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題名:高血壓病人施行腹腔鏡膽囊切除手術期間血壓穩定程度相關因素探討
書刊名:健康促進暨衛生教育雜誌
作者:王春銀陳政友 引用關係
作者(外文):Wang, Chun-yinChen, Cheng-yu
出版日期:2019
卷期:43
頁次:頁23-42
主題關鍵詞:高血壓病人腹腔鏡膽囊切除手術手術期間血壓穩定程度Hypertensive patientLaparoscopic cholecystectomyPerioperative blood pressure stability
原始連結:連回原系統網址new window
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本研究主要目的是針對高血壓病人在手術期間血壓穩定程度及其相關因素作探討。以醫學中心進行腹腔鏡膽囊切除手術的病人為母群體,採病歷回溯方式,以立意取樣選取2016年1月到2017年6月進行腹腔鏡膽囊切除手術有高血壓病人為樣本,共得有效樣本325人。所得資料以單因子變異數分析、斯皮爾曼等級相關及多元迴歸進行統計分析。分析後得以下結果:描述性統計方面:一、「性別」男性167人(51.4%);女性158人(48.6%)。二、「年齡」最小28歲、最大90歲、平均61.56歲、(標準差12.22)。三、「身體質量指數」最小為15.4、最大為43.1、平均為25.8、(標準差為3.8)。四、手術前服用降血壓藥物者有193人(59.4%);手術前無服用降血壓藥物者有132人(40.6%)。五、有高血壓家族疾病史者有161人(49.5%);無高血壓家族疾病史者有164人(50.5%)。推論性統計方面::一、研究對象的「年齡」、「身體質量指數」、「手術前服用降血壓藥物情形」三者與手術期間血壓穩定程度有關係,年齡越高者手術期間血壓穩定程度越不穩定;而身體質量指數(BMI)越高者、手術前有服用降血壓藥物者手術期間的血壓穩定程度越穩定。二、研究對象的性別、年齡、身體質量指數(BMI)、手術前服用降血壓藥物情形及高血壓家族疾病史等背景變項可以有效預測手術期間的血壓穩定程度,並可解釋其總變異量之31.8%,但其中只以「手術前服用降血壓藥物情形」為主要的預測變項。結果顯示,研究對象中手術前未服用降血壓藥物者,手術期間血壓越不穩定。根據研究結果建議:一、醫療單位能跨科部合作,落實在手術前服用降血壓藥物的比率。二、建議各醫療單位(如麻醉科或病房)能籌畫此相關衛生教育如播放衛教影片或辦理手術前衛教說明課程,提供要進行手術伴有慢性疾病的病人及家屬能正確使用手術前慢性病用藥。三、進行手術的外科醫師,在開立手術前醫囑時,就分手術前服用降血壓藥物及不服用降血壓藥物兩派,藉由此研究結果提供及再教育醫護人員,讓預計手術的高血壓病人在手術前能服用降血壓藥物,減少手術中血壓不穩定的程度,期能對手術期間血壓穩定有所助益。
This retrospective study aimed to identify factors that affect intraoperative blood pressure, using medical records of 325 patients who received laparoscopic cholecystectomy from January 2016 to June 2017. ANOVA, Spearman's rank correlation coefficient and multiple regression analysis were used, with the following results: Risk factors of 'age', 'body mass index' and 'administration of anti-hypertensive drugs before surgery' were found to influence blood pressure during surgery. The more advanced the age, the more unstable the blood pressure during surgery. In contrast, higher body mass index and those who received anti-hypertensive drugs resulted in more stable intraoperative blood pressure. Background variables such as gender, age, body mass index, status of antihypertensive drugs taken before operation, and family history of hypertension can help predict blood pressure stability during surgery, accounting for 31.8% of total variance. The status of anti-hypertensive drugs taken before operation was identified as the most significant predictor variable for intraoperative blood pressure stability. Results show that the lack of anti-hypertensive drugs results in greater degree of intraoperative blood pressure stability. Status of anti-hypertensive drugs taken before operation is a significant predictor for perioperative blood pressure stability. Therefore, patients with long-term hypertension under medication control should be instructed to take anti-hypertensive medications before surgery to help maintain stable perioperative blood pressure.
