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研究生:張永坤
研究生(外文):Yung-Kuan Chang
論文名稱:階層式i-PainSystem應用於病患自控式止痛之分析研究
論文名稱(外文):A Hierarchical i-Pain System Applied in Patient-Controlled Analgesia Analysis
指導教授:謝建興
指導教授(外文):Jiann-Shing Shieh
學位類別:碩士
校院名稱:元智大學
系所名稱:機械工程學系
學門:工程學門
學類:機械工程學類
論文種類:學術論文
論文出版年:2006
畢業學年度:94
語文別:中文
論文頁數:58
中文關鍵詞:術後止痛病患自控式止痛PDA網際網路資料庫
外文關鍵詞:Postoperative pain reliefPatient-Controlled AnalgesiaPDAInternetDatabase
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手術後的疼痛常會影響病患在恢復期的生理及心理,若術後止痛之效果不佳,容易讓病患對醫師產生不信任感。因此,如何減輕手術後的疼痛,讓病患能夠舒適地復原一直是麻醉醫師們努力的目標。要想有效地控制疼痛,則必須先做到有效的疼痛評估。過去醫護人員為收集病患資料花費太多時間在文書紀錄方面,為達更方便、更迅速取得病患資料的方法,本系統結合個人電腦、PDA、病患自控式止痛技術、以及網際網路,架設了一個龐大的階層式疼痛資料庫。不僅可以讓醫護人員對術後止痛之訪視更加方便,也讓醫師能夠更輕易地取得並分析病患資料,藉以將最佳止痛法更快速地回饋於病患,達到臨床治療的目的。
Postoperative pain always influences patients'' physiology and psychology in convalescence. If the result of pain control isn''t achieved the expectation, it is apt to let patients'' distrust to the doctor. Therefore, how to remit the postoperative pain and let the patients recover comfortably is always the goals that doctor want to achieve. It must make sure first the influence of pain is assessed if doctors want to control pain effectively. The medical personnel cost a lot of time to collection the document when they collect patients'' data in the past. In order to find the method to get patients'' data more conveniently and rapidly, this system combines PC, PDA, technology of patient-controlled and internet network to build a hierarchical i-Pain system database. It is not only more convenient to visit patients but doctor can analyze patients'' data more easily. Furthermore, doctor can feedback the best algorithm of pain relief to the patients and achieve the clinical and therapeutical purpose.
封面…………………………………………………………………… i
書頁名………………………………………………………………… ii
中文摘要………………………………………………………………iii
英文摘要………………………………………………………………iv
目錄…………………………………………………………………… v
表目錄…………………………………………………………………vi
圖目錄…………………………………………………………………vii

第一章、緒論……………………………………………………………1
1.1 研究背景………………………………………………………1
1.2 文獻回顧………………………………………………………1
1.3 研究目的………………………………………………………2
第二章、i-Pain System之架構……………………………………… 4
第三章、病患資料收集…………………………………………………7
3.1 病患自控式止痛………………………………………………7
3.2 PCA資料收集………………………………………………… 9
3.3 例行之病患訪視紀錄……………………………………… 10
第四章、PDA訪視系統…………………………………………………12
4.1 PDA與醫療………………………………………………… 12
4.2 Windows CE 與程式設計……………………………………13
4.3 PCA使用紀錄之收集…………………………………………14
4.4 電子化之訪視紀錄………………………………………… 15
4.4.1 VAS與BPI………………………………………………… 16
4.4.2人性化介面…………………………………………………19
4.5疼痛醫療建議系統……………………………………………21
第五章、工作站系統………………………………………………… 23
5.1 PCA與PDA之資料彙整……………………………………… 23
5.2 麻醉藥品紀錄單…………………………………………… 24
5.3 上傳機制…………………………………………………… 25
第六章、WEB Server………………………………………………… 27
6.1 WEB Server之基本架構…………………………………… 27
6.1.1 ASP(Active Server Pages)………………………… 27
6.2 資料管理介面……………………………………………… 28
6.3 下載機制…………………………………………………… 30
第七章、病患生理訊號分析………………………………………… 32
7.1 誘發電位…………………………………………………… 32
7.2 Evoked pain pattern………………………………………32
7.3 實驗流程與方法…………………………………………… 34
7.4 無效數據…………………………………………………… 39
第八章、結論………………………………………………………… 41
8.1 結論………………………………………………………… 41
8.2 未來展望…………………………………………………… 41

參考文獻……………………………………………………………… 44
附錄1:簡易疼痛量表…………………………………………………47
附錄2:工作站系統輸出之表單
表一:病患自控式止痛法使用麻醉藥品醫囑單……………… 49
表二:住院病患自控式止痛法使用麻醉藥品紀錄表………… 50
表三:居家護理自控式止痛法使用麻醉藥品紀錄表………… 51
表四:病患自控式止痛法麻醉藥品報銷單…………………… 52
附錄3:Evoked pain pattern群組分析與各參數資料表
表一:手術後4小時之各群組參數表……………………………53
表二:手術後24小時之各群組參數表………………………… 56
[1]Sriwatanakul K, Weis OF, Alloza JL, Kelvie W, Weintraub M and Lasagna L, “Analysis of narcotic analgesic usage in the treatment of postoperative pain”, JAMA, vol.250, pp. 926-929, 1983.
