| 题名 |
某醫學中心呼吸器依賴病人腹部肌肉力量訓練效果之隨機臨床試驗研究 |
| 并列篇名 |
Effects of abdominal muscle training among ventilator-dependent patients in a teaching hospital: A randomized controlled trial |
| DOI |
10.29827/YBYJZZ.202112_5(1).0001 |
| 作者 |
劉家慧(Chia-Hui Liu)；李玉英(Yu-Ying Li)；李佩蓉(Pei-Lung Lee)；陳昱光(Yu-Kuang Chen)；林柏瑤(Po-Yao Lin)；吳聖良(Shang-Liang Wu)；何莉櫻(Li-Ing Ho)；王靜慧(Ching-Hui Wang) |
| 关键词 |
腹部肌肉力量訓練 ； 呼吸生理功能 ； 獨立生活功能 ； 呼吸器脫離成功發生密度 ； 呼吸器依賴病人 ； abdominal muscle training ； respiratory functioning ； functional independence ； incidence density of successful weaning ； ventilator-dependent patients |
| 期刊名称 |
醫保研究雜誌 |
| 卷期/出版年月 |
5卷1期（2021 / 12 / 01） |
| 页次 |
1 - 12 |
| 内容语文 |
繁體中文 |
| 中文摘要 |
目的：比較有否腹部肌肉力量訓練對呼吸器依賴病人之呼吸生理功能、獨立生活功能及呼吸器脫離成功發生密度的影響。方法：本研究採隨機臨床試驗設計，以某醫學中心亞急性呼吸照護病房呼吸器依賴病人為研究對象，收案期間為2018年4月5日至2019年12月31日。利用EXCEL軟體將受試者隨機分派至實驗組24人與控制組23人；共47人。以腹部肌肉力量訓練做為介入措施，每天早上9點至晚上9點，連續28天，將砂袋放置於兩側髂骨嵴連線與劍突交叉處；於第1天、第7天、第14天、第21天、第28天之當天介入前後，收集呼吸生理功能指標（包括：收縮壓、舒張壓、淺快呼吸指數、最大吸氣壓、最大吐氣壓、潮氣容積等六項）與獨立生活功能，每位樣本共獲得10筆資料；以SPSS之廣義估計方程式（generalize estimating equation, GEE）分析。另，亦以脫離成功發生密度為指標，採存活分析Kaplan-Meier之檢定。結果：實驗組與控制組之樣本具同質性，兩組間在年齡等19個混淆因素均未達統計上顯著差異。兩組呼吸器脫離成功發生密度未達顯著差異；即實驗組之2.20%（人／人天）未顯著高於控制組2.09%（人／人天）；另，腹部肌肉力量訓練當天兩組均未能顯著提升呼吸生理功能的六項指標與獨立生活功能。結論：本次腹部肌肉力量訓練未能有效提升呼吸器依賴病人之呼吸生理功能、獨立生活功能及呼吸器脫離成功發生密度。 |
| 英文摘要 |
Purpose. The objectives of this research were to evaluate the respiratory function, functional independence and incidence density of successful weaning from mechanical ventilation in ventilator-dependent patients who have undertaken abdominal muscle training. Method. A randomized controlled trial design was conducted in patients dependent on long-term mechanical ventilation in a Respiratory Care Center (RCC) of a teaching hospital. A total of 47 subjects were recruited from April 5, 2018 to December 31, 2019; twenty-four patients were randomly allocated into an experimental group and twenty-three patients into a control group. In the experimental group, abdominal muscle training was performed by placing a sandbag between the iliac crest and xiphoid process from 9AM to 9PM continuously for 28-days. We analyzed the respiratory function, which included systolic blood pressure, diastolic blood pressure, rapid shallow breathing index, maximal inspiratory pressure, maximal expiratory pressure and tidal volume etc.; functional independence at 1, 7, 14, 21 and 28 days, using the generalized estimating equation (GEE); and incidence density of successful weaning using the Kaplan-Meier method. Result. There were no significant differences between the two groups in terms of nineteen variables. The average age of participants was 76.2±15.1 years old, more than half of which were males (63.8%). The average albumin level was 3.3 ± 0.4 g/dl; functional independence was 1.2 ± 0.4; FiO2 was 28 ± 5.6 %; length of stays before RCC was 31.2 ± 34.7 days; length of MV use before RCC was 24.0 ± 9.4 days; average APACH II was 21.3 ± 4.8; smoking status (27.7 %), endotracheal tube (66 %), tracheal tube (34 %), use of sedative drugs (44.7 %), respiratory diseases (66 %), CAD (17 %), HTN (29.8 %), ICH (8.5 %), CVA (12.8 %), anemia (10.6 %), CKD (19.1 %), HF (14.9 %). The incidence density of successful weaning (2.20%; person/person-days) in experimental group was not significantly higher than control group (2.09%; person/person-days). There were no significant differences between the two groups in terms of respiratory function and functional independence. Conclusions. Abdominal muscle training can't improve the respiratory function, functional independence and the incidence density of successful weaning for ventilator-dependent patients. |
| 主题分类 |
醫藥衛生 >
預防保健與衛生學 醫藥衛生 > 社會醫學 |
| 参考文献 |
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