{"id":1000,"date":"2016-10-04T14:11:51","date_gmt":"2016-10-04T06:11:51","guid":{"rendered":"http:\/\/web.csh.org.tw\/web\/222010\/?p=1000"},"modified":"2017-05-04T14:48:00","modified_gmt":"2017-05-04T06:48:00","slug":"%e8%82%9d%e8%87%9f%e7%a7%bb%e6%a4%8d%e6%96%bc%e8%82%9d%e7%99%8c%e7%97%85%e6%82%a3%e7%9a%84%e8%a7%92%e8%89%b2","status":"publish","type":"post","link":"https:\/\/web.csh.org.tw\/web\/222010\/?p=1000","title":{"rendered":"\u3010 \u809d\u81bd\u5916\u79d1\u3011\u809d\u81df\u79fb\u690d\u65bc\u809d\u764c\u75c5\u60a3\u7684\u89d2\u8272"},"content":{"rendered":"

\u6587\/\u5916\u50b7\u79d1\u4e01\u9e97\u5a1f \u500b\u7ba1\u5e2b\u3001\u00a0\u809d\u81bd\u5916\u79d1 \u674e\u7965\u9e9f \u4e3b\u4efb<\/h4>\n

\u809d\u81df\u79fb\u690d\u662f\u8fd1\u4e09\u5341\u5e74\u4f86\u91ab\u5b78\u4e0a\u6700\u5927\u7a81\u7834\u4e4b\u4e00\u3002\u4ee5\u6cbb\u7642\u975e\u809d\u764c\u6240\u81f4\u7684\u672b\u671f\u809d\u75c5\u800c\u8a00\uff0c\u9577\u671f\u5b58\u6d3b\u7387\u3001\u751f\u6d3b\u54c1\u8cea\u3001\u91cd\u8fd4\u5de5\u4f5c\u5d17\u4f4d\u7387\u6216\u7bc0\u7701\u9577\u671f\u91ab\u7642\u652f\u51fa\uff0c\u809d\u81df\u79fb\u690d\u5df2\u88ab\u8b49\u5be6\u662f\u552f\u4e00\u6709\u6548\u4e4b\u6cbb\u7642\u65b9\u6cd5\u3002<\/p>\n

\u809d\u81df\u79fb\u690d\u9069\u7528\u65bc\u4e0d\u53ef\u9006\u7684\u9032\u884c\u6027\u809d\u75c5\uff0c\u4e14\u7121\u5176\u4ed6\u65b9\u6cd5\u53ef\u4ee5\u6709\u6548\u6cbb\u7642\u3002\u5728\u53f0\u7063\u6700\u5e38\u898b\u7684\u9069\u61c9\u75c7\uff0c\u6210\u4eba\u662fB\u578b\u809d\u708e\u5f15\u8d77\u7684\u809d\u786c\u5316\uff1b\u5152\u7ae5\u5247\u662f\u81bd\u9053\u9589\u9396\u75c7\u3002\u9069\u61c9\u75c7\u7d30\u5206\u5982\u4e0b\uff1a<\/p>\n

\u4e00\u3001\u6975\u671f\u6162\u6027\u809d\u75c5:<\/p>\n

\u7532\u3001\u809d\u5be6\u8cea\u809d\u75c5<\/p>\n

    \n
  1. \u58de\u6b7b\u5f8c\u809d\u786c\u5316(\u75c5\u6bd2\u6027\u3001\u85e5\u7269\u5f15\u8d77)<\/li>\n
  2. \u9152\u7cbe\u6027\u809d\u786c\u5316<\/li>\n
  3. \u81ea\u9ad4\u514d\u75ab\u809d\u75c5<\/li>\n
  4. \u96b1\u56e0\u6027\u809d\u786c\u5316<\/li>\n
  5. \u65b0\u751f\u5152\u809d\u708e\u53ca\u5176\u4ed6\u809d\u75c5(\u5148\u5929\u6027\u809d\u7e96\u7dad\u5316\u7b49)<\/li>\n<\/ol>\n

