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http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/66112完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 陳佳慧 | |
| dc.contributor.author | Shu-Yuan Liu | en |
| dc.contributor.author | 劉淑媛 | zh_TW |
| dc.date.accessioned | 2021-06-17T00:22:13Z | - |
| dc.date.available | 2013-09-18 | |
| dc.date.copyright | 2012-09-18 | |
| dc.date.issued | 2012 | |
| dc.date.submitted | 2012-06-13 | |
| dc.identifier.citation | 中文部分
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/66112 | - |
| dc.description.abstract | 癌症蟬連台灣十大死因第一位已經長達三十年，存活無疑是病人及其家屬最關心的議題。而近來在許多大型研究發現，握力可以有效預測老年人的死亡率；老年人因為賀爾蒙改變、慢性發炎、生活型態改變及營養等問題造成不同程度的肌肉質量下降，而癌症病人因為營養吸收及藥物副作用等問題更會加重肌肉質量下降的情形，因此老年癌症病人肌肉質量下降的情形必然更為嚴重，進而使肌肉力量快速下降。美國AJCC癌症分期是目前用於癌症病人存活預測最通用的方法，但在老年族群的預測力仍待被證實。故本篇主要探討握力與AJCC癌症分期是否能有效預測老年癌症病人的存活時間，研究中使用自96年8月至98年4月止於台北某醫學中心一般外科普通病房65歲以上老年癌症病人共95人之腫瘤切除手術前、手術後以及術後三個月的握力，並收集其癌症病理分期及存活情形，最後控制年齡、性別、身體質量指數(BMI)、癌症別、共病指數(Charlson Comorbidity index)、使用藥物數量及是否有介入措施作存活分析，結果顯示AJCC癌症分期雖然仍是最強大的存活預後因子(p<0.01)，然而術前握力亦可做為獨立預測存活的因子(p<0.05)，研究結果為每增加一公斤的術前握力可以降低約5%的死亡機率。由於握力是一個簡單、即時且非侵入性的測量數值，建議未來可以將術前握力放入老年癌症病人之術前評估項目，增加臨床人員及病人和家屬一個簡單有效的存活預後指標。 | zh_TW |
| dc.description.abstract | Cancer has been the first leading cause of death for the past 30 years in Taiwan. Survival is one of the most concerned issues for patients and their families. Literature has suggested that handgrip strength might be an important prognostic factor for mortality, especially in the elderly, but clinical data are limited.
The purpose of this study was to examine the predictive power of handgrip strength in the elderly cancer population. As part of a trial study evaluating the effect of a nursing intervention on postsurgical functional decline, 95 elderly cancer patients (≧65 years) who were diagnosed with gastric and pancreatic cancer and scheduled for an abdominal surgery were enrolled from August 2007 to April 2009. Their handgrip strengths were taken prospectively at three time points: admission (preoperative baseline), discharge, and three-month after discharge. Whether handgrip strength is a prognostic factor for survival were analyzed using Cox Regression with cancer staging severed as a covariate. The results shown that for every 1 kg increase in preoperative handgrip strength, the all-cause mortality decreased approximately 5% (95% confidence interval 0.90 to 0.99; P<.05). This result was independent of age, gender, cancer staging, cancer types, body mass index, comorbidity, medication taken, and whether an inpatient nursing intervention was received. The findings suggested that while cancer staging remains to be the strongest prognostic factor, the preoperative handgrip strength is an independent prognostic factor for all-cause survival in the elderly cancer patients with diagnoses of gastric and pancreatic cancer. If verified, handgrip strength measure will be a simple, yet effective parameter that is clinically accessible to predict survival so treatment decisions can be well-informed and justified. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-17T00:22:13Z (GMT). No. of bitstreams: 1 ntu-101-R98426001-1.pdf: 546005 bytes, checksum: 51dbef0f601bc658f703bf3e6010c7b6 (MD5) Previous issue date: 2012 | en |
| dc.description.tableofcontents | 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 3 第三節 研究假設 3 第四節 名詞界定 4 第二章 文獻查證 5 第一節 老年人肌肉質量下降的原因 5 第二節 老年人肌肉力量下降的影響 8 第三節 癌症病人的肌肉質量下降 11 第四節 測量肌肉質量及力量的方法 13 第五節 AJCC癌症分期 15 第三章 研究方法 16 第一節 研究設計 16 第二節 研究架構 17 第三節 研究對象 18 第四節 研究工具 19 第五節 資料收集流程 22 第六節 資料處理與分析 23 第七節 研究倫理考量 24 第四章 研究結果 25 第一節 研究對象之基本屬性 25 第二節 握力、癌症分期與存活的單變項分析 30 第三節 比較握力與癌症分期的存活分析 35 第五章 討論 37 第六章 結論與建議 39 第一節 結論 39 第二節 研究限制與建議 40 參考文獻 41 收案資料表 50 | |
| dc.language.iso | zh-TW | |
| dc.subject | 老年人 | zh_TW |
| dc.subject | 存活預後因子 | zh_TW |
| dc.subject | 癌症分期 | zh_TW |
| dc.subject | 握力 | zh_TW |
| dc.subject | 癌症 | zh_TW |
| dc.subject | cancer | en |
| dc.subject | prognostic factor for survival | en |
| dc.subject | cancer staging | en |
| dc.subject | handgrip | en |
| dc.subject | Elderly | en |
| dc.title | 握力和癌症分期在老年癌症病人的存活分析 | zh_TW |
| dc.title | Survival Analysis: Handgrip Strength and Cancer Staging in the Elderly Cancer Patients | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 100-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 詹鼎正,林育麟,張晉豪 | |
| dc.subject.keyword | 老年人,癌症,握力,癌症分期,存活預後因子, | zh_TW |
| dc.subject.keyword | Elderly,cancer,handgrip,cancer staging,prognostic factor for survival, | en |
| dc.relation.page | 50 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2012-06-14 | |
| 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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