影響心臟手術後病人早期拔除氣管內插管之因素

An Exploratory Study of the Factors of Early Extubation agrer Cardiac Surgery

本研究為回溯性設計，目的是探討心臟手術術後病人早期拔除氣管內插管的影響因素，以臺灣地區某醫學中心之成人心臟外科加護中心的病人為研究個案，取樣對象為民八十七年一月至十二月曾接受冠狀動脈繞道手術或心臟瓣膜手術並已移除氣管內插管之病人共161位。結果發現術前、術中、術後等多變項會影響心臟手術術後病人早期拔除氣管內插管，這些影響因素包括病人的年齡、術中的出血量、術後的動脈血酸鹼值及病人身體水份平衡狀態等，亦即當病人年齡小於60歲、手術中出血量小於1000毫升及手術後動脈血酸鹼值大於7.35、身體水份處於負平衡狀態時早期拔管的機率增加。研究結果可為臨床擬定心臟手術術後患者早期拔管邏輯圖(early extubation algorithm)之參考

A retrospective study was designed to investigate the factors of early extubation after cardiac surgery. The samples for this study consisted of 161 patients in cardiovascular CU who had coronary artery bypass graft surgery or vavular surgery in 1998. The major findings were as the follows: age(<60)、amount of intraoperative bleeding less than 1000ml、normal acid base status(PH value) and negative fluid balance are the factors of early extubation(<24 hrs) after cardiac surgery. The end of this result will pilot the early extubation algorithm and guide the health care team members through the multiple steps and decision making points on the way to safe and timely extubation of the patients after cardiac surgery.