    \u4e59\u3001\u81bd\u6c41\u9b31\u6eef\u6027\u809d\u75c5<\/p>\n

      \n
    1. \u81bd\u9053\u9589\u7463\u75c7\u53ca\u5176\u4ed6\u809d\u75c5(Alagille\u6c0f\u75c7\u5019\u7fa4\u3001Byler\u6c0f\u75c5\u7b49)<\/li>\n
    2. \u539f\u767c\u6027\u81bd\u6c41\u6027\u809d\u786c\u5316<\/li>\n
    3. \u786c\u5316\u6027\u81bd\u7ba1\u708e<\/li>\n<\/ol>\n

      \u4e19\u3001\u809d\u8840\u7ba1\u75be\u75c5<\/p>\n

        \n
      1. Budd-Chiari \u75c7\u5019\u7fa4<\/li>\n
      2. \u975c\u8108\u963b\u585e\u75be\u75c5(veno-occlusive disease)<\/li>\n<\/ol>\n

        \u4e8c\u3001 \u731b\u66b4\u6027\u809d\u8870\u7aed<\/p>\n

          \n
        1. \u75c5\u6bd2\u809d\u708e<\/li>\n
        2. \u85e5\u7269\u5f15\u8d77(\u5982halothane, sulphonamides\u7b49)<\/li>\n
        3. \u4ee3\u8b1d\u6027\u809d\u75c5(\u5982Wilson\u6c0f\u75c5\uff0cReyes\u6c0f\u75c7\u5019\u7fa4\u7b49)<\/li>\n<\/ol>\n

          \u4e09\u3001 \u907a\u50b3\u6027\u4ee3\u8b1d\u809d\u75c5<\/p>\n

            \n
          1. \u809d\u91a3\u8caf\u7a4d\u75c7<\/li>\n
          2. \u03b11-\u6297\u80f0\u86cb\u767d\u8122\u7f3a\u4e4f\u75c7<\/li>\n
          3. Wilson\u6c0f\u75c5<\/li>\n
          4. \u5176\u4ed6(tyrosinemia\u7b49)<\/li>\n<\/ol>\n

            \u56db\u3001 \u809d\u81df\u60e1\u6027\u816b\u7624<\/p>\n

              \n
            1. \u809d\u764c(\u809d\u786c\u5316\u4e26\u4e0d\u7b49\u65bc\u809d\u764c)<\/li>\n
            2. \u81bd\u7ba1\u764c<\/li>\n
            3. \u809d\u8089\u7624<\/li>\n<\/ol>\n

              \u4e94\u3001 \u518d\u79fb\u690d<\/p>\n

              \u516d\u3001 \u5176\u4ed6<\/p>\n

                \n
              1. \u809d\u5167\u7d50\u77f3<\/li>\n
              2. \u591a\u56ca\u6027\u809d\u75c5\u3001Caroli\u6c0f\u75c5\u7b49<\/li>\n<\/ol>\n
                \n

