臥床老人壓瘡的軟組織力學性能評估

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题名:	臥床老人壓瘡的軟組織力學性能評估
作者:	盧靜慧
贡献者:	創意商品設計學系
关键词:	壓瘡、有效楊氏模數、印壓測試、吉尼係數、Braden量表、 pressure ulcer、effective Young's modulus、indentor、Gini index、Braden scale
日期:	2018
上传时间:	2018-07-16 02:32:27 (UTC+0)
出版者:	亞洲大學
摘要:	壓瘡是長期臥床的病患最常見的併發症之一。壓瘡會導致皮膚喪失正常功能、造成傷口感染，並常伴隨併發症發生，增加患者死亡率。皮膚軟組織力學在臨床的應用中，具有十分重要的作用，本研究使用印壓測試，透過超音波印壓系統的測量，可得到有效楊氏模數，用以觀察皮膚軟組織的彈性變化。本研究假設：(1)長期臥床壓瘡癒合者(癒合組)、長期臥床壓瘡惡化者(惡化組)、長期臥床無壓瘡患者(臥床組)，彼此之間的骶骨軟組織材料特性有差異性；(2)癒合組及惡化組，彼此之間的骶骨軟組織材料特性與瘡口癒合有相關性。本研究目的是：(1)比較癒合組、惡化組、臥床組，彼此之間的骶骨軟組織有效楊氏模數、軟組織厚度，是否有顯著性差異；(2)比較癒合組、惡化組、臥床組，Braden量表是否有顯著差異；(3)比較癒合組、惡化組、臥床組、健康成年人(正常組)，骶骨軟組織有效楊氏模數、軟組織厚度，是否有顯著性差異。本研究結果是：(1)癒合組、惡化組、臥床組，彼此之間的軟組織有效楊氏模數、軟組織厚度等測量，皆未達到顯著差異；(2)癒合組、惡化組、臥床組，彼此之間的Braden量表評估，於活動力(activity)有統計上顯著性差異；(3)癒合組、惡化組、臥床組、正常組，有效楊氏模數惡化組最低(190.4±60.0 kPa)。吉尼係數(Gini index)分析，惡化組最低(0.07±0.08)；(4)癒合組、惡化組、臥床組，骶骨軟組織厚度，惡化組最薄(12.6±1.9 mm)。吉尼係數惡化組最低(0.05±0.04)。本研究結果是軟組織有效楊氏模數，與軟組織厚度，可以評估壓瘡的癒合情形。 Pressure ulcers are one of the most common complications in patients who are bedridden. Pressure ulcers can cause the skin to lose normal function, cause wound infections, and increasing patient mortality with by complications. The soft tissue mechanics in the skin has a very important role in clinical application. In this study, the indentation test was used to obtain effective Young's modulus and thickness of the skin soft tissue. This hypothesizes of this study were (1) long-term bed ulcers wound healing (healing group), and long-term bed pressure ulcers worsening (unhealed group), and patients with long-term beds without pressure ulcer (nonulcer group) have different patella soft tissue material characteristics. (2) In the healing and unhealed groups, the characteristics of the soft tissue of the sacrum were related to the healing of ulcers. The purpose of this study was to: (1) compare the effective Young's modulus and soft tissue thickness of sacral soft tissue between the healing group, unhealed group, and nonulcer group, whether there is a significant difference; (2) compare the healing group, and the unhealed group, and nonulcer group, whether the Braden scale has significant differences; (3) compare the effective Young's modulus, soft tissue thickness of the sacral soft tissue in the healing group, unhealed group, nonulcer group, and healthy normal adults (normal group), whether there are significant differences. The results of this study were: (1) In healing group, unhealed group, and nonulcer group, there was no significant difference in effective Young's modulus, soft tissue thickness; (2) In healing group, unhealed group and nonulcer group, there was a statistically significant difference in activities between the Braden scales evaluated by each other; (3) In healing group, unhealed group, nonulcer group, and normal group, the effective Young's modulus of unhealed group was the lowest (190.4±60.0 kPa). Gini index analysis showed that the lowest in the unhealed group was 0.07±0.08; (4) in the healing group, unhealed group, nonulcer group, and normal group, the soft tissue thickness was the thinnest in the unhealed group (12.6±1.9 mm). Gini index deteriorated was lowest in the unhealed group (0.05±0.04). The results of this study described that the effective Young's modulus of soft tissue, and soft tissue thickness, which can be used to assess the healing or worsening of pressure ulcers.
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