臺灣博碩士論文加值系統

研究背景：壓力性損傷不但直接造成個體疼痛與焦慮等負向情緒、活動受限、生活品質下降、甚至因病菌侵襲引起敗血性休克與危及生命。目前對傷口癒合評估多採用視覺與經驗性的評估，無法早期發現傷口變差或壞死，對於傷口管理與介入措施之時機也缺乏客觀指標。
研究目的：探討紅外線熱成像在壓力性損傷之傷口癒合進展變化，了解傷口溫度與傷口癒合進展之相關因素。
研究方法：本研究採觀察性研究設計，研究對象採立意取樣，於南部某醫學中心確認為壓力性損傷病患，納入Gr.2-4級壓力性損傷傷口，研究工具包含紅外線熱成像儀、PUSH tool壓力性損傷傷口癒合量表與Braden scale壓力性損傷傷口風險評估量表，透過常規標準傷口換藥，持續評估壓力性損傷傷口進程。研究資料以描述性統計、變異數分析、卡方檢定與廣義估計方程式模式（GEE）進行分析。
研究結果:本研究納入 37名對象,50個壓力性損傷傷口部位，共248筆紅外線熱成像溫度紀錄進行資料分析。研究發現以65歲以上老年人居多，好發尾骨、坐骨與背部等處，近半數落在體重過輕的範圍、具高風險營養不良與慢性共病症的危險因子。
在傷口床、傷口邊緣之溫度上，不同等級的傷口溫度有顯著差異，而傷口周圍皮膚的溫度，無論哪一個等級的壓力性損傷傷口下並無相關。傷口溫度高低與傷口進展有關，傷口邊緣溫度較高者，其傷口癒合較低溫者佳。影響傷口癒合相關的因素中，唯有溫度與傷口癒合過程有顯著相關。
結論： 不同等級的傷口，其傷口床及傷口邊緣之溫度有顯著差異，且傷口邊緣的溫度高與傷口癒合進展成正相關。紅外線熱成像能客觀呈現傷口溫度變化，可做為評估壓力性損傷傷口癒合過程之參考指標。

Pressure injury not only causes pain, limited mobility, reduced quality of life, negative emotions such anxiety, but may also lead to bacteria-induced septic shock and life-threatening medical conditions.
This Longitudinal, observation study finds the association of temperature and the progress of wound healing. This study recruited 37 participants with a total of 50 pressure injury wounds. Subsequently, data analysis was performed using 248 infrared thermography temperature records. linear model, In terms of wound beds and periwound temperature, wound temperature differed significantly with pressure injury of varying levels. The wound-edge skin temperature was not related to the pressure injury grade. Wound temperature was related to the wound healing progress, and higher periwound temperature witnessed more favorable wound healing results. Of factors related to wound healing, only temperature was significantly correlated with wound healing.

Keyword: infrared thermography;pressure injury

目錄
摘要 I
Extended Abstract II
致謝 V
目錄 i
表目錄 iii
圖目錄 iv
第一章 緒論 1
第一節 背景 1
第二節 重要性 2
第三節 研究目的 3
第二章 文獻查證 3
第一節 壓力性損傷 3
第二節 紅外線熱成像之應用 5
一、紅外線與熱輻射基本原理 5
二、溫度與紅外線熱成像之相關性 5
第三節、紅外線熱成像在生物醫療運用 7
第四節、壓力性損傷與紅外線熱像儀的相關文獻與臨床研究 8
第三章 研究方法 10
第一節 研究設計 10
第二節 研究對象與地點 10
第三節 名詞定義 11
一、壓力性損傷（Pressure injury） 11
二、傷口癒合過程（Wound healing process） 11
三、紅外線熱成像下壓力性損傷傷口溫度呈現 12
四、壓力性損傷傷口溫度高低溫組 13
第四節 研究工具 14
一、人口學特性及臨床資料 14
二、紅外線熱成像（Infrared thermography） 14
三、壓力性損傷傷口癒合測量評估工具-PUSH TOOL3.0 15
四、壓力性損傷危險因子評估風險工具-Braden scale 16
第五節 資料收集 16
第六節 資料分析 19
第四章 研究結果 19
第一節 壓力性損傷人口學屬性與壓力性損傷傷口特性 19
第二節 壓力性損傷在壓力性損傷評估量表之相關 22
第三節 各等級壓力性損傷傷口溫度之相關 23
第四節 紅外線熱成像下溫度與壓力性損傷傷口癒合之相關 24
第五節壓力性損傷傷口癒合的相關因素 25
第五章 討論 27
第一節 壓力性損傷 27
第二節 壓力性損傷傷口等級與傷口溫度變化 27
第三節 壓力性損傷傷口溫度差異與傷口癒合 28
第四節 影響壓力性損傷傷口癒合之相關因素 28
第六章 研究限制 29
第七章 結論與建議 30
參考文獻 31
附件 37


表目錄
表一 壓力性損傷傷口資料收集行程表 18
表二 壓力性損傷人口學與臨床特性 20
表三 壓力性損傷傷口特性 22
表四 不同壓力性損傷傷口其PUSH與Braden 量表呈現 23
表五 不同壓力性損傷之傷口與紅外線熱成像溫度之相關 24
表六 高低溫組與傷口癒合相關性 25
表七 壓力性損傷影響傷口癒合與各變項分析 26
表八:臨床資料數據表 37
表九:壓力性損傷傷口癒合測量量表PUSH Tool 38
表十:壓力性損傷危險因子評估量表Braden scale 39

圖目錄
圖1 紅外線熱成像傷口顯示圖 12
圖2 高溫組(IRTp〉IRTc) 13
圖3 低溫組(IRTp〈IRTc) 13
圖4 紅外線熱成像儀 14
圖5 溫濕度測量計 18

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