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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 陳佳慧(Chia-Hui Chen) | |
dc.contributor.author | Shu-Chin Hsieh | en |
dc.contributor.author | 謝素琴 | zh_TW |
dc.date.accessioned | 2021-06-15T06:13:16Z | - |
dc.date.available | 2016-10-07 | |
dc.date.copyright | 2011-10-07 | |
dc.date.issued | 2011 | |
dc.date.submitted | 2011-08-18 | |
dc.identifier.citation | 中文參考文獻
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/47697 | - |
dc.description.abstract | 冠狀動脈硬化屬文明疾病,每年因此而開冠狀動脈繞道手術的病人甚多,然術後進食營養狀況鮮少列為追蹤項目。臨床上熱量估算有各種方式,文獻上公認用間接熱量測量法(IC)所測出的熱量是最為精確的計算方法。
是以本研究目的在於探討經冠狀動脈繞道手術術後一星期的營養給予狀況,與IC的差距,謂之熱量差距;同時探討入院、出院前及出院後2~4週等3個時段營養狀態的改變。研究設計採立意取樣,於北部某一佔床2200床的醫學中心,選取罹患冠心病經醫師診斷須接受冠狀動脈繞道常規手術,預估住院天數大於七天的病人作研究;收案時間自99年4月至99年 9月止,總計收案人數43名,採3階段收案,入院時收集人口學特性、疾病特性及營養狀態評估資料:如迷你營養評估量表(MNA)、身體質量指數(BMI)、體位測量(CC、MAC);術後收集IC與連續七天飲食記錄;出院前與出院後2~4周,收集MNA、BMI、CC、MAC等資料。資料分析採用SPSS16.0版軟體,作描述性統計。 結果顯示: (一)以IC*1.2估算個案熱量所需減去個案實際攝取熱量所得到的熱量差距:手術當日差距-1847.3 ± 465.5卡,手術後第六天差距-712.3 ± 530.4卡,連續七天累進差距達7713.6 ± 3100.5卡。出院前97%的住院病患體重減少,平均減少2.73 ± 2.30公斤。連續7天有53%(N=23)的收案病患每日熱量攝取均少於75%,連續7天有21%(N=9)的收案病患每日熱量攝取均少於50% (二)營養狀態的改變: 大部分的營養狀態參數在3個測量時間點均是減少的趨勢,僅MNA、CC出院後2~4周有回升現象。 整體而言,研究結果顯示:43位經冠狀動脈繞道手術的收案個案,術後的熱量差距和體重減少是普遍存在現況。 | zh_TW |
dc.description.abstract | Energy deficit, defined by the discrepancies between recommended and actual oral caloric intake was a common problem in acute and critical care settings. The aim of this study was to evaluate the energy deficit one week after patients undergoing coronary artery bypass graft surgery. The nutritional status of these patients was also evaluated following the hospitalization at three time points: admission, before discharge, and 2-4 weeks after hospital discharge. The sample consists of 43 participants who were scheduled for an elective coronary artery bypass graft surgery from April to September 2010 at a 2200-bed unban medical center. All participants’ resting energy expenditures were measured once by Indirect Calorimetry within 24 hours after surgery. The obtained resting energy expenditure times 1.2 was then defined as recommended energy requirement. Participants were closely monitored on their actual calorie intake through 7-day daily intake food record to calculate the energy deficit. A structured nutrition assessment including anthropometrics and a Mini-Nutritional Assessment Questionnaire was conducted three times following hospitalization.
Data revealed that energy deficit between recommended and actual intake were -1847.3±465.5 kcal on surgical day. On day 7, this deficit was -712.3±530.4 kcal. The accumulated mean deficit within 7 days was 7713.6±3100.5 kcal. The energy intake failed to exceed 75% of daily requirement on all 7 days for 53.3% of the sample. The average daily energy intake failed to 50% of daily requirement on all 7 days for 21% of the sample. Weight change was significant with 97% participants experienced weight loss and lost on average of 2.73±2.30 Kg by discharge. Most nutrition parameters declined 2-4 weeks following hospitalization. The result suggests that energy deficit and weight loss was common among patients undergoing coronary artery bypass graft surgery. | en |
dc.description.provenance | Made available in DSpace on 2021-06-15T06:13:16Z (GMT). No. of bitstreams: 1 ntu-100-R96426003-1.pdf: 973394 bytes, checksum: f73c9632bff023e50bee085f0200c6a3 (MD5) Previous issue date: 2011 | en |
dc.description.tableofcontents | 目錄
口試委員審定書 I 誌謝 II 中文摘要 III ABSTRACT IV 目錄 VI 圖目錄 VIII 表目錄 IX 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 名詞界定 4 第二章 文獻查證 5 第一節 臨床上熱量測量的方法 5 第二節 臨床上熱量給予的差距對病人的影響 7 第三節 臨床上熱量攝取不足的原因與改善方法 11 第四節 臨床上適用的營養評估方法 12 第三章 研究方法 18 第一節 研究設計 18 第二節 研究概念與架構 19 第三節 研究假設 20 第四節 研究對象及場所 21 第五節 研究工具及效度檢定 22 第六節 資料收集與分析 25 第七節 研究倫理考量 27 第四章 研究結果 28 第一節 研究對象的基本屬性 28 第二節 術後連續七天熱量差距 33 第三節 3次不同時間點營養狀態的改變 36 第五章 討論 41 第一節 熱量差距的現況 41 第二節 體重改變的意義 43 第三節 臨床營養狀態的改變 45 第六章 結論與建議 49 第一節 結論 49 第二節 護理的應用 51 第三節 研究限制及未來研究之建議 52 參考文獻 54 中文參考文獻 54 英文參考文獻 56 附錄 65 附錄一 倫理委員會審查通過函65 附錄二 基本資料表 67 附錄三 迷你營養評估表(MNA) 68 附錄四 七天飲食記錄 70 圖目錄 圖一.研究架構 19 圖二.資料收集流程圖 26 圖三.收案流程圖 32 圖四.實際熱量給予與七天熱量估算差距 33 圖五.每日熱量差距估算(供給-需求)百分比 34 圖六.術後七天熱量估算累計差距 34 圖七.平均MNA的改變 36 圖八.MNA高危險群營養不良百分比 36 圖九.平均MAC的改變 37 圖十.平均CC的改變 37 圖十一.平均BMI的改變 38 圖十二.3次收案平均體重變化 39 圖十三.術後七天連續平均體重變化 40 表目錄 表一.研究者與營養師所估算的5位受試者熱量差距 24 表二.個案基本資料統計 30 | |
dc.language.iso | zh-TW | |
dc.title | 行經冠狀動脈繞道手術術後一星期的營養探討 | zh_TW |
dc.title | The One Week Nutrition Survey of Patients undergoing Coronary Artery Bypass Graft Surgery | en |
dc.type | Thesis | |
dc.date.schoolyear | 99-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 許榮彬,陳珮蓉 | |
dc.subject.keyword | 冠狀動脈手術,營養差距,營養評估,體重改變, | zh_TW |
dc.subject.keyword | Coronary Artery Bypass Graft Surgery,Energy Deficit,Nutrition Survey,Weight Loss, | en |
dc.relation.page | 70 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2011-08-19 | |
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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