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題名:分析手臂運動訓練對病人脫離呼吸器之成效
書刊名:護理暨健康照護研究
作者:童惠芳白玉珠林柏瑤陳美娟蔡雅琪
作者(外文):Tang, Hui-fangPai, Yu-chuLin, Po-yaoChen, Mei-chuanTsai, Ya-chi
出版日期:2012
卷期:8:2
頁次:頁138-148
主題關鍵詞:手臂運動訓練脫離呼吸器Arm exerciseWeaningVentilator
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(9) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:9
  • 共同引用共同引用:17
  • 點閱點閱:120
背景:在病人脫離呼吸器過程中儘早實施手臂運動訓練,以增進呼吸肌強度,此訓練對於脫離呼吸器之影響力值得關注。目的:瞭解及分析手臂運動訓練對病人成功脫離呼吸器之成效。方法:本研究為類實驗研究法,對象為台灣北部某醫學中心加護病房使用呼吸器病人,採隨機取樣,分為訓練組及對照組各收案75人,訓練組在病況穩定即執行手臂運動訓練,對照組維持原有照護模式,研究工具為結構式量表,包括病人呼吸器脫離評估及主觀感受量表。結果:研究結果顯示訓練組住加護病房天數比對照組少8天,使用呼吸器天數少15.5天,醫療費用平均少132,318元,呼吸器脫離率100%,對照組68%;在主觀感受得分方面,訓練組正向情感得分高於對照組,負向情感得分低於對照組。手臂運動訓練後,訓練組病人最大吸氣壓顯著增加11.1cmH(下標 2)O,最大吐氣壓顯著增加15.8 cmH(下標 2)O,潮氣容積顯著增加82.7ml,最大通氣量顯著增加112.3ml,每分鐘換氣量亦顯著增加1L,訓練組淺快呼吸指數較對照組顯著低14.3min/L。以邏輯斯迴歸分析成功脫離呼吸器之預測因子,發現手臂運動訓練每增加一天,成功脫離率增加22.4%。結論/實務應用:研究結果發現手臂運動訓練提高病人之呼吸器脫離率成效佳,建議給予病人手臂運動訓練,協助病人脫離呼吸器,增進生活品質及節省醫療費用。
Background: Weaning ventilator programs include arm exercise training to improve patient respiratory muscle strength. The effectiveness of such training should be evaluated in light of expected results.Purpose: This research evaluated the effectiveness of arm exercise training in a weaning ventilator program.Methods: We adopted a quasi-experiment methodology. Subjects were patients on ventilators recruited from an ICU (intensive care unit) at a medical center in Taipei, Taiwan. We randomly divided subjects between training and control groups containing a total of 75 subjects each. Training group subjects received arm exercise training; Control group subjects received standard nursing care. Constructive scales used to collect data included a demographics questionnaire, ventilator weaning assessment scale, and subjective perception scale.Result: Results showed that numbers of ICU and ventilator days, medical costs, and RSI (rapid shallow breathing index) were all significantly lower in the training group than the control group; The weaning rate of the training group was higher (100% vs. 68%); The subjective perception scale of the training group was significantly higher than the control group, especially in the positive emotion domain. After arm exercise training, Pimax increased 11.1 cmH(subscript 2)O, Pemax increased 15.8 cmH(subscript 2)O, tidal volume increased 82.7 ml, maximal ventilation increased 112.3ml, and minute ventilation increased 1L. We constructed a logistic regression model to predict factors involved in successful ventilator weaning. We found the rate of weaning success increased an average 22.4% for every arm training exercise day.Conclusion: Arm exercise training significantly increased the weaning rate. The training program assisted patients to wean from their ventilator as soon as possible, improved patient quality of life, and effectively reduced medical resource expenditures.
