郭碧照Bih-Jaw Kuo劉淑芳Shwu-Fang Liou醫學研究所2026-10-282004-07-102004https://handle.ncl.edu.tw/11296/5tq6wzhttps://scholars.csmu.edu.tw/handle/123456789/35043長期依賴呼吸器的病患，造成了醫療的沉重負擔，增添了社會成本；因此協助病患早期脫離呼吸器，可減輕家屬照護的不便性及降低健康照護體系的龐大支出。 本研究目的在探討加護病房內下床坐椅活動之呼吸器依賴病患，在血液動力學穩定、營養狀況正常且無感染合併症之狀況下，呼吸器脫離成功與失敗者在肺部復健活動前後其脫離指標（weaning index）的差異性。研究對象以中部某醫學中心重症加護病房內呼吸器依賴病患為可及母群體；所有研究對象共30人、共測得240筆個案呼吸器脫離指標的資料。所收集資料以SPSS/PC套裝軟體進行建檔與分析：以描述性統計、pair-t test、pearson correlation 、獨立t檢定脫離呼吸器成功與失敗病患之脫離指標的差異。 研究結果顯示：整體的呼吸器脫離率（weaning rate）由原來1-3月平均weaning rate27%（沒有下床坐椅者）改善為67%（有下床坐椅者）；加護病房內呼吸器依賴病患的下床坐椅活動之護理措施，可使呼吸器脫離的三種指數：每分鐘通氣量（minute ventilation， MV）、潮氣容積（tidal volume，TV）、呼吸快淺指標（rapid shallow breathing index，RSI）；達到正常值而符合脫離呼吸器的條件；下床坐椅訓練四日後病患的呼吸器脫離指標MV、TV若有改變則容易脫離呼吸器，下床坐椅訓練七日後，病患的呼吸器脫離指標MV、TV、RSI若有改變則容易脫離呼吸器。 研究結果建議重症呼吸醫療團隊能夠制定一個目標一致且多科技整合的呼吸訓練計畫（weaning protocol），透過文獻的探究及計劃內容的適切性，解決重症病房內呼吸器依賴病患的脫離問題。Ventilator dependent patients have caused the heavy burden of medical treatment and social cost. So help patients to break away from the respirator in early days, the ones that can lighten relatives inconvenient and lowers the large expenditure of the health system. The purpose of this study is to investigate the difference of weaning index of pre- and post- respiratory rehabilitation program. Under this perspective, thirty ventilator dependent patients who were sitting on the chair from the bed, in stable hemodynamic, in normal nutrition status and no accompanied infection, were recruited from amount patients at Intensive Care Unit (ICU) of Taichung Veterans General Hospital. There were total 240 data of weaning index obtained. The materials collected file and analyzed in SPSS/PC suit software: Assay from the difference of weaning indexes of the respirator success and failure patients for describing statistics, pair-t test, pearson correlation and independent t test. Results showed that the average whole weaning rate improved from 27% to 67% in January to March. The nursing care of ventilator dependent patient sitting on the chair from the bed led three indexes of weaning ventilator: minute ventilation (MV), tidal volume (TV), rapid shallow breathing index (RSI), reach the normal value and succeed weaning ventilator. Four days training of sitting on the chair from the bed, patient easily weaned from ventilator if weaning index (MV, TV) change. Seven days training of sitting on the chair from the bed, patient easily weaned from ventilator if weaning index (MV, TV, and RSI) change. In conclusion, Intensive Respiratory Care Team needs to integrate an unanimous purpose and multidisciplinary collaboration weaning protocols, to solve the weaning problem of dependent ventilator patients in Intensive Care Unit.呼吸器依賴呼吸器脫離呼吸器脫離指標Ventilator-dependentVentilator weaningWeaning indexthesis