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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 陳佳慧(Cheryl Chia-Hui Chen) | |
| dc.contributor.author | Kuo-Hsiang Wu | en |
| dc.contributor.author | 吳國湘 | zh_TW |
| dc.date.accessioned | 2021-06-16T08:23:00Z | - |
| dc.date.available | 2014-02-25 | |
| dc.date.copyright | 2014-02-25 | |
| dc.date.issued | 2014 | |
| dc.date.submitted | 2014-01-26 | |
| dc.identifier.citation | 中文文獻
中央健康保險局（2011，11月11日）．100年Q1長期使用呼吸器醫療服務品質指標資訊公開．2012年6月18日取自http://www.nhi.gov.tw/resource/Webdata/20166_2_100年Q1呼吸器資訊公開-1111.pdf 朱永祥、熊明旺、林長生、李美璇、王興萬、蘇文勇（2002）．正常年輕男性及女性之音響分析．中華民國耳鼻喉科醫學雜誌，37（3），159-162。 行政院衛生署（2011，10月27日）．民國99年住院患者總人數．2012年6月18日取自www.doh.gov.tw/CHT2006/DisplayStatisticFile.aspx?d=81976 吳國湘、蕭自佑、古世基、陳佳慧（印刷中）．長期經口氣管插管在口腔、咽、喉及氣管之合併症．台灣醫學。 李麗雲（2012）．探討口腔癌病人接受手術及放射線治療後牙關緊閉決定因子與生活品質（碩士論文）．取自臺灣博碩士論文系統。 施至遠、陳人豪（2008）．老年人吞嚥障礙之評估與處置．長期照護雜誌，12（4），337-346。 姚俐音（2008）．口腔護理對預防重症病患呼吸器相關肺炎發生之成效探討（碩士論文）．取自華藝線上圖書館。 許坤榮（2012）．中老年人咀嚼能力之鑑定與其相關因素之探討（博士論文）．取自華藝線上圖書館。 張綺芬（1999）．吞嚥困難的評估與復健．於曾進興總校閱，語言病理學基礎（初版，208-253頁）．台北：心理出版社。 蔡旻璇、吳國湘、蘇涵、陳佳慧（2012）．經口氣管插管於口咽及吞嚥功能的影響．重症醫學雜誌，13（4），185-189。 英文文獻 Aldridge, K. J., & Taylor, N. F. (2011). Dysphagia is a Common and Serious Problem for Adults with Mental Illness: A Systematic Review. Dysphagia, 27(1), 124-137. Andersson, P., Hallberg, I. R., Lorefalt, B., Unosson, M., & Renvert, S. (2004). Oral health problems in elderly rehabilitation patients. 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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/58630 | - |
| dc.description.abstract | 背景：氣管插管在急重症單位是一常見且重要的技術，其對人體的傷害不僅發生於插管的當下，亦會在管路留置期間逐漸產生。這些傷害除造成病人不適感及結構上的損傷外，也會影響口腔喉部構音發聲的功能。而這些功能不一定會自動回復。
研究目的：欲了解長期經口插管對病人主觀感覺、口腔結構及構音發聲功能的損傷、盛行率及其恢復情形。 研究方法：採前瞻性、縱貫性的研究設計，以連續取樣收案。研究工具包括自訂口腔結構損傷調查表、主觀症狀調查表、構音發聲功能評估表、口腔評估指引(OAG)。針對經口插管滿48小時之病人，於成功拔管後48小時內(T0)、7天(T1)、14天(T2)等時間點進行資料收集。 研究結果：收案人數共計50人，平均插管天數為7.9±5.3天。剛拔管時，分別有54%、54%的病人表示輕微喉嚨疼痛、輕微呼吸困難。口腔內損傷（潰瘍、發紅、水腫等）在軟硬顎、前後柱出現比例最高。口腔潰瘍的盛行率為T0：68.2%、T1：48.6%、T2：28%。聲音改變率T0、T1、T2為100%、92.7%、78.6%；唇及舌的構音能力在T0時最差，T2時也只約一半參與者完全恢復。S/Z ratio的評估結果顯示T0、T1時肺活量及喉部狀況都未恢復，T2時喉部已較恢復，但肺活量仍未恢復。OAG分數在T0、T1、T2分別為16.3±2.4、13.8±3.7、12.4±3.1分；三次分數差異達顯著，p<0.001。 結論：長期插管對病人的口腔狀況、唇及舌的構音能力、聲音性質皆會帶來皆會帶來重大影響，且其恢復需要兩周（甚至以上）的時間。 | zh_TW |
| dc.description.abstract | Background: With advances in medical science, an increasing number of patients require airway support and are able to wean from mechanical ventilation. However, orotracheal tube intubation may have temporary, even permanent effects on oral and pharynx structures and functionality of articulation and phonation.
