應用模糊網絡層級分析法於發展肝臟移植手術術後病患風險指標

Abstract

肝臟移植手術術後的病患狀態極不穩定，隨時都可能發生異常的生理變化，為了維持病患安全，需於加護病房中密切監控其狀態。在當前的肝臟移植加護病房中，對肝臟移植手術術後病患肝臟狀態之判讀，以肝臟超音波最為準確，儘管肝臟超音波能有效反映出病患肝臟功能的狀態，但肝臟超音波的檢驗不易進行，在儀器和人力因素的雙重影響下，使超音波檢驗具有較長時間間隔的限制，為改善病患監控之效率，需使用能更頻繁檢驗病患狀態之指標。 當前肝臟移植加護病房已使用多種常規檢驗參數，作為評估病患狀態的參考指標，但這些資訊是大量且分散的，無法有效進行判讀，為解決資訊處理的問題， 本研究納入模糊理論(Fuzzy Theory)的概念，根據專家之經驗，分別給予各項參數不同的異常度歸屬函數(Membership Function)，將參數的數值量化，以發展判讀病患肝臟狀態異常度的一致性指標。此外為解決參數間複雜的交互作用並評估各參數對肝臟狀態的重要性，使用網絡層級分析法(Analytic Network Process, ANP)探討各參數間的相依性和確認各參數的重要性，結合參數相依性和參數權重的評比，建立完善的肝臟狀態風險指標系統，該系統將與肝臟超音波檢驗結果相比較，以驗證肝臟異常度風險指標的準確度。

Liver echo is the most effective way to measure the patient’s liver function especially after the liver transplant surgery. Even though liver echo is the direct measurement, but because of the constraints of the equipment, patients need to transfer to the examination room to do the liver echo, which increase more risk in patients’ safety, and also the difference in physician’s experience will affect the results. So this study provides another way to measure the liver function by using the regular examining parameters. There are many regular examining parameters to evaluate the patient’s liver function, but they are scattered around in different examination sheets. This study uses the concept of Fuzzy Theory and Analytic Network Process to figure out the importance and relations among these parameters based on the physicians’ experiences. Therefore, we can generate an ideal risk index which can express the state of the liver function. Then we verify the accuracy of this risk index by comparing it to the liver echo result.