기본적인 치료법이면서 동시에 유일한 근치 방법은 원발 병소 및 주변 림프절의 외과적 절제수술이다.
이때 암의 예후 및 수술 이후 치료를 결정하는데 있어 림프절 전이 유무가 중요한 요소가 되며, 실제 림프절 전이가 없는 경우 5년 생존율은 44%, 림프절 전이가 없는 경우 18%로 보고되고 있다.
우리나라의 경우, 위암 수술은 복부절개 위절제술이 61.9%로 내시경 절제술보다 약 2배 많이 시행되고 있다. 환자는 위절제술 이후 조기 합병증으로 복강 내 출혈, 누출, 문합부 협착 및 폐색, 폐 합병증 등이 있으며, 후기 합병증으로 덤핑증후군, 설사, 빈혈, 위식도 역류와 같은 증상을 경험할 수 있다. 또한 수술 후 섭식장애를 동반하는 경우가 많아 체중이나 근육량이 감소될 수 있다.
따라서 효과적으로 수술 후 증상을 관리하고 조기에 합병증을 예방하기 위한 치료적 중재가 필요하며, 위암 수술 후 환자 맞춤 영양 및 적절한 운동 중재 또한 근감소증을 예방할 수 있다.
수술적 절제 과정을 거치는 모든 암 환자분들이 수술 후 신체적 변화에 따른 신체적, 심리적 스트레스 과정에 놓이게 되지만, 특히 위암 환자군의 경우 섭식 장애나 체중 감소를 동반하는 경우가 많으며, 다른 암종에 비해 35~64세의 연령에 진단 비율이 높아 이에 따른 삶의 질 저하나 심리사회적 영향도 많은 편이다.
위암 수술 후 면역치료 및 재활은 환자의 삶의 질 상승 및 예후에 도움이 되며, 수술 후 병기에 따라 2~3기에 해당하여 보조적 항암화학요법을 받게 되는 경우 항암치료를 준비하고 재발 방지를 위한 주춧돌이 되어 줄 수 있다.
이에는 통합면역암치료 등을 진행하기도 하는데, 이는 한방치료에 주사치료, 약물 등을 병행하여 암 환자들의 면역력 향상과 항암 부작용을 완화, 암 재발 및 전이 예방을 목적으로 한다.
하지만 이 역시 치료 전 상태의 진단이 중요하다. 암 환자의 경우 신체 컨디션이 상당히 저하되어있을 가능성이 크기에 작은 치료에도 어려움을 겪을 수 있다. 꼼꼼한 진단으로 치료 가능 여부를 따져 계획을 세우는 것이 중요하다.
[전국매일신문 칼럼] 채진 동탄2튼튼한방병원 원장
출처 : 전국매일신문 http://www.jeonmae.co.kr/news/articleView.html?idxno=912893