95 慢性阻塞性肺疾病病人 低效性呼吸型態 之護理 1 國軍台中總醫院加護病房護理師 陳慧雯 1 李雅欣 2 王桂芸 3* 2 國防醫學院護理系講師 護理部副主任暨國防醫學院護理系兼任教授 3 台北榮民總醫院 摘要 : 慢性阻塞性肺疾病 (chronic obstructive pulmonary disease, COPD) 為一長期 慢性 且無法完全恢 復的呼吸道疾病, 病人必須終身與此疾病共存 此類病人常因疾病特性而影響其正常的 通氣 功能, 當病人吸氣或吐氣無法提供足夠的通氣, 無法維持肺部適當的擴張和收縮, 就會產生 低 效性呼吸型態 的問題, 長久下來不但會造成病 人生理 心理與行為的改變, 更可能影響個體之 情緒 活動及生活品質, 護理人員要處理慢性阻 塞性肺疾病病人之 低效性呼吸型態 的問題, 必須從造成的原因著手, 包括改善呼吸肌功能 改善肺擴張受限情形及維持呼吸道通暢三方面, 因此筆者針對相關議題統合相關實證文獻, 期能 作為臨床護理人員在照護此類病人的參考 關鍵詞 : 慢性阻塞性肺疾病 低效性呼吸型態 照護 chronic obstructive pulmonary disease, COPD Rabe et al., 2007 2003 COPD COPD COPD COPD COPD Rabe et al., 2007 COPD COPD 100 5 30 * 11217 201 02 28757233
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97 COPD ㈠ corticosteroid Rabe et al., 2007 ㈡ 77% COPD active cycle breathing Tang, Taylor, & Blackstock, 2010 Lapin, 2002 Crowe, Geddes, Brooks, & Reid, 2006 BiPAP 2009 Crowe et al., 2006 COPD ㈠ body mass index, BMI muscle mass fat-free mass COPD Girón et al., 2009 COPD Weekes, Emery, & Elia, 2009 COPD 1.5~2g COPD Cai et al., 2003 COPD Progestogens megestrol acetate cytokine Weisberg et al., 2002 ㈡ 1 2 1 3 Crowe et al., 2006 2003 100
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100 COPD and Ineffective Breathing Pattern Ineffective Breathing Pattern Care for COPD Patients Hui-Wen Chen 1 Ya-Hsin Lee 2 Kwua-Yun Wang 3 * 1 RN, MSN, Intensive Care Unit, Taichung Armed Forces General Hospital; 2 RN, MSN, Instructor, School of Nursing, National Defense Medical Center; 3 RN, PhD, Assistant Director, Department of Nursing, Taipei Veterans General Hospital & Adjunct Professor, School of Nursing, National Defense Medical Center. Abstract: Chronic obstructive pulmonary disease (COPD) is a long-term, chronic respiratory disease from which patients never fully recover. COPD patients usually face abnormal aeration caused by the disease. Patients that are unable to breathe and aspirate adequately and maintain lung appropriate expansion and contraction are considered to have ineffective breathing patterns. This causes physical, psychological and behavioral changes in COPD patients and impacts their emotional condition, daily activities and quality of life. Nurses who care for COPD patients with ineffective breathing patters can improve breathing muscle functions, improve respiration and keep the airway clean. In this paper, the author reviews and integrates relevant findings on this subject from the empirical literature in order to assist clinical nurses responsible for the care of COPD patients. Key Words: chronic obstructive pulmonary disease (COPD), ineffective breathing pattern, care. Accepted for publication: May 30, 2011 *Address correspondence to: Kwua-Yun Wang, No. 201, Shipai Rd. Sec. 2, Beitou District, Taipei City 11217, Taiwan, ROC. Tel: +886 (2) 2875-7233; E-mail: kywang7@vghtpe.gov.tw