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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 季昭華(Chao-Hua Chie) | |
dc.contributor.author | Chen Yi-Lin | en |
dc.contributor.author | 陳以琳 | zh_TW |
dc.date.accessioned | 2021-06-17T01:42:20Z | - |
dc.date.available | 2020-08-02 | |
dc.date.copyright | 2017-08-02 | |
dc.date.issued | 2017 | |
dc.date.submitted | 2017-07-27 | |
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/67653 | - |
dc.description.abstract | I. 研究目的
海龜於全世界皆列為需要保育的動物之一,但擱淺海龜的救援及復健時間的增加常引起救傷單位的經濟、人力及設備的兩難,而全球對於復健時間與臨床檢查之間的相關研究較不充分,本研究綜合臨床檢查、放射線檢查及血液檢查結果,分析與復健時間和預後最相關之因子,並建立一預後評估系統,於救傷單位臨床判斷復健海龜預後使用,以供提早評估或野放的依據。 II. 研究對象及方法 本研究對象為2012年九月至2016年六月來自北臺灣的救傷海龜共四十二隻,海龜於甫救治後初次檢驗共三十一項項目,然後全部復健海龜依總復健時間分成六組,以復健時間長短和檢驗結果的相關性進行統計分析。依照卡方檢定、勝算比和主成份分析後找出最有顯著相關的因子,最後列入一個預後分析系統來預測救 傷海龜的復健時間。 III. 結果 總體救傷海龜於2012年至2016年的復健時間平均為52±74.24天,其中復健時間大於或小於兩個月的海龜約各為一半(45%及55%)。經過三個階段的統計分析後,分析出影響復健最相關的因子為:尿酸增加、漂浮問題、淋巴球數目下降、白蛋白下降、白蛋白/總蛋白及異嗜球/淋巴球共六項。這六項因子建構的預後評分系統獲得一個預測復健的時間。此系統經ROC曲線驗證後其AUC為0.715,取切 點為13.475時其靈敏度及特異度各為0.75及0.75,陽性似然比為3.0。 IV. 討論: 本研究中提出的六項因子於人醫或小動物醫學皆具有高度一致性,廣泛用於各項嚴重疾病的預後研究中,或於其他的擱淺海龜調查報告中也都有提及,表示各因子皆具有高度可信度。這六項因子和海龜的臨床診斷有相關性,表示這些相關的病理變化和影響到的臟器系統,是海龜傷救處置的重點,會影響海龜復原和野放的速度。而本研究所提出的系統屬於可接受的表現度,但仍需要後續更多前瞻性研究持續驗證證明。 V. 結論 本研究於臨床上可用於初步預測救傷海龜的復建時間,本系統以尿酸增加、漂浮問題、淋巴球數目下降、白蛋白下降、白蛋白/總蛋白及異嗜球/淋巴球六項因子評估救傷海龜的預後,研究結果支持此六項因子具有可接受的預後預測表現,表示若依照本研究設計治療及復健,可依據這六項因子預測其復健時間,以達復建時間縮短及復健效果可預測性提高的效果,並減少檢驗資源消耗,可針對此六項檢驗預測其預後,提供一驗證性資料之初步結果於臨床使用。 | zh_TW |
dc.description.abstract | I. Aim
Stranding sea turtle and their long hospitalization case is a worldwide resource and finance issue. However, the relationship between clinical findings and outcomes of rehabilitation is not usually discussed. This study aim to set up a prognostic system to predict the prognosis of rescue sea turtles, and eventually, use the resource efficiently. II. Method & material Overall, there were forty-two sea turtles rescued from northern Taiwan during September, 2012 and June, 2016. All turtles were tested for thirty-one items. The relation of different rehabilitation period and clinical tests was analyzed by chi-squared test, odds ratio and principle component analysis by order. The most significantly related factors were recognized after the analysis. III. Result Overall, the mean rehabilitation period was 52±74.24 days. It was noted that the proportion of rehabilitation time longer and less than two months were both nearly a half. After statistic analysis, the most relative factor between clinical exam and rehabilitation time were: increasing in uric acid, lymphopenia, hypoalbuminemia, albumin/ total protein ratio, heterohil/ lymphocyte ratio and buoyancy problem. These six factors will be used to set up a clinical system of prognosis prediction. It was tested for ROC curve, and the AUC was 0.715, with 75% sensitivity, 75% specificity at the cut-off point 13.475. The positive likelihood was 3.0. IV. Discussion The six factors was high consistence with other prognostic research of human medicine and small animal medicine, and was mentioned in other stranded sea turtles widely. That indicates the high reliability. The six factors were strong related to the clin-ical diagnosis of turtle. It indicated that the associated pathological changes and af-fected organs will be the point of rehabilitation. And they will affect the time of recov-ery and release. The system was acceptable as well. But it will be needed to improve by alternation and validation. V. Conclusion The research can use to predict the rehabilitation time about rescued sea turtles. The result supports the acceptable performance of prognostic prediction. The period of rehabilitation can be assessed with these six factors. Therefore, it is possible to improve the efficacy and shorten the time of rehabilitation. And, the cost of examination re-source can be controlled as well. The research provides a preliminary result of evidence to predict prognosis in rescued turtle in wildlife rehabilitation. | en |
dc.description.provenance | Made available in DSpace on 2021-06-17T01:42:20Z (GMT). No. of bitstreams: 1 ntu-106-R03643011-1.pdf: 2194327 bytes, checksum: 1ed9d323ad526197a6b1e6a5c54c268b (MD5) Previous issue date: 2017 | en |
dc.description.tableofcontents | 誌謝 i
中文摘要 iii ABSTRACT v 目錄 vii 圖目錄 ix 表目錄 x 第一章 前言 1 第二章 文獻探討 2 第一節 台灣地區常見海龜介紹 2 第二節 預後因子研究 4 第三節 評估海龜健康狀態方法 9 第四節 與海龜有關的預後研究 17 第五節 救傷海龜的常見臨床病理變化 19 第三章 材料方法 22 第一節 北台灣救傷海龜基礎檢傷 22 第二節 實驗材料 24 第三節 實驗方法 26 第四節 統計分析 30 第四章 結果 32 第一節 救傷海龜總體統計分析 32 第二節 以復健時間分組後的救傷海龜血液數值分析 36 第三節 臨床因子統計結果分析 40 第四節 預後評估系統建構 48 第五節 預後評估系統表現 50 第五章 討論 53 第一節 救傷海龜統計結果討論 53 第二節 臨床檢查異常結果與其他國家研究比較 55 第三節 預後因子重複性驗證 57 第四節 造成各因子異常的初步診斷 62 第五節 造成各預後因子的偏差討論 65 第六節 預後評估系統設計及偏差討論 67 第六章 結論 69 參考文獻 70 附錄 79 | |
dc.language.iso | zh-TW | |
dc.title | 北台灣救傷海龜之臨床預後因子研究 | zh_TW |
dc.title | The study of clinical prognostic factors of stranded sea turtles in northern Taiwan. | en |
dc.type | Thesis | |
dc.date.schoolyear | 105-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 程一駿,余品奐 | |
dc.subject.keyword | 海龜,救傷,預後因子, | zh_TW |
dc.subject.keyword | sea turtle,rehabilitation,prognostic factor, | en |
dc.relation.page | 84 | |
dc.identifier.doi | 10.6342/NTU201702182 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2017-07-28 | |
dc.contributor.author-college | 獸醫專業學院 | zh_TW |
dc.contributor.author-dept | 臨床動物醫學研究所 | zh_TW |
顯示於系所單位: | 臨床動物醫學研究所 |
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