關於心臟外科冠狀動脈旁路搭橋手術加護病房譫妄發病率之資料探勘

Data mining about related factors of Postoperative delirium Morbidity in CABG

毛席容(Xirong Mao)

指導教授 ： 吳立青

國立中央大學/理學院/系統生物與生物資訊研究所/碩士(2015年)

摘要

冠狀動脈搭橋術(冠狀動脈繞道手術)，即冠狀動脈旁路移植術，簡稱冠脈搭橋或搭橋，是一項緩解心絞痛和減少冠心病死亡風險的手術。搭橋所用的動脈或靜脈均來自患者自身（乳內動脈、橈動脈、胃網膜右動脈、大隱靜脈）。將血管橋接於冠狀動脈，以繞過冠脈粥樣硬化狹窄部，從而提高冠脈灌注，增加心肌氧供。這項手術通常在心臟停搏下進行，需使用體外循環支持; 而搭橋手術也可在跳動的心臟上進行，所謂的“非體外循環”手術。該手術術後會有和其他手術一樣的併發症，比如術後譫妄，一些研究表明，譫妄是指一組綜合征，又稱為急性腦綜合征，表現為意識障礙，行為無章，沒有目的、注意力無法集中。通常起病急，病情波動明顯，該綜合征常見于老年患者。患者的認知功能下降，覺醒度改變、感知覺異常、日夜顛倒。嚴格來說譫妄並非一種疾病，而是由多種原因導致的臨床綜合征。本文中我們通過簡短智能測驗（MMSE）的指標來檢測術後病患的智能情況。進而分析其與術後病患本身以及加護病房中因素的關係。

關鍵字

冠狀動脈繞道手術 ； 譫妄 ； 關聯性 ； 發病率

並列摘要

Coronary artery bypass grafting (CABG operation), which is also called coronary artery bypass grafting, referred to as coronary bypass or bypass, is a relief of angina and reduce the risk of death from coronary heart disease operation. The bypass artery or vein were derived from the patient’s own (internal mammary artery, radial artery, right gastroepiploic artery, saphenous vein). The operation bridges the blood vessel on coronary artery to get around the coronary atherosclerotic stenosis, improve coronary perfusion, and increase myocardial oxygen supply. This operation is usually performed in cardiac arrest, requiring the use of cardiopulmonary bypass support; and bypass surgery can also be performed on the beating heart, the so-called “off-pump” operation. Same as other operation, CABG gets risk of coronary artery bypass grafting. For example, the Postoperative delirium, some research shows that delirium is a group of syndrome, also known as acute brain syndrome, the expression is recognizant obstacle, behavior no chapter, no purpose, inability to concentrate. To be strict, delirium is not a disease but clinical syndrome caused by a variety of reasons. In this paper we use MMSE to evaluate the intelligent condition of patients after operation, then analysis the relationships between MMSE and the condition of patients themselves or the ICU.

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