期刊論文
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2.Rello, J.、Diaz, E.(2003)。Pneumonia in the intensive care unit。Critical Care Medicine,31(10),2544-2551。  new window
3.王玲玲、邱艷芬、方亞芸(20060700)。改良式擴胸運動對腹部手術病患肺功能之成效。臺灣醫學,10(4),413-421。  延伸查詢new window
4.白玉珠、鄒怡真、黃鈴雅、洪曉佩、陶秀蘭(20020600)。脫離呼吸器護理評估量表之發展與測試。榮總護理,19(2),168-178。new window  延伸查詢new window
其他
1.白玉珠、董金蓮、洪曉佩、鄒怡真、楊惠菁、黃朱貝(Pai, Y. C., Tung, C. L., Hong, S. P., Tsou, Y. C., Yang, H. C, & Huang, C. P.)(2007)。病人下床活動訓練與脫離呼吸器之相關性研究(A study of mobility training program and the weaning off of ventilators)。  延伸查詢new window
2.行政院衛生署(Department of Health, Executive Yuan, Taiwan, ROC)(2010)。98 年度全民健康保險醫療統計年報(2009 national health insurance medical statistics annual report)。  延伸查詢new window
3.吳淑芬、吳清平、謝國洲、黃忠智(Wu, S. F., Wu, C. P., Hsieh, K. C., & Huang, C. C.)(2010)。應用肺部復原治療於加護病房之成效初探(Effects of pulmonary recondition therapy in intensive care unit patients-A preliminary report)。  延伸查詢new window
4.范聖心(Fan, S. H.)(2007)。肺部復健運動訓練對肺葉切除術後病患生理、心理及生活品質之成效探討(The effectiveness of pulmonary rehabilitation exercise training on physical, psychic and quality of life in patients after lung lobectomy)。  延伸查詢new window
5.胡淑琴、李茹萍(Hu, S. C., & Li, R. P.)(2006)。吸氣肌肉訓練對呼吸器依賴患者脫離之成效(Effects of inspiratory muscle training on weaning in ventilator-dependent patients)。  延伸查詢new window
6.張美玉(Chang, M. Y.)(2006)。成功脫離機械式換氣之概念分析(A concept analysis of successful weaning from mechanical ventilation)。  延伸查詢new window
7.California Pulmonary Rehabilitation Collaborative Group(2004)。Effects of pulmonary rehabilitation on dyspnea, quality of life, and healthcare costs in California。  new window
8.P. Caruso, S. D. Denari, S. A. Ruiz, K. G. Bernal, G. M. Manfrin, C. Friedrich & D. Deheinzelin(2005)。Inspiratory muscle training is ineffective in mechanically ventilated critically ill patients。  new window
9.F. Filsoufi, P. B. Rahmanian, J. G. Castillo, J. Chikwe & D. H. Adams(2008)。Predictors and early and late outcomes of respiratory failure in contemporary cardiac surgery。  new window
10.G. Francesco, C. Claudia, B. Roberto, G. Michela, S. Loredana, C. Carla & S. Giorgio(2005)。Arm exercise and hyperinflation in patients with COPD: Effect of arm training。  new window
11.R. O. Hopkins(2010)。Early activity in the ICU beyond safety and feasibility。  new window
12.F. T. Janaudis, K. Hill, R. Goldstein, K. Wadell & D. Brooks(2009)。Arm exercise training in patients with chronic obstructive pulmonary disease: A systematic review。  new window
13.K. A. Kyung & P. A. Chin(2007)。The effect of a pulmonary rehabilitation programme on older patients with chronic pulmonary disease。  new window
14.I. Laoutaris, A. Dritsas, M. D. Brown, A. Manginas, P. A. Alivizatos & D. V. Cokkinos(2004)。Inspiratory muscle training to rnhance weaning from mechanical ventilation。  new window
15.L. H. Moodie, J. C. Reeve, N. Vermeulen & M. R. Elkins(2011)。Inspiratory muscle training to facilitate weaning from mechanical ventilation: Protocol for a systematic review。  new window
16.K. O’Brien, E. L. Geddes, W. D. Reid, D. Brooks & J. Crowe(2008)。Inspiratory muscle training compare with other rehabilitation interventions in chronic obstructive pulmonary disease: A systematic review update。  new window
17.B. J. Petrof, S. Jaber & S. Matecki(2010)。Ventilator-induced diaphragmatic dysfunction。  new window
18.R. Porta, M. Vitacca, L. S. Gilè, E. Clini, L. Bianchi, E. Zanotti & A N. mbrosino(2005)。Supported arm training in patients recently weaned from mechanical ventilation。  new window
19.V. S. Probst, T. Troosters, F. Pitta, M. Decramer & R. Gosselink(2006)。Cardiopulmonary stress during exercise training in patients with COPD。  new window
20.J. H. Ralph, J. E. Petra, R. L. Cecile & T. M. Hans(2006)。Exercise performance improves in patients with COPD due to respiratory muscle endurance training。  new window
21.C. L. Rochester(2003)。Exercise training in COPD。  new window
22.P. Ser’on, P. Riedemann, S. Munoz, A. Doussoulin, P. Villarroel & X. Cea(2005)。Effect of inspiratory muscle training on muscle strength and quality of life in patients with chronic airflow limitation: A randomized controlled trail。  new window
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