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來源資料
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題名 | 某醫學中心內外科成人加護中心病患自拔氣管內管之相關因素探討=Factors Related to Self-Extubation of Endotracheal Tube in Adult Intensive Care Unit |
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作者 | 張玲華; 何善台; 張秉宜; 蔣偉瑋; 游蕙菁; | 書刊名 | 中華民國重症醫學雜誌 |
卷期 | 4:3 2002.07[民91.07] |
頁次 | 頁162-170 |
分類號 | 415.415 |
關鍵詞 | 加護中心; 病患自拔氣管內管; 危險因子; Intensive care units; Patients' self extubation; Risk factors; |
語文 | 中文(Chinese) |
中文摘要 | 本研究為敘述性之研究,目的在探討某醫學中心内、外科成人加護中心病患自拔氣管内管的危險因子。研究結果得知:(一)88年8月至89年7月住加護中心氣管内管插管病人數共1152人次,有64位病患發生自拔氣管内管,自拔管發生率為5.6%,其中内科加護中心自拔管發生率高於外科加護中心;(二)病患自拔管均是發生於護理員不在病患床邊時,以夜班頻率最高(50%),且當護理員照護病人數較多時較易發生;(三)64位病患自拔管中以男性居多(70.3%),但女性病患的蓄意自拔管卻高於男性病患(p<0.005);(四)自拔管病患中分別有79.7%及84.4%未使用鎮定劑及止痛劑,其中又以内科加護中心更為明顯(p<0.001);(五)執行口部插管之病患其自拔管意圖較強且較易發生自拔管,甚至會有二度自拔管發生(p<0.001);(六)使用氣管内管超過48小時較易發生病患自拔管(70.3%),且其發生與病患之蓄意企圖有關(p<0.005);(七)有54.7%病患自拔管後需再重新插管以維持呼吸功能。 |
英文摘要 | A descriptive stud was conducted in both medical and surgical ICUs to explore risk factors related to patients' self-extubation. The following results were found: (1) Sixty four incidents were recorded in a total of 1152 intubations (5.6%); one half happened during night shift. 70.3% of incidents happened later than 48 hours after intubation which was highly related to intentional self-extubation (p<.005). (2) Male patients had a higher rate of self-extubation (70.3%), yet females had more intentional self-extubations (p<.005). (3) Patients not receiving sedatives or analgesics had higher self-extubation rates, 79.7% and 84.4%, respectively, and medical patients dominated (p<.001). (4) Using an oral endotracheal tube was highly related to intentional self-extubation (p<.005) as well as to repeated self-extubation (p<.001). (5) 54.7% of self-extubation needed to be reintubated to maintain respiration. |
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