跳到主要內容

簡易檢索 / 詳目顯示

回結果列表
研究生： 毛席容
Xirong Mao
論文名稱： 關於心臟外科冠狀動脈旁路搭橋手術加護病房譫妄發病率之資料探勘
Data mining about related factors of Postoperative delirium Morbidity in CABG
指導教授： 吳立青
口試委員:
學位類別： 碩士
Master
系所名稱： 生醫理工學院 - 系統生物與生物資訊研究所
Graduate Institute of Systems Biology and Bioinformatics
論文出版年： 2015
畢業學年度： 103
語文別： 英文
論文頁數： 37
中文關鍵詞： 冠狀動脈繞道手術 、譫妄 、關聯性 、發病率
相關次數： 點閱：11  下載：0 
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報

    • 冠狀動脈搭橋術(冠狀動脈繞道手術)，即冠狀動脈旁路移植術，簡稱冠脈搭橋或搭橋，是一項緩解心絞痛和減少冠心病死亡風險的手術。搭橋所用的動脈或靜脈均來自患者自身（乳內動脈、橈動脈、胃網膜右動脈、大隱靜脈）。將血管橋接於冠狀動脈，以繞過冠脈粥樣硬化狹窄部，從而提高冠脈灌注，增加心肌氧供。這項手術通常在心臟停搏下進行，需使用體外循環支持; 而搭橋手術也可在跳動的心臟上進行，所謂的“非體外循環”手術。該手術術後會有和其他手術一樣的併發症，比如術後譫妄，一些研究表明，譫妄是指一組綜合征，又稱為急性腦綜合征，表現為意識障礙，行為無章，沒有目的、注意力無法集中。通常起病急，病情波動明顯，該綜合征常見于老年患者。患者的認知功能下降，覺醒度改變、感知覺異常、日夜顛倒。嚴格來說譫妄並非一種疾病，而是由多種原因導致的臨床綜合征。本文中我們通過簡短智能測驗（MMSE）的指標來檢測術後病患的智能情況。進而分析其與術後病患本身以及加護病房中因素的關係。

    Coronary artery bypass grafting (CABG operation), which is also called coronary artery bypass grafting, referred to as coronary bypass or bypass, is a relief of angina and reduce the risk of death from coronary heart disease operation. The bypass artery or vein were derived from the patient’s own (internal mammary artery, radial artery, right gastroepiploic artery, saphenous vein). The operation bridges the blood vessel on coronary artery to get around the coronary atherosclerotic stenosis, improve coronary perfusion, and increase myocardial oxygen supply. This operation is usually performed in cardiac arrest, requiring the use of cardiopulmonary bypass support; and bypass surgery can also be performed on the beating heart, the so-called “off-pump” operation. Same as other operation, CABG gets risk of coronary artery bypass grafting. For example, the Postoperative delirium, some research shows that delirium is a group of syndrome, also known as acute brain syndrome, the expression is recognizant obstacle, behavior no chapter, no purpose, inability to concentrate. To be strict, delirium is not a disease but clinical syndrome caused by a variety of reasons. In this paper we use MMSE to evaluate the intelligent condition of patients after operation, then analysis the relationships between MMSE and the condition of patients themselves or the ICU.

    English Abstract i Chinese abstract ii Chapter 1 Instruction 1 Chapter 2 Methods and Material 1 2-1 Mini-mental state examination 1 2-2 WEKA 4 2-3 Tendency of the attributes 4 2-4 Decision tree 5 2-5 C4.5 Algorithm 6 2-6 Cross-validation 7 2-7 Sampling 7 2-8 Chi-square test 8 Chapter 3 Results 10 3-1 Data Preprocessing 10 3-1-1 Blood pressure 10 3-1-2 Days stay in ICU 11 3-1-3 Days stay in Hospital 11 3-1-4 Age 11 3-1-5 Complications and disease history 11 3-1-6 Marriage 11 3-1-7 Smoking and Drinking 12 3-1-8 MMSE 12 3-1-9 DRS 13 3-1-10 EF before/after op 13 3-1-11 Cr 14 3-1-12 Position of the bed 14 3-2 The result of WEKA 16 3-3 The result of Chi-square test 20 3-3-1 Age and Days in hospital 20 3-3-2 The position of bed 21 3-4 The result of combination of attributes 22 Chapter 4 Discussion 24 References 25

