呼吸器依賴患者預後因子之探討-以某區域醫院 呼吸照護中心為例

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Title:	呼吸器依賴患者預後因子之探討-以某區域醫院呼吸照護中心為例 A Study on Prognostic Factors of Ventilator Dependend Patients in a Regional Hospital Respiratory Care Center 長期呼吸器依賴患者疾病的多樣性和疾病的嚴重度等因素會造成預後結果的不同，為減少不必要的醫療資源浪費，探討呼吸器依賴患者預後結果的相關影響因素，可提供臨床照護團隊相關評估，增加呼吸器脫離率，減少呼吸器患依賴者的疾病成本與經濟負擔，使患者早日回歸家庭。本研究的主要目的為探討某區域醫院呼吸照護中心的呼吸器依賴患者，BMI體位分組與呼吸器脫離指標之相關性，對於呼吸器依賴患者的影響，並探討性別、科別、疾病別、年齡、BMI、白蛋白(Albumin)、每分鐘通氣量(MV)、最大吸氣壓力(MIP)、淺快呼吸指數(RSBI)是否與預後結果有顯著相關性。本研究採用回溯性病歷紀錄研究分析，採用2018年1月1日至2019年6月30日間，某呼吸照護中心長期使用呼吸器154位個案病歷資料。個案條件須符合呼吸器使用天數大於21天呼吸器之病患，共記錄病患包括就診科別、性別、年齡、身高、體重、白蛋白數值、最大吸氣壓力、每分鐘通氣量、淺快呼吸指數、呼吸器脫離、過去病史、轉呼吸照護病房(Respiratory Care Ward, RCW)及死亡。資料收集後，以描述性統計呈現個案狀況，再利用單因子變異數分析，比較組間差異，與卡方檢定驗證研究變項與預後結果間的相關性。研究結果顯示，白蛋白(Albumin)、每分鐘通氣量(VE)、最大吸氣壓力(MIP)數值在體位分組四組之間無統計上顯著差異。性別、年齡、BMI與體位分組與預後結果無顯著相關性。科別、白蛋白(Albumin)、每分鐘通氣量(VE)、最大吸氣壓力(MIP)、淺快呼吸指數(RSBI)，則與預後結果有顯著相關性。「白蛋白」、「每分鐘通氣量」、「最大吸氣壓力」和「淺快呼吸指標」可做為呼吸器依賴患者呼吸器脫離預後結果之重要參考指標。建議國內院所可將最大吸氣壓力和淺快呼吸指標列為常規測量項目，可有助於醫療團隊對呼吸器依賴病患呼吸器脫離時機進行有效的評估。 The diversity and severity of diseases in ventilator dependent patients cause vary outcome. Investigation to the prognostic factors in ventilator dependent patients can be helpful in economic burden estimation, even improving weaning rate from ventilators for clinic application. This study for ventilation dependent patients is held in a certain respiratory care center ( RCC ). Grouping body mass index ( BMI ) for these patients and ventilator weaning index is calculated. The gender, sex, age, vary of diseases, BMI, albumin level, Minute Ventilation (VE ), maximal inspiratory pressure ( MIP ), rapid Shallow Breathing Index (RSBI) are put into concerned with prognosis. From 2018 Jen. to 2019 June, a retrospect study of 154 patients in RCC with more than 21 days ventilator using are performed. The original diseases, gender, age, height, body weight, albumin level, MIP, VE, RSBI, transfer rate to RCW and morbidity are recorded. We use descriptive statistic for present illness, and ANOVA for connection about BMI with MIP, albumin level, RSBI, MV. At last the Chi-square test for prognosis after weaning and ventilator weaning index is made completely. The study reveals no significant difference in albumin level, MV, MIP between BMI groups. Gender, age, BMI group have no statistic connection with prognosis. We find the original disease, albumin level, MV, MIP, RSBI are strongly concerned with prognosis. The albumin level, MV, MIP, RSBI can be the reference factors for ventilator weaning prognosis. We suggest that MIP and RSBI should be a routine procedure in clinic application for ventilators weaning.
Authors:	蔡亞諼
Contributors:	醫務管理系林為森
Keywords:	呼吸器依賴預後因子身體質量指數呼吸器依賴病患 prognostic factors of ventilator dependence Body Mass Index ( BMI ) Ventilator dependent patients
Date:	2020
Issue Date:	2022-10-21 10:26:33 (UTC+8)
Relation:	電子全文公開日期：2025-02-01 學年度：108， 62頁
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Dissertations and Theses

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