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題名:不同臥位對肝硬化腹水病人之血氧飽和度、舒適度與呼吸困難程度之影響
書刊名:護理雜誌
作者:徐雯娟賀倫惠林梅香邱綉玲
作者(外文):Hsu, Wen-chuanHo, Lun-huiLin, Mei-hsiangChiu, Hsiu-ling
出版日期:2014
卷期:61:5
頁次:頁66-74
主題關鍵詞:肝硬化腹水床頭抬高臥位氧合Liver cirrhosisAscitesHead-up positionOxygenation
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(3) 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:3
  • 共同引用共同引用:20
  • 點閱點閱:69
背景 肝硬化合併腹水對患者影響是多面的,一旦合併症引發呼吸困難或其他不適情形,病人生活品質會大受影響,在生理、心理與社會各層面皆出現負面的衝擊。目的 探討不同床頭抬高臥位對肝硬化腹水病人之血氧飽和度、舒適度與呼吸困難程度之影響。方法 採類實驗性研究設計,以方便取樣,招募臺灣北部某醫學中心之胃腸肝膽科病房252位肝硬化病人為研究對象。依照研究設計監測研究對象在床頭抬高15度、30度及45度等三種不同角度臥位的血氧飽和度、舒適度與呼吸困難程度,所得的測量值進行推論性統計分析。結果 (1)在血氧值方面,病人在三種不同角度臥位中不具統計意義;三組角度在時間改變於調整角度5分鐘後測量統計上有顯著差異(p<.01),病人血氧值在15度臥位時較45度時高;(2)在舒適程度方面,病人在三種不同角度臥位中不具統計意義;(3)在呼吸困難程度方面,病人在三種不同角度臥位中,於45度臥位時較15度時呼吸困難(p<.05)。因此,腹水病人在15度臥位時比30度及45度臥位時更能獲得較佳血氧飽和度,且較不會有呼吸困難的感覺。結論/實務應用 研究結果可作為照護腹水病人,改變臥位時的參考,在考量病情下,提供適當適切的臥位及調整床頭角度,使病人氧合及舒適程度更趨於穩定狀態,減少合併症的發生。
Background: Chronic liver disease and cirrhosis are collectively ranked as the ninth most prevalent cause of death in Taiwan. Ascites is the most common comorbidity associated with liver cirrhosis. Different body postures affect pulmonary ventilation and arterial oxygen partial pressure. Thus, ensuring proper body posture in patients is an important clinical nursing intervention that significantly affects the recovery of patients. Purpose: This study investigates the effects of head posture on oxygenation saturation, comfort, and dyspnea in patients with liver cirrhosis-related ascites. Methods: A quasi-experimental study design was used. A total of 252 participants were recruited from a medical centre hospital in Taiwan. Participants were allocated randomly into three groups of bed-elevation angles: 15 degrees, 30 degrees, and 45 degrees. The physiological indices were measured at 5, 10, 15, 20, 25, and 30 minutes in order to investigate the change in oxygenation saturations that were attributable to the different angles. Data were analyzed using descriptive statistics. The generalized estimating equation (GEE) was used for statistical analysis, with the level of significance set at: α = .05. Results: After controlling for confounding variables, the results showed that patients in the three groups earned similar scores for the degree of difficulty in the oxygen values. The supine group earned significantly different scores than the other two groups in terms of blood oxygen values related to time to change the angle of the three groups at five minutes after adjusting the angle (p<.01). This study found no differences among the three groups in terms of comfort. In terms of breathing, this sudy found a significant difference between 45-degree and 15-degree supine dyspnea(p<.05). Therefore, patients with ascites at 15 degrees supine and with better access to better oxygen saturation had superior results to their peers at 30 degrees and 45 degrees supine. Furthermore, this group was less likely to perceive breathing difficulties. Conclusions / Implications for Practice: The results of this study may guide health education and care for nurses in order to improve the quality of care for patients with chronic liver disease / cirrhosis with concomitant ascites.
