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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 賴裕和(Yeur-Hur Lai,) | |
dc.contributor.author | Wen-Tzu Chiu | en |
dc.contributor.author | 邱文姿 | zh_TW |
dc.date.accessioned | 2021-06-13T00:01:35Z | - |
dc.date.available | 2008-08-08 | |
dc.date.copyright | 2007-08-08 | |
dc.date.issued | 2007 | |
dc.date.submitted | 2007-07-30 | |
dc.identifier.citation | 參考資料
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/28140 | - |
dc.description.abstract | 本研究以重覆性生理測量研究方法,來探討鼻咽癌病患於放射治療期間,放射治療導致皮膚反應之功能學和形態學變化之趨勢與相關因素。從96年1月16日至6月8日,為期4個月。以立意取樣,收案數共計19名,平均年齡46歲,男女比為3:1。以放射治療劑量為主軸,每累積大於10Gy時,為測量時間點,由放射治療開始前治治療結束共八次測量。利用RTOG 放射治療皮膚毒性評估準則、皮膚角質水份分析、皮膚色素分析,以及微循環血流分析與自擬自覺症狀量表為本研究工具,以SPSS 15.0版軟體中,GEE統計模式 ( generalized estimating equations method )作計算分析。
研究結果放射性皮膚的生理反應軌跡,皮膚角質層水分含量與放射治療劑量累積呈現顯著負相關(p=.009),自覺皮膚症狀感受、皮膚黑紅色素分析、微循環血流變化呈現正相關。自覺症狀困擾項目上以『發紅』、『皮膚變黑』、『搔癢感』為前三位,自覺症狀困擾以及皮膚生理變化的發生時間,開始於T2,嚴重程度以T6為高峰期。對於皮膚損傷因子以放射治療劑量、相關化學治療、皮膚角質層水份改變、血流變化與病患因應照護方式皆有顯著相關(p<.005)。另外,微循環血流與放射劑量累積時間呈正相關(p=.000,β= .292),但皮膚損傷與血流是呈現負相關(p=.034 β=-.844)。因此,放射治療皮膚反應於微循環血流變化與皮膚嚴重程度應存在重要相關因素,是未來皮膚放射醫療照護研究發展之方向 。 | zh_TW |
dc.description.abstract | The purpose of this repeated measurement study is measure skin function and morphology weekly during radiotherapy. The 19 patients enrolled this study from Jan 16 to June 8, 2007. Measurement of tools were use Corneometer, Mexameter, and Laser Doppler Image for analysis skin function, RTOG skin reaction scores and the self-reports of patients. Statistics analysis was use software of SPSS 15.0, generalized estimating equations method.
This study found water loss of cutonaus with the accumulated dose had negative relative. However, skin color analysis, microcirculation change and self-report of symptom with radiation accumulated dose had positive relative doses. The symptom of 'erythema”, “discoloration”, and “skin itching” have significance relative of self-report of symptom. The symptom distress and physical assessment had changed from 20 Gy, the peak stage at over 60Gy. Radiation induced skin damage influence factor had age, radiation doses, received induction chemotherapy, microcirculation change, and skin intervention. Another, this study found microculatin change with increased radiation doses had positive relative(p=.000,β= .292), but if had skin damage, microculatin changed to negative relative (p=.034β= -.844). In conclusion, blood perfusion with radiation therapy induced skin damage had very important machism. Therefore, early detection of these reactions for better care is further in research of radiation- dermatology and radiation nursing. | en |
