- 期刊
成功脫離呼吸器之影響因素與護理
Influencial Factors and Nursing of Successfully Weaning from Mechanical Ventilation
摘要
如何協助呼吸器依賴病患成功脫離呼吸器的議題，是呼吸照護團隊的重要挑戰，影響呼吸器依賴病患脫離呼吸器的變化甚多，其中常伴隨各種合併症，而導致延長使用呼吸器。甚或脫離呼吸器失敗並重覆插管，脫離呼吸器的失敗率高達26-42%（平均31.2%）、2-5%的病患是在脫離過程中失敗的、反覆重插管率13%、死亡率約27%，進而造成病患與家屬身心健康及經濟的負擔。面對此挑戰，及需醫療專業團隊清楚了解呼吸器脫離失敗的因素，並發展相關對策，適當運用護理技巧，以增加呼吸依賴病患脫離呼吸器的成功率。本文將分為一、影響呼吸器依賴病患脫離失敗的因素；二、脫離呼吸器的指標建立；三、呼吸器依賴病患脫離呼吸器的護理評估；四、脫離呼吸器的護理等方面進行探討。將脫離呼吸器依賴的影響因素分成生理與心理層面，將準備脫離呼吸器前的病患進行整體性評估，並依據脫離呼吸器指標，評估脫離成功率，將脫離指標適當運用於護理過程，以提供日後臨床上護理照護指引，使醫療專業團隊更能明確掌握病患整體需求，進而達到呼吸器脫離的成功率。
並列摘要
The issue of how to assist ventilation-dependent patients to succeed in weaning from ventilator is an important challenge to the professional health team. There are many variables of influencing ventilation-Dependent patients to wean from ventilator, including to accompanying complications so that the patients have to lengthen the time of using ventilator. There are four parts in the article: 1. the factors of failing to wean from ventilator, 2. making the indicators of weaning from ventilator, 3. the nursing assessment of weaning from ventilation-dependent patients, 4. the nursing care of those weaning from ventilator. Therefore, we should dicuss in these parts. Our discussions divided the factors into two parts: physiology and psychology. We did an integral assessment for the patients who were going to wean from the ventilator and assess the success rate in weaning from ventilator according to the indicators. Besides we used the indicators properly in nursing process to offer the clinical nursing guide and to let professional health team be needed for ventilation-dependent-patients so that we would have a good success rate in weaning from ventilator.