開胸手術患者應用誘導性肺量測定器介入措施之生理狀況成果評量

造成胸腔手術病患死亡的主因之一是肺合併症，諸多文獻探討病患在術前採用誘導性肺量測器，可有效預防手術後肺合併症的發生。本研究的主要目的是探討應用誘導性肺量測定器於開胸手術病患的術後胸部X光檢查結果、發燒狀況、動脈血氧合度值與白血球值之成果。研究的設計為類實驗性設計法，以台北市某一級教學醫院之開胸手術病患對為對象，收案時間為88年11月至89年4月，共收案對照組42人及實驗組23人，用獨立及相依樣本t檢定、卡方檢定與McNemar考驗以進行資料分析。研究結果顯示：在術後第三天的胸部X光檢查結果、1~3天的發燒狀況與白血球值三方面，實驗組呈現手術後肺合併症人數與發燒人數、平均體溫與白血球值均低於對照組；而實驗組在術後1~3天的動脈血氧合度值均高於對照組。根據以上結果，可促使醫療從業人員更加確認教導手術患者使用誘導肺量測定器，對於預防手術後肺合併症的發生確實具有改善之成效。

關鍵字

開胸手術；誘導性肺量測定器；成果評量；動脈血氧合度值

並列摘要

Pulmonary complications are the major cause of morbidity following thoracic surgery. Many studies reported using incentive spirometry to prevent lung complications following surgery. The purpose of this study is to explore the effect of incentive spirometry on thoracic surgery patients. Indicators used in the study included: 1) chest X-ray,2)fever,3) PaO2/FiO2 ,4) WBC. A qusi-experimental research design was employed for this study. During November 1999 to April 2000, total of sixty-five samples were selected from a 1200-beds teaching hospital; forty-two patients were in the control group and twenty-three patients were in the experimental group. Five instruments were used in this study: recording file, incentive spirometry, thermometer, gas analytic machine and blood count machine. Statistical methods including t-test, paired t-test, chi-square and McNemar test were used for data analysis. There was a significantly higher incidence of postoperative pulmonary complications in the radiologic evidence on the third postoperative day, and in the fever condition and WBC data on the 1~3postoperative days in the control group. The PaO2/FiO2 results of the experimental qroup were better than those of the control qroup during the 1~3 postoperative days. The fingings suggest that using incentive spirometry following thoracic surgery could prevent postoperative pulmonary complications.

並列關鍵字

thoracic surgery ； incentive spirometry ； outcome measurement ； PaO2/FiO2

被引用紀錄

黃巧文（2004）。不同肺擴張訓練法對肺葉切除病患手術後肺部合併症及肺功能的影響〔碩士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU.2004.02523

洪儀珍（2006）。胸腔手術病人的術後疼痛、肺功能和肩功能之評估〔碩士論文，臺北醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0007-1704200715033206

延伸閱讀

鄧喬鳳、石燕菁、陳家寶、林宜美、高昭琦、徐莞雲（2013）。降低開胸手術病人使用誘發性肺計量器不完整率改善方案。榮總護理，30(3)，320-328。https://doi.org/10.6142/VGHN.30.3.320
Huang, H. H., Hsu, N. Y., Chen, P. R., Shih, C. S., Shiah, D. C., & Hang, L. W. (2003). 視訊輔助胸腔鏡手術對肺氣腫病人併自發性氣胸的處理. Mid-Taiwan Journal of Medicine, 8(2), 78-84. https://doi.org/10.6558/MTJM.2003.8(2).4
鄭如潔（2020）。客製化衛教介入方式對慢性阻塞性肺病門診病人健康結果之成效研究〔碩士論文，中臺科技大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0099-0702202315020470
Su, N. Y., Huang, C. J., Tsai, P., Hsu, Y. W., Hung, Y. C., & Cheng, C. R. (2002). 開心手術期間之心搏量的測量：食道超音波及肺動脈導管測量之比較. Acta Anaesthesiologica Sinica, 40(3), 127-133. https://doi.org/10.6955/AAS.200209.0127
Ellmerer, M., Haluzik, M., Blaha, J., Kremen, J., Svacina, S., Plasnik, A., Ikeoka, D., Bodenlenz, M., Schaupp, L., Plank, J., & Pieber, T. R. (2009). Clinical Evaluation of Subcutaneous Lactate Measurement in Patients after Major Cardiac Surgery. International Journal of Endocrinology, 2009(), c1-8. https://doi.org/10.1155/2009/390975

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開胸手術患者應用誘導性肺量測定器介入措施之生理狀況成果評量

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