[2]Weis OF, Sriwatanakul K, Alloza JL, Weintraub M and Lasagna LA, “Attitudes of patients, housestaff, and nurses toward postoperative analgesic care”, Anesth Analg, vol.62 , pp. 70-74, 1983.
[3]Donovan M, Dillon P and McGuire L, “Incidence and characteristics of pain in a sample of medical-surgical inpatients”, Pain, vol.30, pp. 69-78, 1987.
[4]隋善中,“手術後疼痛影響因素及疼痛管理之探討---以某醫學中心為例”,國立台灣大學,91學年度
[5]李梅琛,賴裕和,陳美伶,劉淑娟,“病人疼痛特質與疼痛信念對手術後使用止痛藥物之影響”,護理雜誌,第四十八卷 第一期
[6]楊曜臨,張淑真,陳宗鷹,“病人術後自控式疼痛控制”,慈濟醫學, 第17卷第6期,51-55頁,2005年
[7]Chin HC, Shieh JS, Wen YR, Sun WL, “The data mining of a patient-controlled analgesia (PCA) machine using fuzzy logic theory”, Annual Meeting of Chinese Association for The Study of Pain, Vol. 13, No. 1, pp. 11-12, 2003.
[8]Shieh JS, Dai CY, Wen YR, Sun WZ, “Clinical survey of the novel fuzzy pain intensity index for the assessment of postoperative pain via patient-controlled analgesia”, Annual Meeting of Chinese Association for The Study of Pain on “Multi-disciplinary Approach to Pain”, April 10-11, Taichung, Taiwan, pp. 166-167, 2004.
[9]蘇雅妮、謝建興、張永坤、孫維仁,“PDA 應用在病患自控式止痛的巡房系統之研發”,中華民國94年度生物醫學工程科技研討會暨國科會醫工學門成果發表會大會,pp.93,2005.
[10]http://www.kmuh.org.tw/www/kmcj/data/9312/14.htm
[11]Sechzer PH, “Studies in pain with the analgesic-demand system”, Anesth Analg, vol.50, pp. 1-10, 1971.
[12]Forrest WH , Smethurst PW and Kienitz ME, “Self-administration of intravenous analgesics”, Anesthesiology, vol.33, pp. 363-365, 1970.
[13]Keeri-Szanto M, “Apparatus for demand analgesia”, Can Anaesth Soc J, vol.18, pp. 581-582, 1971.
[14]Tamsen A, Hartvig P, Dahlstrom B, Lindstrom B and Holmdahl MH, “Patient controlled analgesic therapy in the early postoperative period”, Acta Anaesthesiol Scand, vol.23, no.5, pp. 462-470, 1979.
[15]Burns JW, Hodsman NB, McLintock TT, Gillies GW, Kenny GN and McArdle CS, “The influence of patient characteristics on the requirements for postoperative analgesia. A reassessment using patient-controlled analgesia”, Anaesthesia, vol.44, no.1, pp. 2-6, 1989.
[16]Kluger MT, Owen H, “Patients'' expectations of patient-controlled analgesia”, Anaesthesia, vol.45, no.12, pp. 1072-1074, 1990.
[17]McQuay HJ, Bullingham RE, Moore RA, Evans PJ and Lloyd JW, “Some patients don''t need analgesics after surgery”, Journal of the Royal Society of Medicine, vol.75, no.9, pp. 705-708, 1982.
[18]Parker RK, Holtmann B and White PF, “Patient-controlled analgesia. Does a concurrent opioid infusion improve pain management after surgery?”, JAMA, vol.266, no.14, pp. 1947-1952, 1991
[19]王進德,“Pocket PC 2002程式設計實務”,全華科技圖書,台北,民國91年
[20]Cleeland CS, “Measurement and prevalence of pain in cancer”, Semin Oncol Nurs, vol.1, no.2, pp. 87-92, 1985.
[21]Cleeland CS, “Pain assessment in cancer”, In: Effects of Cancer on Quality of Life, Osoba D (ed.) Boca Raton, Florida:CRC Press, vol.21, pp. 293-305, 1991
[22]Cleeland CS, Ryan KM, “Pain assessment: global use of the Brief Pain Inventory”, Ann Acad Med Singapore, vol.23, no.2, pp. 129-138, 1994
[23]Vander AJ, Sherman JH, and Luciano DS, “Human physiology”, McGraw-Hill, 1994
[24]Spehlmann R, “Evoked Potential Primer-visual, auditory, and somatosensory evoked potentials in clinical diagnosis”, Butterworth Publishers, 1985.
[25]Iselin-Chaves IA, El Moalem H, Gan TJ, Ginsberg B, Dufore S R N and Glass PS, ”Changes in the auditory evoked potentials and the bispectral index following propofol or propofol and alfentanil”, Anesthesiology, vol.92, no.5, pp. 1300-1310, 2000
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