    1. V. C. Pangman, J. Sloan, L. Guse, An examination of psychometric properties of the mini-mental state examination and the standardized mini-mental state examination: implications for clinical practice. Applied nursing research : ANR 13, 209-213 (2000); published online EpubNov (10.1053/apnr.2000.9231).
    2. M. N. Tombaugh TN, The mini-mental state examination: a comprehensive review. JAGS 40, 922-935 (1992).
    3. J. P. Tuijl, E. M. Scholte, A. J. de Craen, R. C. van der Mast, Screening for cognitive impairment in older general hospital patients: comparison of the Six-Item Cognitive Impairment Test with the Mini-Mental State Examination. International journal of geriatric psychiatry 27, 755-762 (2012); published online EpubJul (10.1002/gps.2776).
    4. M. F. Folstein, SE; Mchugh, PR, "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189-198 (1975).
    5. E. W. J. Hinton, The Usefulness of the Clinical Tests of the Sensorium. The British Journal of Psychiatry 119, 9-18 (1971).
    6. J. Ruesch, Intellectual Impairment in Head Injuries. The American Journal of Psychiatry 100, 480-496 (1944).
    7. D. Wechsler, A Standardized Memory Scale for Clinical Use. The Journal of Psychology: Interdisciplinary and Applied 19, 87-95 (1945).
    8. L. X. Guerrero-Berroa E, Schmeidler J et al., The MMSE orientation for time domain is a strong predictor of subsequent cognitive decline in the elderly. Int J Geriatr Psychiatry 24, 1429 (2009).
    9. F. C. Morales LS, Gutierrez P, Kleinman M, Teresi JA; Flowers; Gutierrez; Kleinman; Teresi Item and scale differential functioning of the Mini-Mental State Exam assessed using the Differential Item and Test Functioning (DFIT) Framework. Medical Care 44, S143 (2006).
    10. R. G. Ganguli M, Huff FJ et al., Serial sevens versus world backwards: a comparison of the two measures of attention from the MMSE. J Geriatr Psychiatry Neurol 3, 203 (1990).
    11. L. M. Espino DV, Palmer RF, Hazuda HP; Lichtenstein; Palmer; Hazuda, Evaluation of the mini-mental state examination's internal consistency in a community-based sample of Mexican-American and European-American elders: results from the San Antonio Longitudinal Study of Aging. J Am Geriatr Soc 52, 822 (May 2004).
    12. M. D, In-office mental status testing: a practical guide. Geriatrics 46, 54 (1991).
    13. A. J. Crum RM, Bassett SS, Folstein MF; Anthony; Bassett; Folstein, Population-based norms for the Mini-Mental State Examination by age and educational level. JAMA 269, 2386 (1993).
    14. I. H. W. E. F. M. A. Hall, Data Mining: Practical machine learning tools and techniques, 3rd Edition. Morgan Kaufmann, San Francisco. Retrieved 2011-01-19., (2011).
    15. J. R. Quinlan, C4. 5: programs for machine learning. (Morgan kaufmann, 1993), vol. 1.
    16. R. O. Duda, P. E. Hart, D. G. Stork, Pattern classification. (John Wiley & Sons, 2012).
    17. A. Goyal, R. Mehta, Performance Comparison of Naïve Bayes and J48 Classification Algorithms. International Journal of Applied Engineering Research, ISSN, 0973-4562 (2012).
    18. W. F. A. T. R. H. Feigenbaum, Feigenbaum's Echocardiography. Lippincott Williams & Wilkins. ISBN 978-0-7817-9557-9., (2010).
    19. http://www.medicinenet.com/creatinine_blood_test/article.htm.

    QR CODE
    :::