Purpose: To investigate the prevalence of oral and pharynx damage and impairments of articulation and phonation after prolonged endotracheal intubation. Method: We conducted a prospective, longitudinal study with a consecutive sampling. Participants were recruited consecutively from 6 medical intensive care units at an urban medical center in Taiwan. Participants’ oral and pharynx structures, articulation and phonation functions were assessed at three time points: 48 hours within extubation, and 7th and 14th day post-extubation. Result: In total, 50 participants were included in this study (33 males and 17 females, age of 60.7±14.9 years, and average length of intubation was 7.9±5.3 days). The prevalence of sore throat was 54%. The prevalence rates of oral ulcers were 68.2%, 48.6%, and 28%, respectively, within 48 hours, 7th and 14th day after extubation. The articulation was significantly affected but about half of the participants recovered within 14 days after extubation. Seven days after extubation, the quality of voice, measured by S/Z ratio, was higher than 1.4 suggesting impairment on phonation. At 14th day after extubation, although S/Z ratio was back to normal, most patients still presented with shorter durations of S and Z sound suggesting pulmonary insufficiency. Overall, the oral conditions after extubation, measured by the oral assessment guide were poor with scores ranged from 16.3±2.4, 13.8±3.7 and 12.4±3.1, respectively (p <0.001). Conclusion: The impairments on oral and pharynx structures, articulation, and phonation were highly prevalent after prolonged orotracheal intubation and the recovery of these conditions may take 2 weeks, or even longer. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-16T08:23:00Z (GMT). No. of bitstreams: 1 ntu-103-R98426017-1.pdf: 1409035 bytes, checksum: 48356b21e44b45967ed6dd9e9d4cd1e1 (MD5) Previous issue date: 2014 | en |
| dc.description.tableofcontents | 口試委員會審定書 i
摘要 ii Abstract iii 目錄 v 圖表目錄 vii 第一章 緒論 1 第一節 研究動機及重要性 1 第二節 研究目的及假設 2 第三節 名詞界定 3 第二章 文獻查證 4 第一節 氣管內管對口咽功能的影響 4 第二節 拔除氣管內管後的主、客觀口咽症狀 7 第三節 其他影響口咽功能的因素 14 第四節 口咽結構及功能的評估工具 17 第三章 研究方法 24 第一節 研究概念架構 24 第二節 研究設計 25 第三節 研究對象及場所 26 第四節 研究工具 27 第五節 資料收集流程 30 第六節 資料處理與分析 32 第七節 研究倫理考量 33 第四章 研究結果 34 第一節 研究參與者之人口學資料及疾病特性 36 第二節 插管相關資料之描述 39 第三節 拔管後主觀感覺調查及口腔結構損傷 41 第四節 拔管後構音發聲功能 45 第五節 口腔評估指引OAG 55 第五章 討論 57 第一節 拔管後主觀症狀與口腔結構的損傷 57 第二節 拔管後構音發聲功能 61 第三節 口腔評估指引OAG 65 第六章 結論與建議 66 第一節 結論 66 第二節 研究限制與建議 67 參考文獻 69 中文文獻 69 英文文獻 70 附錄 85 | |
| dc.language.iso | zh-TW | |
| dc.subject | 長期插管 | zh_TW |
| dc.subject | 構音發聲 | zh_TW |
| dc.subject | 損傷 | zh_TW |
| dc.subject | 經口插管 | zh_TW |
| dc.subject | prolonged intubation | en |
| dc.subject | orotracheal intubation | en |
| dc.subject | damage | en |
| dc.subject | articulation | en |
| dc.subject | phonation | en |
| dc.title | 長期經口插管對口腔及咽部結構、構音發聲功能之影響 | zh_TW |
| dc.title | The Effects on Oral and Pharyngeal Structures, Articulation and Phonation Functions following Prolonged Endotracheal Intubation | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 102-1 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 王亭貴(Tyng-Guey Wang),古世基(Shih-Chi Ku),蕭自佑(Tzu-Yu Hsiao) | |
| dc.subject.keyword | 長期插管,經口插管,損傷,構音發聲, | zh_TW |
| dc.subject.keyword | prolonged intubation,orotracheal intubation,damage,articulation,phonation, | en |
| dc.relation.page | 89 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2014-01-27 | |
| 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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| ntu-103-1.pdf 未授權公開取用 | 1.38 MB | Adobe PDF |
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