                \u00a0 \u00a0 \u00a0 \u7531\u65bc\u624b\u8853\u4fb5\u8972\u6027\u9ad8\uff0c\u809d\u764c\u5fa9\u767c\u7387\u4ea6\u9ad8\uff0c\u79fb\u690d\u5728\u6700\u521d\u4e26\u975e\u809d\u764c\u7684\u6a19\u6e96\u6cbb\u7642\u3002\u904e\u53bb\uff0c\u82e5\u75c5\u60a3\u7121\u6cd5\u63a5\u53d7\u624b\u8853\u5207\u9664\u6216\u5c04\u983b\u71d2\u878d\u7b49\u6cbb\u7642\u7684\u8a71\uff0c\u5f80\u5f80\u5c31\u662f\u589c\u5165\u7d55\u671b\u6df1\u6df5\u3002\u7136\u800c\uff0c\u96a8\u8457\u79fb\u690d\u91ab\u5b78\u7684\u9032\u6b65\uff0c\u7fa9\u5927\u5229\u570b\u5bb6\u764c\u75c7\u7814\u7a76\u4e2d\u5fc3\uff0c1996\u5e74\u5728\u65b0\u82f1\u683c\u862d\u91ab\u5b78\u96dc\u8a8c\u4e0a\uff0c\u767c\u8868\u8457\u540d\u7684\u7c73\u862d\u6e96\u5247(Milan Criteria)\u5f8c\uff0c\u809d\u81df\u79fb\u690d\u6210\u70ba\u809d\u764c\u7684\u6a19\u6e96\u6cbb\u7642\u4e4b\u4e00\u3002\u76ee\u524d\u809d\u764c\u75c5\u60a3\uff0c\u63a5\u53d7\u809d\u81df\u79fb\u690d\u76845\u5e74\u5b58\u6d3b\u7387\u5747\u905470%\u4ee5\u4e0a\uff0c\u4e0d\u905c\u65bc\u56e0\u826f\u6027\u75be\u75c5\u800c\u63a5\u53d7\u79fb\u690d\u7684\u6210\u7e3e\u3002\u4f46\u5fc5\u9808\u7b26\u5408\u4ee5\u4e0b\u689d\u4ef6\uff0c\u624d\u53ef\u80fd\u6709\u6b64\u6210\u6548\uff1a(1)\u5728\u5f71\u50cf\u5b78\u4e0a\uff0c\u4e0d\u80fd\u6709\u8840\u7ba1\u4fb5\u72af\u3002(2)\u63a5\u53d7\u8166\u6b7b\u6350\u809d\u8005\uff0c\u82e5\u53ea\u6709\u55ae\u9846\u809d\u764c\uff0c\u9808\u5c0f\u65bc5\u516c\u5206\uff1b\u82e5\u70ba\u591a\u767c\u6027\u809d\u764c\uff0c\u5247\u4e0d\u53ef\u591a\u65bc\u4e09\u9846\uff0c\u5176\u4e2d\u6700\u5927\u9846\u4e4b\u76f4\u5f91\u4e0d\u5927\u65bc3\u516c\u5206(Milan Criteria)\u3002(3)\u63a5\u53d7\u89aa\u5c6c\u6d3b\u9ad4\u6350\u809d\u8005\uff0c\u82e5\u53ea\u6709\u55ae\u9846\u809d\u764c\uff0c\u9808\u5c0f\u65bc6.5\u516c\u5206\uff1b\u82e5\u70ba\u591a\u767c\u6027\u809d\u764c\uff0c\u5247\u4e0d\u53ef\u591a\u65bc\u4e09\u9846\uff0c\u5176\u4e2d\u6700\u5927\u9846\u4e4b\u76f4\u5f91\u4e0d\u5927\u65bc4.5\u516c\u5206\u4e14\u4e09\u9846\u809d\u764c\u76f4\u5f91\u7e3d\u5408\u4e0d\u53ef\u5927\u65bc8\u516c\u5206(UCSF criteria\uff0c\u7f8e\u570b\u820a\u91d1\u5c71\u5927\u5b78\u6e96\u5247)\u3002\u4e5f\u662f\u6211\u570b\u5065\u4fdd\u7f72\u6240\u63a1\u7528\u7684\u5be9\u6838\u6a19\u6e96\u3002\u56e0\u6b64\uff0c\u8a31\u591a\u809d\u764c\u60a3\u8005\u53d7\u60e0\u65bc\u809d\u81df\u79fb\u690d\u3002<\/p>\n

