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部科簡介

麻醉部簡介

  • 簡介
    麻醉學科源自因應外科系統手術創傷而衍生之醫藥專業，在手術期間提供安寧無干擾之生理個體，讓病患在無知覺而舒適下使手術治療順利完成，兼顧病患個別器官功能矯治，務使生理機能正常運轉，由於掌握器官功能之變異和感覺抑制之專業本能，而衍生處理急性與慢性疼痛控制，重症加護醫療，呼吸治療及心肺腦復甦急救等，使專業觸角延展至各醫療體系，兼具輔助和積極醫療之使命。 

 

  • 發展計劃
    ( 一 ) 強化主治醫師次專業分科培養，使年青醫師得以學有專精，造就多元化，各司各職之教學。
    ( 二 ) 加強與各榮民醫院麻醉服務之連繫，代訓專業麻醉醫師。
    ( 三 ) 推廣術後疼痛之觀念和效益，以減少手術後精神和肉體上之痛苦，以減少心肺循環之負荷，促進術後無痛康復，八十五年以後，更新止痛概念，分別修飾各傷害性接受體，以行平衡止痛法，止痛品質更上層樓，副作用亦有效緩和。
    ( 四 ) 推展電腦化作業，凡諸儀器﹑藥品﹑消耗性材料皆納入電腦程式管制，進而在長程計劃中，以電腦化作業管理一切麻醉服務作業。
    ( 五 ) 強化心臟循環監視系統，並常規應用經食道心臟超音波以監視開刀病患或心臟病者行一般大手術，同時援用光纖肺動脈導管，在監視循環變化之餘亦監視耗氧代謝變化，中樞神經監視亦日趨熱絡，陸續引進術中腦波﹑腦血流及含氧狀態之監視。
    ( 六 )  強化基礎實驗研究，研究在於追求真理，成果在於改善臨服務，臨床上之不惑，存疑未決，有待基礎實驗推演求真，因果循環，在於求取更美好臨床品質，為全民健康付上一份心力。
    ( 七 ) 強化麻醉後恢復室之功能，成立麻醉術後加護病房，對重大手術病者加強預防性積極治療，減少併發症之機會。
    ( 八 ) 推廣手術期間內科治療，即在手術期間對形形色色之疾病加以積極治療，以矯治生理異常和提升其功能狀態，更有資本接受手術之挑戰，令整體醫療品質上升和減少因併發症滋生而耗費之醫療資源。
    ( 九 ) 近年來蒙李德譽主任﹑蔡勝國主任﹑陳國瀚主任及鄒美勇主任大力支持，積極培養後進，充實師資，現麻醉學科已有教育部部頒 教授二人﹑副教授三人﹑助理教授九人﹑講師二人﹑兼任臨床教師五人，教學設備也不斷更新擴充，尤其急救訓練設備之擴充更為顯著。 

 

  • 教學活動
    （一） 麻醉學： 必修 1 學分，對象為陽明醫學系五年級及牙醫系五年級學生，講授麻醉學之基本概念與各種麻醉藥物之藥理及麻醉技術之介紹 
    （二） 臨床麻醉見習： 必修 1 學分，對醫學系六年級學生分梯次小組討論臨床麻醉之基本技巧，監視設備使用和各麻醉次專科（包括心臟血管外科﹑神經外科﹑小兒外科﹑產科疼痛及重症加護等）之介紹，分組見習地點為臺北榮總手術室﹑加護病房及疼痛門診。 
  • 課程
    麻醉前訪視及麻醉危險性之評估。 氣管插管。 臨床麻醉監視系統。 吸入性麻醉劑之藥理及應用。 靜脈注射麻醉劑之藥理及應用。 肌肉鬆弛劑之藥理及應用。 局部麻醉劑之藥理及應用。 脊髓及硬脊膜外腔尾椎之區域麻醉法。 疼痛控制簡介。

 

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部主任

部主任照片

張文貴 Chang WeN-Kuei

 

學歷

臺北醫學大學 醫學系 醫學士

考試院公共衛生醫生高等考試及格

 

