臺灣博碩士論文加值系統

腦中風一直高居十大死因的前三位，有三分之一的患者造成殘疾，帶給社會或個人、家庭沈重的醫療負擔。近年由於高血壓防治已有顯著的成效，腦梗塞的死亡率比腦出血下降許多，但存活者常留下不可治癒的失能，不僅造成病患本身的痛苦也增加家庭與社會的負擔。而腦中風的原因與治療過程不盡相同，由於中風會導致個人感覺、運動、認知及情感功能上的改變，造成個人暫時性或永久性的功能障礙。中風後倖存的個案，約有30~50%會殘留中度至重度的失能障礙，造成日常生活皆需他人協助。本研究以資料探勘技術為核心，建置腦中風臨床生理功能所造成的缺失評估與中風發生之危險因子的變異性進行探討。於2010年5且2013年4月期間，以北部某醫學中心急診室之護理資訊系統資料進行分析，包含病人的人口學、慢性疾病、健康行為、日常生活功能及平均住院天數等相關的統計資料，研究目的在於探討中風病人特性要因並針對健康行為與危險因子進行相關探討，另外由樣本群體找出中風後對日常生活影響及依賴程度的關係。本研究內容應用SPSS18.0之系統分析。其結果，中風病人以男性較多占61.7%，65歲以上者占54.6%，出血性中風較梗塞性多占84.4%，兩類中風病人都可能因失能而導致日常生活呈現中度至嚴重的依賴他人。以卡方檢定後發現，BMI值、疾病類型、與性別在統計上達顯著性。以健康行為(抽菸、喝酒)和慢性疾病(心臟病、高血壓、高血脂、糖尿病)的關係，其中心臟病及糖尿病在統計上達顯著性。結果顯示，病人有抽菸及喝酒者，有1-12倍不等可能發生慢性疾病的危險性。經各類變項進行相關推論結果，顯示中風疾病類型與mRS、BI、心臟疾病、家族史及慢性疾病者在統計上達顯著性(P<0.01)。再以Liner regression進行迴歸分析發現，心臟疾病是梗塞性中風疾病的最大影響因子(95%CI介於0.282-0.617)，而出血性中風對於日後日常生活BI的影響最多(95%CI介於1.128-1.729)。期待能將以上的研究結果，提供於臨床照顧病人較客觀具體的參考資訊，可協助病人及家屬能獲得更高的生活品質。

Stroke has been ranked as top three most common cause of death in Taiwan, one-third of the patients resulting in disability, social or bring individuals, families got heavy medical burden. Has been remarkable advancement in recent years due to the effectiveness of prevention and treatment of hypertension, cerebral infarction, cerebral hemorrhage mortality decline than past, but survivors often incurable disability leave, not only cause pain but also increase the burden on the patient's family and the community, and the brain the reason and treatment of stroke vary due stroke can cause personal feeling, changing motor, cognitive and emotional function on, resulting in temporary or permanent personal dysfunction . After surviving a stroke cases, about 30 to 50 percent will be left with moderate to severe disability, resulting in daily life who must be helped by others. In this study, data mining technology as the core, the variability of risk factors occurring physiological functions build stroke caused by clinical evaluation and stroke investigate. In May 2010 and April 2013 period to care information system data in a medical center emergency room for analysis, relevant statistics data demographics, chronic diseases, health behaviors, activities of daily living and the average length of stay included patients.
The purpose is to explore the characteristics of stroke patients and for the health behavior due to discuss disease-related factors, the relationship between post-stroke by the sample group to identify the impact on daily life and the degree of dependence. The research application of systems analysis SPSS18.0. As a result, many stroke patients to 61.7% in men over 65 years old accounted for 54.6%, hemorrhagic stroke accounted for 84.4% as compared to Brain-infarct. After conducting the chi-square test was found, BMI values, disease type, and gender was statistically significant. Health behaviors (smoking, drinking), and the relationship between chronic diseases (heart disease, high blood pressure, high cholesterol, diabetes), heart disease and diabetes, which was statistically significant. The results showed that those patients with smoking and drinking, there may occur 1-12 times ranging from chronic diseases dangerous. After all kinds of variables associated corollary, showing the type of disease and stroke mRS, BI, heart disease, HD, and family history of chronic diseases was statistical significant (P <0.01). Then Liner regression regression analysis found that heart disease is the biggest factor infarction stroke disease (95% CI ranged from 0.282-0.617), up to hemorrhagic stroke for the future BI impact everyday life (95% CI ranged from 1.128 -1.729). The results of studies provide a more objective clinical patient care for specific reference information to help patients and their families can get a higher quality of life.

誌謝 II
論文摘要 III
ABSTRACT IV
目錄 V
圖目錄 VI
表目錄 VII
第一章 緒論 1
第一節 研究背景及動機 1
第二節 研究目的 2
第三節 研究範圍 3
第四節 研究流程 4
第二章 文獻探討 5
第一節 腦中風定義 5
第二節 中風病人與健康行為的影響 8
第三節 腦中風病人基本特質的影響 10
第四節 中風疾病相關的危險因子 11
第五節 中風病人失能的評估工具 14
第六節 資料探勘技術 16
第三章 研究方法 19
第一節 研究架構 19
第二節 研究假設 21
第三節 研究工具 21
第四節 資料處理與分析 23
第四章 研究結果 32
第一節 描述性統計分析 32
第二節 相關推論性統計分析 39
第三節 疾病診斷與慢性疾病之相關性推論統計分析 46
第五章 結論與建議 51
第一節 人口學方面 51
第二節 健康行為方面 52
第三節 中風病人失能障礙與慢性疾病 53
第四節 研究限制 55
第五節 未來建議與臨床應用 55
參考文獻 57
附錄一 modified Rankin Scale (mRS) 64
附錄二 巴氏量表(Barthel Index) 65

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