                \u53e6\u5916\uff0c\u91dd\u5c0d\u809d\u764c\u964d\u671f\u6cbb\u7642\u662f\u6307\u82e5\u816b\u7624\u8d85\u904e\u79fb\u690d\u7684\u6a19\u6e96\uff0c\u5247\u5148\u4ee5\u809d\u52d5\u8108\u6813\u585e\u3001\u5c04\u983b\u71d2\u878d\uff0c\u751a\u81f3\u5207\u9664\u8853\u4f86\u9032\u884c\u809d\u764c\u6cbb\u7642\uff0c\u8a2d\u6cd5\u5148\u964d\u4f4e\u809d\u764c\u671f\u5225\u3002\u7d93\u6cbb\u7642\u4e00\u6bb5\u6642\u9593\u5f8c\u518d\u8a55\u4f30\u816b\u7624\u5206\u671f\uff0c\u5982\u7b26\u5408\u6a19\u6e96\uff0c\u4ecd\u53ef\u9032\u884c\u79fb\u690d\u624b\u8853\u3002\u5728\u7c73\u862d\u6a19\u6e96\u4e0b\u7d93\u964d\u671f\u6cbb\u7642\u518d\u63a5\u53d7\u79fb\u690d\u7684\u75c5\u60a3\uff0c\u4e94\u5e74\u5b58\u6d3b\u7387\u6700\u9ad8\u53ef\u905490%\uff0c\u4e0d\u4e9e\u65bc\u975e\u964d\u671f\u60a3\u8005\u3002<\/p>\n

                \u76ee\u524d\u79fb\u690d\u6a19\u6e96\u7684\u7f3a\u9ede\uff0c\u4ee5\u816b\u7624\u5927\u5c0f\u548c\u6578\u76ee\u4f86\u8a55\u4f30\uff0c\u7121\u6cd5\u5b8c\u5168\u53cd\u61c9\u809d\u764c\u7684\u816b\u7624\uff0c\u4f8b\u5982\u76ee\u524d\u7121\u53c3\u8003\u80ce\u5152\u86cb\u767d(AFP)\u6307\u6578\u7684\u9ad8\u4f4e\u3002\u6240\u4ee5\u9678\u7e8c\u591a\u9805\u6a19\u6e96\u88ab\u63d0\u51fa\uff0c\u4e5f\u9700\u8981\u66f4\u591a\u7814\u7a76\u4f86\u767c\u73fe\u65b0\u7684\u809d\u764c\u6a19\u8a18\uff0c\u9078\u64c7\u9069\u7576\u7684\u75c5\u60a3\u63a5\u53d7\u809d\u81df\u79fb\u690d\u3002<\/p>\n

                \u5c0d\u65bc\u809d\u81df\u5207\u9664\u548c\u79fb\u690d\u6cbb\u7642\u809d\u764c\u7684\u6bd4\u8f03\u4f86\u8aaa\uff0c\u809d\u5207\u9664\u6cbb\u7642\u8cbb\u7528\u76f8\u5c0d\u4f4e\u3001\u5b89\u5168\u3001\u4e14\u6b7b\u4ea1\u7387\u4f4e\uff0c\u7f3a\u9ede\u662f\u5fa9\u767c\u7387\u9ad8\uff0c\u7121\u6cd5\u540c\u6642\u6cbb\u7642\u6162\u6027\u809d\u75c5\u548c\u809d\u786c\u5316\u3002\u809d\u81df\u79fb\u690d\u7684\u512a\u9ede\u662f\u5fa9\u767c\u7387\u4f4e\uff0c\u53ef\u540c\u6642\u6cbb\u7642\u809d\u786c\u5316\u53ca\u809d\u764c\uff0c\u4f46\u8cbb\u7528\u8f03\u6602\u8cb4\uff0c\u6280\u8853\u9580\u6abb\u8981\u6c42\u76f8\u5c0d\u9ad8\uff0c\u4e14\u6350\u8d08\u4f86\u6e90\u6709\u9650\u3002\u6240\u4ee5\u82e5\u809d\u529f\u80fd\u8a31\u53ef\u4ecd\u4ee5\u624b\u8853\u5207\u9664\u70ba\u7b2c\u4e00\u512a\u5148\u8003\u616e\uff0c\u8853\u5f8c\u7684\u75c5\u7406\u5831\u544a\u4e5f\u53ef\u505a\u70ba\u65e5\u5f8c\u6cbb\u7642\u6216\u79fb\u690d\u7684\u53c3\u8003\u3002<\/p>\n

