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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/37908完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 葉力森 | |
| dc.contributor.author | Yi-Hsuan Lin | en |
| dc.contributor.author | 林佚宣 | zh_TW |
| dc.date.accessioned | 2021-06-13T15:50:30Z | - |
| dc.date.available | 2008-07-02 | |
| dc.date.copyright | 2008-07-02 | |
| dc.date.issued | 2008 | |
| dc.date.submitted | 2008-06-26 | |
| dc.identifier.citation | 1. Burk RL, Zawie DA, Garvey MS: Balloon catheter dilation of intramural esophageal strictures in the dog and cat: a description of the procedure and a report of six cases. Semin Vet Med Surg (Small Anim) 2:241-247, 1987
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/37908 | - |
| dc.description.abstract | 一、 研究目的
本研究之目的為調查犬隻在全身麻醉下進行各式外科手術時之胃食道逆流 發生率，並分析影響逆流發生的危險因子 二、 研究程序 於台灣大學生農學院附設動物醫院外科，隨機收集100隻進行非消化道手術 外科程序及全身麻醉之犬隻的連續食道酸鹼值。所有的犬隻在手術前皆禁食12 至20個小時。若犬隻本身有慢性消化道或長期服用影響消化道運動相關的藥 物，皆不納入研究。 術前給藥由各麻醉師根據犬隻的生理狀況及手術程序來設計。所有的犬隻都 是用propofol作為導入麻醉，以isoflurane維持麻醉。在麻醉穩定後，由一名熟 悉食道酸鹼測量儀之人員將酸鹼探頭經口置入食道遠端之固定位置，測量食 道酸鹼值。所有的犬隻在麻醉中皆有完善的生理監控及紀錄。最後將所收集的資 料用統計方法分析，評估影響胃食道逆流相關之風險因子。 三、 結果 100隻狗中有35隻狗發生總共44次逆流。導入麻醉時Propofol的用量以及 麻醉時間的長短與胃食道逆流的風險呈現正相關，並有54%的逆流是發生在導入後20分鐘內。年齡、體重、品種、性別、胖瘦、ASA級別、手術的類型/姿勢、和術前給藥等與胃食道逆流之發生在統計上沒有顯著的關係。另外，在本研究中的鹼性逆流率遠高於過去其他犬隻的文獻，但在其中3隻發生鹼性逆流的狗的食道液體，只有一隻狗的bilirubin(代表有12指腸逆流)呈現陽性反應，其餘兩隻皆呈現陰性反應。 四、 結論 Propofol與胃食道逆流之發生有劑量效應(dose-dependent)。無論麻醉時間長 短都有胃食道逆流的風險，所以即使是短暫的麻醉，也不可忽略逆流重要性。過去認為是診斷胃食道逆流的黃金標準—食道酸檢測定，在鹼性逆流的認定標準上尚有瑕疵，未來可能還需要更多的研究來調整其定義。 | zh_TW |
| dc.description.abstract | Objective To investigate the incidence and risk factors of gastroesophageal reflux in anesthetized dogs undergoing various surgical procedures.
