麻醉病人術後轉送加護病房之生命徵象變化調查及相關因素

Changes of vital signs and factors among surgery patients transferring from the operation room to the intensive care units

宗秋鳳(Chiu-Feng Tsung)

指導教授 ： 劉紋妙

中臺科技大學/護理學院/護理研究所/碩士(2012年)

摘要

本研究旨在探討麻醉病人術後轉送加護病房之生命徵象變化調查及相關因素。研究樣本取自中部某醫學中心，自西元2009年9月至2010年8月間麻醉手術後轉加護病房病人，排除術後轉恢復室病人、僅接受局部麻醉病人及年齡未滿18歲者，共1050 人。本研究採回溯性調閱病歷記錄方式收集資料，其結果以SPSS 16.0 for Windows 統計套裝軟體分析。結果顯示：研究對象64.57%為男性，在年齡方面分佈為18至97歲（平均為60.62±17.566歲）。轉送確實造成病人生命徵象的變動，轉送時生命徵象不良事件發生率約43-47%；其中收縮壓（p= .000）、舒張壓（p= .000）、心跳速率（p= .000）及血氧濃度（p= .0295）皆達統計上顯著的差異。至於轉送時生命徵象不良事件預測因子中，收縮壓改變大於20%有年齡分層、急診手術、氣管內管、dopamine、levophed、dobutamine；與舒張壓改變大於20%有關為手術科別、氣管內管、dopamine；與心跳速率改變大於20%有關分別是手術科別、dopamine；與血氧濃度下降大於5%有關，分別是手術科別、dopamine、Morphine。此結果可提供醫護人員未來轉送術後病人至加護病房之安全參考。

關鍵字

生命徵象不良事件 ； 轉送 ； 麻醉病人術後

並列摘要

This study was to investigate the change of vital signs of surgery patients transferring from the operation room to the intensive care unit (ICU). Data was analyzed from September 2009 to August 2010, with a total of 1050 patients from a medical center in central Taiwan. Patients transferring to the post-operative care unit after surgery, receiving local anesthetic and younger than 18 years old were excluded from the study. A retrospective method with reviewing medical charts was utilized. The majority of the subjects were men (64.57%), and the range of age was from 18 to 97 (mean=60.62±17.566).
Results indicated that patients` vital signs changed during transferring. The rate of adverse changes of vital signs during transferring was around 43-47%. Significant differences before and during intrahospital transportation were found in systolic blood pressure (p= .000), diastolic blood pressure (p= .000), heart rate(p= .000) and SpO2(p= .0295). Significant predictors for systolic blood pressure change were age, emergency surgery, endotracheal intubation, and medication (dopamine, levophed, dobutamine). Type of surgery, endotracheal intubation and dopamine utilization were critical predictors for diastolic blood pressure change. Surgery types and dopamine were predicted for heart rate alteration; similarly, surgery types, dopamine, Morphine were predictors for the decrease of SpO2. This study can be of a safety awareness for health care staffs transporting surgery patients from the operation room to ICUs.

並列關鍵字

vital signs adverse event ； transferring ； surgery patients

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