臺灣博碩士論文加值系統

背景：
冠狀動脈繞道行體外循環術之心律異常被視為一項嚴重的合併症，且可能導致術後預後不佳，此外，這些受心律異常影響的病患有可能增加疾病發病率及死亡率，本研究主要評估病患接受了冠狀動脈繞道行體外循環術之心律異常因素。
方法：
本篇為回溯性研究，在2015年1月至12月期間於馬偕紀念醫院招募47位接受冠狀動脈繞道行體外循環之病患。首先，我們用年齡層將病人分成兩個組群，其為 Group I (老年期病患  65歲) 與Group II (成年期病患 ≤ 64歲)；其次，我們將進一步分析有相關心律異常的組群，將其再分為兩個次群組Group A (病患有心律異常) 與Group B (病患無心律異常)，其心律異常風險因素將進一步被分析。
結果：
Group I病患平均年齡(73.25 ± 7.17 歲) 明顯高於Group II，而老年期冠狀動脈繞道行體外循環術病患之心律異常總發生率為33.3%。本研究發現手術時間（213.88±59.74 min）與心律異常有顯著相關性，並運用接受者操作特徵曲線分析顯示，當手術時間超過170分鐘時，其心律異常被視為一個敏感性切點。
結論：
在本研究中，我們證實老年期病患是心律異常的高風險群，體外循環技術與心律異常無關。因此，我們證實當手術時間超過170分鐘時，將增加老年期心律異常的風險。

Background：
Dysrhythmia is a serious complication associated with on-pump Coronary artery bypass grafting surgery (CABG) and can yield poor prognoses after CABG surgery. In addition, affected patients may be at an increased risk of morbidity or mortality. This study evaluated on-pump CABG arrhythmogenic factors among patients who had undergone this type of surgery.
Methods：
This retrospective study recruited 47 patients admitted to Mackay Memorial Hospital from January to December 2015. We initially divided the patients into two groups based on age: Group I (elder patients aged  65 years old) and Group II (adults aged ≤ 64 years old). Second, we formed a relative dysrhythmia group for further analysis, which was divided into two subgroups: Group A (patients with dysrhythmia) and Group B (patients without dysrhythmia). The risks were further analyzed.
Results：
The mean age of the patients in Group I (73.25 ± 7.17 years) was considerably higher than in Group II. The overall incidence of dysrhythmia was 33.3% in elder patients who had undergone on-pump CABG. This study found that surgery length (213.88 ± 59.74 min) was significantly associated with dysrhythmia. A receiver operating characteristic curve analysis revealed that a sensitivity cutoff point is obtained when the surgery period is longer than 170 min.
Conclusions：
In this study, we demonstrated that elder patients are a high-risk group for dysrhythmia and CPB technique isn’t related to dysrhythmia. Moreover, we demonstrated that the risk of dysrhythmia in elder patients increases when the surgery period is longer than 170 min.

致謝 i
中文摘要 ii
英文摘要 iv
目錄 vi
第一章 研究介紹 1
第二章 研究方法 3
第三章 研究結果 7
第四章 討論 10
第五章 結論 14
第六章 研究限制 15
第七章 期刊論文 16
參考文獻 32
圖目錄 38
表目錄 43
附錄 47

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