期刊論文
1.Fanger, P. O.(1967)。Calculation of thermal comfort: Introduction of a basic thermo comfort equation。ASHRAE Trans,73,121-132。  new window
2.郭于鈴、邱艷芬(20070300)。早產兒臥位對氧合及血液動力學的影響。榮總護理,24(1),18-30。new window  延伸查詢new window
3.游雅蘭、蘇婉麗、劉惠玲、曾昭梅(20090300)。比較三種不同俯臥姿勢對早產兒生理指標的影響。榮總護理,26(1),18-26。new window  延伸查詢new window
4.王盈文、侯明志(20040300)。自發性腹膜炎的診斷治療及最新發展。臨床醫學,53(3)=315,225-230。new window  延伸查詢new window
5.吳秀霞、陳美玲(20060100)。一位肝硬化合併腹水病患的護理經驗。國立臺北護理學院護理(學)系學刊,2(1),1-8。  延伸查詢new window
6.吳晏秀、陳淑銘、陳玲珠(20131200)。運用舒適理論於一位肺癌病人善終之護理經驗。榮總護理,30(4),340-346。new window  延伸查詢new window
7.林偉彬、簡榮南(20000900)。成年肝硬化病患之腹水控制原則。當代醫學,27(9)=323,15-20。  延伸查詢new window
8.邱倩卉、薛琬萱(2012)。應用Orem理論照護一位急診肝性腹水病人之經驗。馬偕護理雜誌,6(1),82-90。  延伸查詢new window
9.陳怡呈、蔡淑玲、蔡昌雄、黃珊(20120900)。肝硬化合併腹水病患之調適經驗。新臺北護理期刊,14(2),13-21。  延伸查詢new window
10.陳美倫、郭憲文、陳滋彥(19940800)。肝硬化病人支持系統、憂鬱與焦慮反應及其因應行為之相關性研究。中華公共衛生雜誌,13(4),330-341。new window  延伸查詢new window
11.黃麗珠、劉雪娥、李中一、邱愛富(20040600)。宜蘭縣泰雅族原住民肝硬化病患的生活品質及其相關因素之探討。輔仁醫學期刊,2(2),27-37。  延伸查詢new window
12.蔡麗紅(20060600)。肝性腹水之治療及護理。長庚護理,17(2)=54,172-178。new window  延伸查詢new window
13.Bernardi, M.、Santini, C.、Trevisani, F.、Baraldini, M.、Ligabue, A.、Gasbarrini, G.(1985)。Renal function impairment induced by change in posture in patients with cirrhosis and ascites。Gut,14,629-635。  new window
14.Correa, K. S.、Karloh, M.、Martins, L. Q.、dos Santos, K.、Mayer, A. F.(2011)。Can the Glittre ADL test differentiate the functional capacity of COPD patients from that of healthy subjects。Brazilian Journal of Physical Therapy,15(6),467-473。  new window
15.Devitt, J.、Shellman, L.、Gardner, K.、Nichols, L. W.(2011)。Using positioning after a colonoscopy for patient comfort management。Gastroenterology Nursing,34(2),93-100。  new window
16.Foroncewicz, B.、Mucha, K.、Szparaga, B.、Raczynska, J.、Ciszek, M.、Pilecki, T.、Pczek, L.(2011)。Rehabilitation and 6-minute walk test after liver transplantation。Transplantation Proceedings,43(8),3021-3024。  new window
17.Lee, L.,、Grap, M. J.(2008)。Care and management of the patient with ascites。Medsurg Nursing,17(6),376-381。  new window
18.Lipsky, M. S.、Sternbach, M. R.(1996)。Evaluation and initial management of patients with ascites。American Family Physician,54(4),1327-1333。  new window
19.Sargent, S.(2006)。The management and nursing care of cirrhotic ascites。British Journal of Nursing,15(4),212-219。  new window
20.Shively, M.(1998)。Effect of position chang on mixed venous oxygen saturation in bypass coronary artery surgery patients。Heart and Lung,17(1),51-59。  new window
21.Somberg, J. C.、Molnar, J.(2009)。Therapeutic approaches to the treatment of edema and ascites: The use of diuretics。American Journal of Therapeutics,16(1),98-101。  new window
22.Thiadens, T.、Vervat, E.、Albertyn, R.、van Dijk, M.、Van As, A. B.(2011)。Evaluation of pain incidence and pain management in a South African paediatric trauma unit。South African Medical Journal,101(8),533-536。  new window
23.Vaes, A. W.、Annegarn, J.、Meijer, K.、Cuijpers, M. W. J.、Frans-sen, F. M. E.、Wiechert, J.、Spruit, M. A.(2012)。The effects of a "new" walking aid on exercise performance in patients with COPD: A randomized crossover trial。Chest Journal,141(5),1224-1232。  new window
24.胡志棠(2001)。肝硬化篇(下)。當代醫學,28(10)=336,838-846。  延伸查詢new window
25.鄭秀容(20040600)。肝硬化病人之臨床護理問題。榮總護理,21(2),188-196。new window  延伸查詢new window
26.Starr, S.、Hand, H.(2002)。Nursing care of chronic and acute liver failure。Nursing Standard,16(40),47-54。  new window
27.蘇幼雲、王璟璇(20041100)。一位肝硬化合併脾腫大患者接受脾栓塞治療之護理經驗。高雄護理雜誌,21(2),35-43。  延伸查詢new window
28.劉樹泉(19980200)。癌末呼吸困難評估的文獻探討。安寧療護,7,43-53。new window  延伸查詢new window
29.蔡佳玲、李雅玲、胡文郁(20120200)。舒適之概念分析。護理雜誌,59(1),77-82。new window  延伸查詢new window
30.Sivayokan, T.、Dillon, J. F.(2004)。Cirrhotic ascites: A review of management。Hospital Medicine,65(1),22-26。  new window
學位論文
1.黃令宜(2001)。體位改變對單側結核性肋膜積水病患氣體交換之影響(碩士論文)。國立陽明大學。  延伸查詢new window
圖書
1.張美玉、劉慧玲(2000)。實用重症護理學。台北市:五南。  延伸查詢new window
2.Polit, Denise F.、Beck, Cheryl Tatano(2004)。Nursing research: Principles and methods。Lippincott Williams & Wilkins。  new window
其他
1.衛生福利部(2014)。102年國人主要死因統計,http://www.mohw.gov.tw/cht/DOS/Statistic.aspx7f_ list_no=312andfod」ist_no=5012。  new window
 
 
 
 
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