dc.description.provenance | Made available in DSpace on 2021-06-13T00:01:35Z (GMT). No. of bitstreams: 1 ntu-96-R92426002-1.pdf: 1780170 bytes, checksum: 8122b2c7361ac110960bb1ae0c79c728 (MD5) Previous issue date: 2007 | en |
dc.description.tableofcontents | 目 錄
目 錄 ii 表目錄 iii 圖目錄 iv 附件目錄 v 致 謝 vi 中文摘要 vii 第一章 緒論 1 第一節 研究動機 1 第二節 研究目的 3 第三節 研究問題 4 第二章 文獻查證 5 第一節 鼻咽癌之治療概念 5 第二節 放射治療皮膚反應 6 一、皮膚基礎生理概論 6 二、放射線治療基本概論 7 三、放射線治療對皮膚生理之影響 8 四、放射線治療造成皮膚反應之影響因素 9 第三節 放射性皮膚反應之相關研究 11 (一)臨床症狀觀察 11 (二)病患自覺感受方面 12 (三)在放射性皮膚反應分析方面 13 第三章 研究方法 15 第一節 操作性定義 15 第二節 研究設計 16 第四章 結果分析 22 第一節 基本人口學特性之描述性統計 22 第二節 疾病與治療特性之描述性統計 23 第三節 皮膚生理測量指標、自覺感受症狀困擾指標之變化 24 第四節 影響皮膚生理測量指標之相關因子 26 第五節 放射線治療導致皮膚損傷之相關因素 27 第五章 討論 28 第六章 結 論 32 第七章 研究限制 33 第八章 護理應用與貢獻及未來發展 34 參考資料 36 表目錄 表 一 基本人口學特性之描述性統計 43 表 二 疾病特性之描述性統計 44 表 三 治療特性之描述性分析 45 表 四 RTOG皮膚毒性指標分析與放射累積劑量時間之描述性分析 46 表 五 皮膚水份含量分析與時間因素變化量之描述性統計 47 表 六 色素分析-黑色素分析與時間因素變化量之描述性統計 49 表 七 色素分析-紅色素分析與時間因素變化量之描述性統計 51 表 八 微循環血流量與時間因素變化量之描述性統計 52 表 九 自覺症狀量表分析 55 表 十 放射累積劑量影響, 57 表 十一 放射累積劑量影響,雙側頸部之皮膚血流變化量相關分析 58 表 十二 皮膚評估指標與與治療特性之相關性 59 表 十三 皮膚是否損傷之預測因素分析 63 圖目錄 圖A~H皮膚巨觀觀察圖 64 圖a~h皮膚微觀觀察圖 65 圖一 放射治療劑量累積時,皮膚完整與否之皮膚角質層水份含量分析圖 66 圖二 放射治療劑量累積時,皮膚完整與否之皮膚黑色素含量分析圖 66 圖三 放射治療劑量累積時,皮膚完整與否之皮膚紅色素含量分析圖 67 圖四 放射治療劑量累積時,皮膚完整與否之頸部皮膚微循環血流分析圖 67 圖五 自覺感受與放射治療累積劑量之相關性分析圖 68 附件目錄 附件 1 倫理委員會審查通過 通知函 69 附件 2 受試者同意書 70 附件 3 Chart list 74 附件 4 Case follow report 75 附件 5 皮膚症狀自覺評量表 76 | |
dc.language.iso | zh-TW | |
dc.title | 鼻咽癌患者於放射線治療期間皮膚反應之臨床與生理病理探討 | zh_TW |
dc.title | Clinical and Pathophysiological Assessment of the Skin Reactions in Nasopharyngeal Carcinoma Patients Receiving Radiotherapy | en |
dc.type | Thesis | |
dc.date.schoolyear | 95-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 余幸司(Hsin-Su Yu),丁禮莉(Lai-Lei Ting) | |
dc.contributor.oralexamcommittee | #VALUE! | |
dc.subject.keyword | 放射性皮膚反應,放射性皮膚之生理病理,微血循環灌流改變, | zh_TW |
dc.subject.keyword | rediation-induced skin reaction,Pathophysiology of skin reaction,microciculation change, | en |
dc.relation.page | 76 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2007-07-31 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 護理學研究所 | zh_TW |
顯示於系所單位: | 護理學系所 |
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