Animals A total of 100 dogs, 6.9 ± 4.5 years old, weighing 10.8 ± 9.6 kg Methods The study group was dogs presenting to the National Taiwan University Veterinary Hospital for non-gastrointestinal procedures and surgeries requiring general anesthesia. Dogs with chronic gastrointestinal diseases or being persistently treated with drugs known to affect gastric motility/physiology and the tone of gastroesophageal sphincter were excluded. The premedication protocol was designed by anesthetists according to the physical status and the nature surgical procedure. All dogs were induced with propofol to achieve endotracheal intubation. Anesthesia was maintained with isoflurane in oxygen. Esophageal pH probe was placed during anesthesia. The gastroesophageal reflux was defined as the esophageal pH value under 4.0 or increasing above 7.5. Results Thirty-five dogs experienced gastroesophageal reflux during anesthesia, with a total of 44 episodes. The dosage of induction propofol and the duration of anesthesia had positive correlation with the risk of gastroesophageal reflux. The incidence of alkaline reflux was much higher than previously reported. In 3 episodes of alkaline reflux, only 1 showed bilirubin positive. Conclusions and Clinical relevance The risk of gastroesophageal reflux associating with induced propofol is dose-dependent. And all dogs have risk of reflux regardless of the length of anesthesia. Although measuring esophageal pH is the gold standard in diagnosing gastroesophageal reflux, esophageal secretion may contribute to false positive interpretation of alkaline reflux. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-13T15:50:30Z (GMT). No. of bitstreams: 1 ntu-97-R93629028-1.pdf: 1179591 bytes, checksum: f7aa5224e5dbd6480f889f4958e82e86 (MD5) Previous issue date: 2008 | en |
| dc.description.tableofcontents | 目錄 i
圖次 iii 表次 iv 中文摘要 v 英文摘要 vii 第二章 文獻探討 2 第一節 胃食道逆流、反流及嘔吐之定義 2 第二節 胃食道逆流之病理生理學 3 一、 食道及下食道括約肌之解剖構造及生理學 3 二、下食道括約肌之神經調控 5 三、下食道括約肌之化學受器調控 6 四、胃食道逆流之發生 8 五、胃食道逆流與食道炎及食道狹窄之關係 9 六、胃食道逆流與吸入性肺炎之關係 12 第三節 胃食道逆流之流行病學 14 第四節 胃食道逆流之診斷 19 一、食道酸鹼測定 19 二、 其他方式 20 第五節 食道炎和食道狹窄的診斷及治療 22 一、食道炎及食道狹窄之臨床症狀 22 二、食道炎及食道狹窄之診斷方式 22 三、食道炎及食道狹窄之治療 24 3-1 藥物治療 24 3-2 外科治療 27 第六節 影響麻醉中胃食道逆流發生之因子 30 一、藥物 30 二、手術類型 31 三、手術姿勢 32 四、麻醉時間 34 五、年紀 35 六、品種 35 七、性別 37 八、胃內的酸鹼值 38 九、胃內容量與禁食時間 38 十、其他 39 第七節 麻醉中胃食道逆流之預防及處置 41 一、預防麻醉中胃食道逆流及肺吸入之方式 41 二、麻醉中發生逆流之處理 44 參考文獻 46 第三章 麻醉中犬隻之胃食道逆流 55 附錄 1 所有犬隻的連續變項之平均及中間數 73 附錄 2 有胃食道逆流(GER)及無GER病患連續變項之比較 74 附錄 4 本研究犬隻品種分布情形 76 附錄 5 GER開始發生的時間點 78 附錄 6 性別分布 79 附錄 7 手術內容 80 附錄 8 手術類型之比較 82 附錄 9 手術姿勢 83 附錄 10 麻醉前給藥 84 附錄 11 麻醉風險 87 附錄 12 犬隻胖瘦與GER之分布 88 附錄 13 犬隻發生反流之情形 89 附錄 14 與GER發生風險相關之因子 90 附錄 15 GER之存活分析(Cox regression) 91 | |
| dc.language.iso | zh-TW | |
| dc.subject | 犬 | zh_TW |
| dc.subject | 鹼性逆流 | zh_TW |
| dc.subject | 胃食道逆流 | zh_TW |
| dc.subject | gastroesophageal reflux | en |
| dc.subject | dog | en |
| dc.subject | alkaline reflux | en |
| dc.title | 麻醉中犬隻胃食道逆流之調查 | zh_TW |
| dc.title | The prevalence of gastroesophageal reflux in anesthetized dogs | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 96-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 林中天,張紹光 | |
| dc.subject.keyword | 犬,胃食道逆流,鹼性逆流, | zh_TW |
| dc.subject.keyword | dog,gastroesophageal reflux,alkaline reflux, | en |
| dc.relation.page | 92 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2008-06-26 | |
| dc.contributor.author-college | 生物資源暨農學院 | zh_TW |
| dc.contributor.author-dept | 獸醫學研究所 | zh_TW |
| 顯示於系所單位： | 獸醫學系 | |
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