期刊論文
1.林廷燦、朱文洋、劉怡君、鍾瑞嶂(20121200)。外科病人手術前後心血管風險評估及內科處理。內科學誌,23(6),403-421。  延伸查詢new window
2.Flegal, K. M.、Graubard, B. I.、Williamson, D. F.、Gail, M. H.(2005)。Excess deaths associated with underweight, overweight, and obesity。The Journal of the American Medical Association,293(15),1861-1867。  new window
3.Wright, J. T.、Williamson, J. D.、Whelton, P. K.、Snyder, J. K.、Sink, K. M.、Rocco, M. V.(2015)。A Randomized Trial of Intensive versus Standard Blood-Pressure Control。The New England journal of medicine,373(22),2103-2116。  new window
4.Mosso, J. L.、Wiederhold, B. K.、Paglia, F. L.、Guarino, D.、Barbera, D. L.(2017)。Study of gender differences in VR response following cardiac surgery。Journal of Psychology and Cognition,2(1)。  new window
5.Silva, D. R.(2017)。Obesity: the verse and the reverse。J Bras Nefrol,39(3),232-233。  new window
6.Varon, J.、Marik, P. E.(2008)。Perioperative hypertension management。Vasc Health Risk Manag,4(3),615-627。  new window
7.Whelton, P. K.、Carey, R. M.、Aronow, W. S.、Casey, D. E.、Collins, K. J.、Dennison, Himmelfarb, C.、Williamson, J. D.、Wright, J. T.(2018)。2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines。J Am Coll Cardiol,71(19),e127-e248。  new window
8.Charlson, M. E.、MacKenzie, C. R.、Gold, J. P.、Ales, K. L.、Topkins, M.、Shires, G. T.(1990)。Intraoperative blood pressure. What patterns identify patients at risk for postoperative complications?。Ann Surg,212,567-580。  new window
9.Esler, M.、Lambert, G.、Schlaich, M.、Dixon, J.、Sari, C. I.、Lambert, E.(2018)。Obesity Paradox in Hypertension:。Hypertension,77(1),22-33。  new window
10.Hartle, A.、McCormack, T.、Carlisle, J.、Anderson, S.、Pichel, A.、Beckett, N.(2016)。The measurement of adult blood pressure and management of hypertension before elective surgery: Joint Guidelines from the Association of Anaesthetists of Great Britain and Ireland and the British Hypertension Society。Anaesthesia,71,326-337。  new window
11.Kristensen, S. D.、Knuuti, J.、Saraste, A.、Anker, S.、Bøtker, H. E.、De, H. S.(2014)。ESC/ESA Guidelines on non-cardiac surgery: Cardiovascular assessment and management. The Joint Task Force on non-cardiac surgery: Cardiovascular assessment and management of the European Society of Cardiology and the European Society of Anaesthesiology。Eur J Anaesthesiol,31,517-573。  new window
12.Ard, J. L.(2016)。Searching for baseline blood pressure: A comparison of blood pressure at three different care points。Journal of Clinical euroscience,34,59-62。  new window