現職

臺北榮民總醫院麻醉部 部主任

國立陽明大學 醫學院 部定副教授

國防醫學大學 醫學系 臨床教授

 

經歷

臺北榮民總醫院麻醉部醫師兼副關渡醫院副院長

臺北榮民總醫院麻醉部一般麻醉科主任

臺北榮民總醫院麻醉部主治醫師

臺北榮民總醫院麻醉部臨床研究醫師

臺北榮民總醫院麻醉部總醫師

臺北榮民總醫院外科部麻醉科住院醫師

 

專長 

胸腔外科麻醉骨科、小兒麻醉

心臟血管外科麻醉

經食道心臟超音波 

疼痛控制、神經阻斷

 

近年發表論文

  1. Li YS, Chang KY, Lin SP, Chang MC, Chang WK. Group-based trajectory analysis of acute pain after spine surgery and risk factors for rebound pain. Front Med (Lausanne). 2022(9):907126. (SCI).
  2. Yen FY, Chang WK, Lin SP, Lin TP, Chang KY. Association Between Epidural Analgesia and Cancer Recurrence or Survival After Surgery for Renal Cell Carcinoma: A Propensity Weighted Analysis. Front Med (Lausanne). 2022(8):782336. (SCI).
  3. Tsai HJ, Chang WK, Yen FY, Lin SP, Lin TP, Chang KY. Influential Factors and Personalized Prediction Model of Acute Pain Trajectories after Surgery for Renal Cell Carcinoma. J Pers Med. 2022 (3):360. (SCI).
  4. Yeh CY, Chang WK, Wu HL, Chau GY, Tai YH, Chang KY. Associations of Multimodal Analgesia With Postoperative Pain Trajectories and Morphine Consumption After Hepatic Cancer Surgery. Front Med (Lausanne). 2022(8):777369. (SCI).
  5. Hsu FK, Chang WK, Lin KJ, Chu TJ, Fang WL, Chang KY. Effect of epidural analgesia on cancer outcomes after gastric cancer resection: a single-centre cohort study in Taiwan. BMJ Open. 2022 (8);12(3):e053050. (SCI).
  6. Liou JY, Wang HY, Kuo IT, Chang WK, Ting CK. Simulation-Based Gastrointestinal Endoscopy Sedations: A Novel Validation to Multidrug Pharmacodynamic Modeling. Pharmaceutics. 2022 (27);14(10):2056.
  7. Huang WC, Tan EC, Huang SS, Chou CJ, Chang WK, Chu YC. Postoperative Sore Throat Helps Predict Swallowing Disturbance on Postoperative Day 30 of Anterior Cervical Spine Surgery: A Secondary Exploratory Analysis of a Randomized Clinical Trial of Tracheal Intubation Modes. Dysphagia. 2022;37(1):37-47. (SCI).
  8. Chang WK, Li YS, Wu HL, Tai YH, Lin SP, Chang KY. Group-based trajectory analysis of postoperative pain in epidural analgesia for video-assisted thoracoscopic surgery and risk factors of rebound pain. J Chin Med Assoc. 2022;85(2):216-221. (SCI).
  9. Li YS, Tan EC, Tsai YJ, Mandell MS, Huang SS, Chiang TY, Huang WC, Chang WK, Chu YC. A Tapered Cuff Tracheal Tube Decreases the Need for Cuff Pressure Adjustment After Surgical Retraction During Anterior Cervical Spine Surgery: A Randomized Controlled, Double-Blind Trial. Front Med (Lausanne). 2022(29);9:920726. (SCI).
  10. Wang HY, Lo MT, Chen KH, Mandell S, Chang WK, Lin C, Ting CK. Strong Early Phase Parasympathetic Inhibition Followed by Sympathetic Withdrawal During Propofol Induction: Temporal Response Assessed by Wavelet-Based Spectral Analysis and Photoplethysmography. Front Physiol. 2021(13);12:705153.
  11. Hsu FK, Chang WK, Lin KJ, Liu CY, Fang WL, Chang KY. The Associations between Perioperative Blood Transfusion and Long-Term Outcomes after Stomach Cancer Surgery. Cancers (Basel). 2021;13(21):5438.
  12. Chang WK, Tai YH, Lin SP, Wu HL, Tsou MY, Chang KY. An investigation of the relationships between postoperative pain trajectories and outcomes after surgery for colorectal cancer. J Chin Med Assoc. 2019;82(11):865-871.
