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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 孫維仁 | |
| dc.contributor.author | Chung-Kun Hui | en |
| dc.contributor.author | 許仲寬 | zh_TW |
| dc.date.accessioned | 2021-06-08T01:39:01Z | - |
| dc.date.copyright | 2016-08-26 | |
| dc.date.issued | 2016 | |
| dc.date.submitted | 2016-08-22 | |
| dc.identifier.citation | Burger, L., & Fitzpatrick, J. (2009). Prevention of inadvertent perioperative hypothermia. Br J Nurs, 18(18), 1114, 1116-1119.
Cattaneo, C. G., Frank, S. M., Hesel, T. W., El-Rahmany, H. K., Kim, L. J., & Tran, K. M. (2000). The accuracy and precision of body temperature monitoring methods during regional and general anesthesia. Anesth Analg, 90(4), 938-945. Cooper, S. (2006). The effect of preoperative warming on patients' postoperative temperatures. AORN J, 83(5), 1073-1076, 1079-1084; quiz 1085-1078. Forstot, R. M. (1995). The etiology and management of inadvertent perioperative hypothermia. J Clin Anesth, 7(8), 657-674. Frank, S. M., Beattie, C., Christopherson, R., Norris, E. J., Perler, B. A., Williams, G. M., et al. (1993). Unintentional hypothermia is associated with postoperative myocardial ischemia. The Perioperative Ischemia Randomized Anesthesia Trial Study Group. Anesthesiology, 78(3), 468-476. Frank, S. M., Shir, Y., Raja, S. N., Fleisher, L. A., & Beattie, C. (1994). Core hypothermia and skin-surface temperature gradients. Epidural versus general anesthesia and the effects of age. Anesthesiology, 80(3), 502-508. Hooper, V. D., Chard, R., Clifford, T., Fetzer, S., Fossum, S., Godden, B., et al. (2010). ASPAN's evidence-based clinical practice guideline for the promotion of perioperative normothermia: second edition. J Perianesth Nurs, 25(6), 346-365. Horn, E. P., Bein, B., Bohm, R., Steinfath, M., Sahili, N., & Hocker, J. (2012). The effect of short time periods of pre-operative warming in the prevention of peri-operative hypothermia. Anaesthesia, 67(6), 612-617. Kellam, M. D., Dieckmann, L. S., & Austin, P. N. (2013). Forced-air warming devices and the risk of surgical site infections. AORN J, 98(4), 354-366; quiz 367-359. Kimberger, O., Held, C., Stadelmann, K., Mayer, N., Hunkeler, C., Sessler, D. I., et al. (2008). Resistive polymer versus forced-air warming: comparable heat transfer and core rewarming rates in volunteers. Anesth Analg, 107(5), 1621-1626. Kongsayreepong, S., Chaibundit, C., Chadpaibool, J., Komoltri, C., Suraseranivongse, S., Suwannanonda, P., et al. (2003). Predictor of core hypothermia and the surgical intensive care unit. Anesth Analg, 96(3), 826-833, table of contents. Kurz, A., Kurz, M., Poeschl, G., Faryniak, B., Redl, G., & Hackl, W. (1993). Forced-air warming maintains intraoperative normothermia better than circulating-water mattresses. Anesth Analg, 77(1), 89-95. Kurz, A., Sessler, D. I., & Lenhardt, R. (1996). Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med, 334(19), 1209-1215. Macario, A., & Dexter, F. (2002). What are the most important risk factors for a patient's developing intraoperative hypothermia? Anesth Analg, 94(1), 215-220, table of contents. Mahoney, C. B., & Odom, J. (1999). Maintaining intraoperative normothermia: a meta-analysis of outcomes with costs. AANA J, 67(2), 155-163. Marx, J. (2006). Rosen's emergency medicine: concepts and clinical practice (pp. 2239): Mosby/Elsevier. Morris, R. H. (1971). Operating room temperature and the anesthetized, paralyzed patient. Arch Surg, 102(2), 95-97. Murphy, J. (2006). Temperature & Humidity Control In Surgery Rooms. ASHRAE, 48, 18-25. Perez-Protto, S., Sessler, D. I., Reynolds, L. F., Bakri, M. H., Mascha, E., Cywinski, J., et