13.Ashwell, M.、Hsieh, S. D.(2005)。Six reasons why the waist-to-height ratio is a rapid and effective global indicator for health risks of obesity and how its use could simplify the international public health message on obesity。International Journal of Food Sciences and Nutrition,56(5),303-307。  new window
14.Chobanian, A. V.、Bakris, G. L.、Black, H. R.、Cushman, W. C.、Green, L. A.、Izzo, J. L.(2003)。National High Blood Pressure Education Program Coordinating Committee。JAMA,289(19),2560-2572。  new window
15.Aloni, Y.、Evron, S.、Ezri, T.、Medalion, B.、Protianov, M.、Szmuk, P.、Sullam, M. M.(2006)。Morbidly Obese Patients are Hemodynamically Stable During Laparoscopic Surgery: A Thoracic Bioimpedance Study。Journal of Clinical Monitoring and Computing,20,261-266。  new window
16.賴奇正、馬光遠、邱春旺、劉俊鵬(20140600)。參與JNC 8的專家們發表之2014年高血壓指引報告。內科學誌,25(3),165-175。  延伸查詢new window
17.陳俞榕、劉建廷、林藍萍、林金定(20141200)。成人高血壓自知率與健康行為相關性:性別差異分析。臺灣老人保健學刊,10(2),156-167。new window  延伸查詢new window
18.黃珊、陳順宇、陳淑華(20151100)。建構手術室病人安全照護作業模式--以手術病人辨識、部位、程序安全為例。健康科技期刊,3(1),52-67。  延伸查詢new window
19.張旺德、何燕、官志忠(2016)。eNOS基因多態性與原發性高血壓的關係。貴陽醫學院學報,41(1),1-4。  延伸查詢new window
20.洪麗珍(19960100)。中老年人血壓及其相關因子之研究--梧棲鎮社區性調查。弘光醫專學報,27,1-15。  延伸查詢new window
21.吳彥(2014)。高血壓患者在圍術期的血壓控制要點。中國醫學前沿雜誌,6(4)。  延伸查詢new window
22.吳瑞堯、周駿賢(20110100)。運用資料探勘技術於六大死因慢性疾病之研究。資訊管理學報,18(1),187-211。new window  延伸查詢new window
23.吳東昇、陳永煌、林易申、王鍾慶、高東煒、張耀文(20140400)。2014成人高血壓治療指引JNC 8簡介。中華職業醫學雜誌,21(2),59-72。  延伸查詢new window
24.吳淑禎、呂萬安(2015)。大專青年腰圍與血脂肪、血液流體力學之相關性研究。中醫藥研究論叢,18(1),13-26。  延伸查詢new window
25.王鴻懿、孫寧玲(2013)。歐洲高血壓管理指南介紹。中國醫學前沿雜誌,5(6)。  延伸查詢new window
26.王文甫(2016)。三角習題--高血壓、腦中風、失智症。血管醫學防治季刊,25,4-6。  延伸查詢new window
研究報告
1.衛生福利部統計處(2016)。105年國人死因統計。  延伸查詢new window
學位論文
1.江正慶(2005)。調整肩部穴位對高血壓患者的療效評估(碩士論文)。南華大學。  延伸查詢new window
圖書
1.World Health Organization(2009)。WHO Guidelines on Hand Hygiene in Health Care。Geneva:World Health Organization。  new window
2.Clive, R. G.、Quick, M. B.、Simon, J. F.、Harper, M. B.(2013)。Essential Surgery: Problems, Diagnosis and Management With STUDENT CONSULT Online Access (Burkitt, Essential Surgery)。  new window
3.鄭宏(2014)。你走進麻醉世界。科學出版社。  延伸查詢new window
其他
1.陳榮基(2018)。血壓的測量,http://www.24drs.com/Special_Report/Hypertension/1020_2_1.asp。  new window
2.王筱萍(20160328)。病人用藥教育--術前用藥管理之一般原則和應用,http://www.taiwan-pharma.org.tw/weekly/1959/1959-5-2.htm。  延伸查詢new window
3.王宗道(2017)。中華民國心臟學會及台灣高血壓學會2017年血壓新標準記者會,https://health.ettoday.net/news/1052070#ixzz57v7z52PA。  延伸查詢new window
圖書論文
1.Blaustein, A. S.、Waxter, L. F.(2002)。Evaluation and management of the perioperative patient。Current diagnosis and treatment in cardiology。Ho-Chi BOOK Publishing Co.。  new window
 
 
 
 
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