  13. Huang WC, Tan CH, Chang CC, Kuo YH, Hsu TJ, Chang WK, Huang SS, Chen PT, Chu YC (2020, May). Effect of tracheal intubation mode on cuff pressure during retractor splay and dysphonia recovery after for anterior cervical spine surgery: a randomized clinical trial. Spine, 45(9): 565-572. (SCI).
  14. Lee MY, Chang WK, Wu HL, Lin SP, Tsou MY, Chang KY (2020, Jan). Dynamic analysis of variations in postoperative pain trajectories over time in patients receiving epidural analgesia using latent curve models. Journal of the Chinese Medical Association, 83(1): 89-94. (SCI).
  15. Chang WK, Tai YH, Lin SP, Wu HL, Tsou MY, Chang KY (2019, Nov). An investigation of the relationships between postoperative pain trajectories and outcomes after surgery for colorectal cancer. Journal of the Chinese Medical Association, 82(11): 865-871. (SCI).
  16. Chiou YW, Ting CK, Wang HY, Tsou MY, Chang WK (2019, Dec). Enhanced recovery after surgery: prediction for early extubation in video-assisted thoracic surgery using a response surface model in anesthesia. Journal of the Formosan Medical Association, 118(10):1450-1457. (SCI).
  17. Chang WK, Tai YH, Lin SP, Wu HL, Chan MY, Chang KY (2019, Oct). Perioperative blood transfusions are not associated with overall survival in elderly patients receiving surgery for fractured hips . Journal of the Chinese Medical Association, 82(10):787-790. (SCI).
  18. Teng WN, Ting CK, Wang YT, Hou MC, Chang WK, Tsou MY, Chiang H, Lin CL (2019, Jul). High-flow nasal cannula and mandibular advancement bite block decrease hypoxic events during sedative esophagogastroduodenoscopy: a randomized clinical trial. BioMed Research International, 4206795. (SCI).
  19. Kuo YM, Hsu PC, Hung CC, Hu YY, Huang YJ, Gan YL, Lin CH, Shie FS, Chang WK, Kao LS, Tsou MY, Lee YH (2019, Jul). Soluble epoxide hydrolase inhibition attenuates excitotoxicity involving 14,15-epoxyeicosatrienoic acid- mediated astrocytic survival and plasticity to preserve glutamate homeostasis. Molecular Neurobiology, 56(12): 8451-8474. (SCI).
  20. Liou JY, Wang HY, Tsou MY, Chang WK, Kuo IT, Ting CK (2019, May). Opioid and propofol pharmacodynamics modeling during brain mapping in awake craniotomy. Journal of the Chinese Medical Association, 82(5):390–395. (SCI).
  21. Wu HL, Tai YH, Chang WK, Chang KY, Tsou MY, Cherng YG, Lin SP (2019, May). Does postoperative morphine consumption for acute surgical pain impact oncologic outcomes after colorectal cancer resection?: A retrospective cohort study. Medicine, 98(18):e15442. (SCI).
  22. Chang WK, Lee MY, Tai YH, Kuo YM, Tsou MY, Chang KY (2019, Apr). Does epidural analgesia improve the cancer outcome in hepatocellular carcinoma after resection surgery? A retrospective analysis. Journal of the Chinese Medical Association, 82(4):295-299. (SCI).
  23. Ying-Hsuan Tai, Wen-Kuei Chang, Hsiang-Ling Wu, Min-Ya Chan, Hsiu-His Chen, Kuang-Yi Chang. The effect of epidural analgesia on cancer progression in patients with stage IV colorectal cancer after primary tumor resection-A retrospective cohort study. PLoS One journal.pone.0200893 July 20, 2018

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