al. (2010). Circulating-water garment or the combination of a circulating-water mattress and forced-air cover to maintain core temperature during major upper-abdominal surgery. Br J Anaesth, 105(4), 466-470. Sessler, D. I. (2000). Perioperative heat balance. Anesthesiology, 92(2), 578-596. Sessler, D. I. (2009). New surgical thermal management guidelines. Lancet, 374(9695), 1049-1050. Sessler, D. I. (2016). Perioperative thermoregulation and heat balance. Lancet, 387(10038), 2655-2664. Sessler, D. I., Olmsted, R. N., & Kuelpmann, R. (2011). Forced-air warming does not worsen air quality in laminar flow operating rooms. Anesth Analg, 113(6), 1416-1421. Shin, K. M., Ahn, J. H., Kim, I. S., Lee, J. Y., Kang, S. S., Hong, S. J., et al. (2015). The efficacy of pre-warming on reducing intraprocedural hypothermia in endovascular coiling of cerebral aneurysms. BMC Anesthesiol, 15, 8. | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/18908 | - |
| dc.description.abstract | 標題
應用主動式充氣暖毯以預防手術非預期性低體溫之決策時機 背景 在手術後滿意度調查中，病人常會抱怨手術室太過寒冷，以及因此造成的顫抖現象。傳統的手術中預防低體溫措施相當有限：通常是布單溫毯及加溫過的點滴注射液體，必要時再加上光照式保暖設備如烤燈或紅外線燈、接觸式保暖設備如溫水床墊等。根據基隆長庚醫院統計，手術非預期性低體溫的發生率約44%，平均每月330例 <36℃，其中甚至還有6% (平均約48例)嚴重到低於35℃。雖然研究結果顯示主動式暖氣保溫設備比傳統保溫方式效果更佳，更能讓病人於手術中維持體溫且感覺溫暖，但因台灣全民健康保險對此不給付，需要病人自費，由病人自行決定是否採用主動式暖氣保溫設備。因非預期性低體溫不是必然會發生，常有病人詢問是否可以等到真的有低體溫發生後再使用，以節省需要自行負擔的醫療費用。以往文獻並無這方面資料，因此我們執行此研究以探討低體溫發生後再使用主動式暖氣保溫設備的救援效果。 方法 經過人體試驗委員會核准後，本研究共收集90位需接受全身麻醉的手術病患，並隨機分配為三組：對照組傳統常規(Routine Thermal Care, RTC)、主動式暖氣保溫(Forced-Air Warming, FAW)、傳統常規加主動式暖氣保溫救援(Rescue)。 結果 主動式暖氣保溫組別FAW在減少非預期性低體溫的發生率方面具有顯著優勢(FAW 33%, RTC 90%, Rescue 86%, p < 0.05)。至於研究目標的救援組別Rescue，雖然其平均手術後體溫比對照組RTC稍高(35.30℃ vs. 34.95℃)，但不具統計意義。 結論 預防性使用主動式暖氣保溫設備的保暖效果比手術中使用主動式暖氣保溫設備來治療非預期性低體溫的效果為佳。 | zh_TW |
| dc.description.provenance | Made available in DSpace on 2021-06-08T01:39:01Z (GMT). No. of bitstreams: 1 ntu-105-P94421025-1.pdf: 1255755 bytes, checksum: bf3daa80f60d20d6c3ab468c923c8192 (MD5) Previous issue date: 2016 | en |
| dc.description.tableofcontents | 目 錄
口試委員審定書………………………………………………………………………. i 誌謝 ….…………………………………………………………………….…...……. ii 中文摘要…………………………………………………………………….….……. iii 英文摘要…………………………………………………………………………….... v 碩士論文內容 第一章 緒論 ……….……………….…………………………………………….. 1 第一節 背景及文獻回顧 …………………………………………………… 1 第二節 欲研究的問題及其重要性…………………………………………… 3 第三節 研究的假說與特定目的 …………………………………………… 4 第二章 研究方法與材料……………………..…………………………………….. 5 第三章 結果.…………………………….………………………………………….. 7 第四章 討論………………………………….….………………………………….. 8 第五章 展望……………………………………….……………………………….. 10 第六章 論文英文簡述 ………………………...………………………………….. 11 參考文獻…………………………………………….…..………………………….. 20 圖表………………………………………………………..….…………………….. 22 照片1 主動式暖氣保溫設備 ……………………….…………………….. 22 照片2 主動式暖氣保溫設備的使用情形………………….…………….... 23 表1 不同手術的低體溫發生率………………..………….…………….. 24 表2 病人特徵…………….………………………..…………………….. 25 表3 三組病人的低體溫發生率……………………...………………….. 26 圖1 基隆長庚醫院非預期性低體溫統計資料………...……………….. 27 圖2 一位分配在救援組病人的體溫變化………………...…………….. 28 圖3 三組病人在手術前中後的體溫變.…………………………..…….. 29 | |
| dc.language.iso | zh-TW | |
| dc.title | 應用主動式充氣暖毯以預防手術非預期性低體溫之決策時機 | zh_TW |
| dc.title | Timing to decide the application of forced air warming in preventing inadvertent perioperative hypothermia | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 104-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 黃凱文,葉育彰 | |
| dc.subject.keyword | 低體溫,非預期性,手術,主動式暖氣保溫,麻醉, | zh_TW |
| dc.subject.keyword | hypothermia,inadvertent,perioperative,forced air warming,anesthesia, | en |
| dc.relation.page | 29 | |
| dc.identifier.doi | 10.6342/NTU201603494 | |
| dc.rights.note | 未授權 | |
| dc.date.accepted | 2016-08-22 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 臨床醫學研究所 | zh_TW |
| 顯示於系所單位： | 臨床醫學研究所 | |
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