                \u76ee\u524d\uff0c\u5728\u809d\u5207\u9664\u624b\u8853\u53ca\u5176\u5b83\u809d\u764c\u6cbb\u7642\u7684\u9032\u6b65\u4e0b\uff0c\u5df2\u5927\u5e45\u6539\u5584\u809d\u764c\u7684\u5b58\u6d3b\u7387\u548c\u5b58\u6d3b\u6642\u9593\u3002\u809d\u81df\u79fb\u690d\u63d0\u4f9b\u5c0f\u578b\u809d\u764c\u540c\u6642\u6cbb\u7642\u816b\u7624\u53ca\u6162\u6027\u809d\u75c5\u7684\u6a5f\u6703\u3002\u76f8\u4fe1\u672a\u4f86\u52a0\u4e0a\u809d\u764c\u6a19\u8a18\u7684\u767c\u5c55\u548c\u6a19\u9776\u6cbb\u7642\u7684\u9032\u6b65\uff0c\u80fd\u63d0\u4f9b\u66f4\u5168\u9762\u6027\u7684\u6cbb\u7642\u3002\u7b46\u8005\u9664\u4e86\u5e0c\u671b\u570b\u5167\u5668\u5b98\u6350\u8d08\u7684\u89c0\u5ff5\u80fd\u66f4\u63d0\u6607\u5916\uff0c\u4ea6\u5fc5\u9808\u6307\u51fa\uff0c\u5728\u8207\u6642\u9593\u8cfd\u8dd1\u7684\u7b49\u5f85\u904e\u7a0b\u4e2d\uff0c\u7d93\u904e\u56b4\u5bc6\u7684\u8a55\u4f30\uff0c\u75c5\u60a3\u4e4b\u914d\u5076\u6216\u4e94\u7b49\u5167\u8840\u3001\u59fb\u89aa\uff0c\u53ef\u4ee5\u6350\u51fa\u90e8\u4efd\u7684\u809d\u81df\u4f86\u62ef\u6551\u81f3\u611b\u3002\u7576\u7136\u6d3b\u9ad4\u809d\u81df\u79fb\u690d\uff0c\u5fc5\u9808\u5728\u78ba\u4fdd\u6350\u8d08\u8005\u5b89\u5168\u7684\u524d\u63d0\u4e0b\u9032\u884c\u3002\u800c\u53d7\u8d08\u8005\u5728\u8853\u5f8c\uff0c\u5fc5\u9808\u7d42\u8eab\u670d\u7528\u6297\u6392\u65a5\u85e5\uff0c\u4e5f\u5f97\u9762\u5c0d\u53ef\u80fd\u767c\u751f\u7684\u5927\u5927\u5c0f\u5c0f\u4f75\u767c\u75c7\u53ca\u5fa9\u767c\u7684\u53ef\u80fd\u6027\u3002\u5c0d\u75c5\u60a3\u3001\u5bb6\u5c6c\u53ca\u91ab\u7642\u5718\u968a\u800c\u8a00\uff0c\u90fd\u662f\u4e0d\u7c21\u55ae\u7684\u4e8b\u3002\u7136\u800c\uff0c\u5728\u809d\u81df\u79fb\u690d\u6210\u70ba\u4f8b\u884c\u624b\u8853\u4e14\u5177\u6709\u826f\u597d\u7642\u6548\u7684\u4eca\u5929\uff0c\u6211\u5011\u61c9\u8a72\u4ee5\u66f4\u7a4d\u6975\u7684\u614b\u5ea6\u4f86\u9762\u5c0d\u773c\u524d\u7684\u56f0\u5883\u3002<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

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