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題名:腦部損傷併發低血壓病人對不同臥位時之腦部灌流及生理指標的影響
書刊名:長庚護理
作者:陳虹如陳淑卿 引用關係賀倫惠余文彬駱佳宜魏國珍林幼麗
作者(外文):Chen, Hung-juChen, Shu-chingHo, Lun-huiYu, Wen-pinLo, Chia-yiWei, Kuo-chenLin, Yu-li
出版日期:2018
卷期:29:2=102
頁次:頁163-172
主題關鍵詞:腦部損傷低血壓頭低腳高姿勢腦部灌流壓顱內壓Intracranial disorderHypotensionTrendelenburg positionCerebral perfusion pressureIntracranial pressure
原始連結:連回原系統網址new window
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  • 共同引用共同引用:3
  • 點閱點閱:2
目的:探討腦部損傷併發低血壓病人對不同臥位時之腦部灌流與生理指標的影響。方法:採類實驗性研究設計,以方便取樣,招募台灣北部某醫學中心之神經科加護病房84位腦部損傷併發低血壓病人為研究對象。依照研究設計監測研究對象在平躺與頭低腳高姿勢1分鐘、3分鐘、5分鐘、10分鐘、15分鐘、30分鐘、60分鐘、120分鐘等8個觀察點的顱內壓、腦灌流及生理指標,所測的測量值進行推論性統計分析。結果:(1)腦部灌流方面,在平躺及頭低腳高二組間不具統計意義;而顱內壓於二組間會隨著時間增加。(2)生理指標方面,在平躺及頭低腳高二組間不具統計意義,結論:研究結果可作為照護腦部損傷病人,當合併低血壓時,改變臥位時的參考,在考量病情下,提供適當適切的臥位,使病人的生理指標、顱內壓與腦部灌流壓更趨於穩定狀態,減少合併症的發生。
Purposes: The aim of the study was too explore the effects of different berths on cerebral perfusion pressure and physiological parameters in patients with intracranial disorder patients complicated with hypotension Method: The quasi-experiment recruited 84 patients with brain injury complicated with hypotension from the neurological intensive care unit in a medical center in northern Taiwan. Intracranial pressure, brain perfusion, and physiological indicators of each subject in the positions of lying flat and trendelenburg in 1 minute, 3 minutes, 5 minutes, 10 minutes, 15 minutes, 30 minutes, 60 minutes and 120 minutes were monitored. Results: There was no statistically significant difference in brain perfusion between the group of lying flat and trendelenburg, but intracranial pressure increased over time. There was no statistically significant difference in physiological indicators between the group of lying flat and trendelenburg. Conclusion: The results of this study can be used as a reference for changing lying positions when taking care of patients with intracranial disorder complicated with hypotension. Individualized lying positions can be provided to stabilize patients' physiological indicators, intracranial pressure, and cerebral perfusion pressure to reduce the risk of complications.
期刊論文
1.邱艷芬(20000600)。從腦灌流壓與腦組織的存活談頭部外傷病人的護理。護理雜誌,47(3),59-64。new window  延伸查詢new window
2.Price, A. M.、Collins, T. J.、Gallagher, A.(2003)。Nursing care of the acute head injury: A review of the evidence。Nursing in Critical Care,8(3),126-133。  new window
3.Mavrocordatos, P.、Bissonnette, B.、Ravussin, P.(2000)。Effects of neck position and head elevation on intracranial pressure in anaesthetized neurosurgical patients: preliminary results。Journal of Neurosurgical Anesthesiology,12(1),10。  new window
4.Hacke, W.、Kaste, M.、Skyhoj, O. T.、Orgogozo, J. M.、Bogousslavsky, J.(2000)。European Stroke Initiative (EUSI) Recommendations for Stroke Management The European Stroke Initiative Writing Committee。European Journal of Neurology,7(6),607-623。  new window
5.Bridges, N.、Jarquin-Valdivia, A. A.(2005)。Use of the Trendelenburg position as the resuscitation position: to T or not to T?。American Journal of Critical Care,14(5),364-368。  new window
6.Ng, I.、Lim, J.、Wong, H. B.(2004)。Effects of head posture on cerebral hemodynamics: Its influences on intracranial pressure, cerebral perfusion pressure, and cerebral oxygenation。Neurosurgery,54(3),593-597。  new window
7.Mestecky, A. M.(2007)。Management of severe traumatic brain injury: The need for the knowledgeable nurse。British Journal of Neuroscience Nursing,3(1),7-13。  new window
8.Mello, P.、Sharma, V.、Dellinger, R.(2004)。Shock overview。Seminar in Respiratory and Critical Care Medicine,25(6),619-628。  new window
9.Shammas, A.、Clark, A. P.(2007)。Trendelenburg positioning to treat acute hypotension: helpful or harmful?。Clinical Nurse Specialist,21(4),181-187。  new window
研究報告
1.衛生福利部(2017)。104年國人死因結果統計。  延伸查詢new window
圖書
1.Polit, D. F.、Beck, C. T.(2004)。Nursing research: Appraising evidence for nursing practice。Philadelphia, PA:Wolters Kluwer/Lippincott Williams & Wilkins。  new window
2.曾麗音、孫淑惠(2000)。基本護理學。台北:大揚。  延伸查詢new window
3.陳偉鵬(2010)。臨床症狀護理。台北:華杏。  延伸查詢new window
4.Alarcon, J. D.、Rubiano, A. M.、Okonkwo, D. O.、Urrútia, G.、Bonfill, C.(2012)。Elevation of the head during intensive care management in patients with severe traumatic brain injury (Protocol)。John Wiley and Sons, Ltd。  new window
圖書論文
1.曾翊萱(2011)。神經系統疾病與護理。新編內外科護理學。台北:永大。  延伸查詢new window
2.范淑芳(2011)。急症與護理。新編內外科護理學。台北:永大。  延伸查詢new window
 
 
 
 
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