{"id":4536,"date":"2021-12-13T08:43:30","date_gmt":"2021-12-13T00:43:30","guid":{"rendered":"http:\/\/web.csh.org.tw\/web\/cshmagazine\/?p=4536"},"modified":"2021-12-22T11:30:34","modified_gmt":"2021-12-22T03:30:34","slug":"%e5%a4%9c%e5%b0%bf%e7%9a%84%e8%a8%ba%e6%96%b7%e8%88%87%e6%b2%bb%e7%99%82","status":"publish","type":"post","link":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/?p=4536","title":{"rendered":"\u591c\u5c3f\u7684\u8a3a\u65b7\u8207\u6cbb\u7642"},"content":{"rendered":"\n

\u6ccc\u5c3f\u79d1 \u5f6d\u81f4\u51f1 \u4f4f\u9662\u91ab\u5e2b<\/p>\n\n\n\n

\u591c\u5c3f\u662f\u500b\u5e38\u898b\u7684\u75c7\u72c0\uff0c \u96d6\u7136\u4e4d\u770b\u4e0b\u4e0d\u662f\u4ec0\u9ebc\u56b4\u91cd\u7684\u75be\u75c5\uff0c \u4f46\u662f\u537b\u6703\u5927\u5927\u7684\u5f71\u97ff\u7761\u7720\u54c1\u8cea\uff0c \u9020\u6210\u65e5\u9593\u7cbe\u795e\u6e19\u6563\uff0c \u767c\u751f\u5728\u8001\u4eba\u7684\u591c\u5c3f\u66f4\u6703\u589e\u52a0\u8dcc\u5012\u7684\u98a8\u96aa\uff0c \u751a\u81f3\u9020\u6210\u9aa8\u6298\u6216\u982d\u90e8\u5916\u50b7\u3002\u76ee\u524d\u7814\u7a76\u8a8d\u70ba\uff0c \u5728\u6709\u591c\u5c3f\u7684\u65cf\u7fa4\u7522\u751f\u6182\u9b31\u8207\u751f\u6d3b\u54c1\u8cea\u964d\u4f4e\u7684\u767c\u751f\u7387\u78ba\u5be6\u9ad8\u65bc\u6c92\u6709\u591c\u5c3f\u7684\u65cf\u7fa4\uff0c \u800c\u6709\u5169\u6b21\u4ee5\u4e0a\u7684\u591c\u5c3f\u60a3\u8005\u6703\u986f\u8457\u5f71\u97ff\u751f\u6d3b\u54c1\u8cea\u3002\u591c\u5c3f\u7684\u76db\u884c\u7387(Prevalence)\u4e5f\u96a8\u8457\u5e74\u9f61\u589e\u9577\u800c\u589e\u52a0\uff0c \u64da\u7d71\u8a08\u6709\u516d\u6210\u4e03\u5341\u6b72\u4ee5\u4e0a\u7684\u9577\u8005\u6703\u53d7\u5230\u591c\u5c3f\u6240\u56f0\u64fe\u3002
\u9020\u6210\u591c\u5c3f\u539f\u56e0\u975e\u5e38\u591a\uff0c \u9664\u4e86\u8ddf\u672c\u8eab\u7684\u751f\u6d3b\u7fd2\u6163\u6709\u95dc\uff0c \u6ccc\u5c3f\u9053\u554f\u984c\u3001\u8377\u723e\u8499\u5206\u6ccc\u3001\u60c5\u7dd2\u56e0\u7d20\u7b49\u90fd\u6709\u76f8\u95dc\u3002\u6240\u4ee5\u6ccc\u5c3f\u79d1\u91ab\u5e2b\u5728\u8a55\u4f30\u591c\u5c3f\u7684\u60a3\u8005\uff0c \u9700\u8981\u4ee5\u66f4\u5168\u9762\u7684\u601d\u8003\u4f86\u5206\u6790\u5176\u80cc\u5f8c\u53ef\u80fd\u7684\u6210\u56e0\u3002<\/p>\n\n\n\n

\u591c\u5c3f\u7684\u8a3a\u65b7\u6d41\u7a0b<\/p>\n\n\n\n

\u75c5\u53f2\u8a62\u554f
1 . \u4e86\u89e3\u75c5\u4eba\u559d\u6c34\u8207\u6392\u5c3f\u7684\u7fd2\u6163\u3001\u7761\u7720\u6642\u9593\u7b49\u751f\u6d3b\u4f5c\u606f\u3002
2 . \u642d\u914d\u76f8\u95dc\u554f\u5377\u53ca\u91cf\u8868( ex: \u570b\u969b\u651d\u8b77\u817a\u75c7\u72c0\u8a55\u5206\u8868)\u4f86\u91cf\u5316\u75c5\u4eba\u7684\u75c7\u72c0\uff0c \u4ee5\u4e86\u89e3\u75c5\u4eba\u7684\u56b4\u91cd\u7a0b\u5ea6\u3002
3 . \u8a62\u554f\u662f\u5426\u6709\u5168\u8eab\u6027\u75be\u75c5\uff0c \u5305\u542b\u5fc3\u81df\u75c5\u3001\u7cd6\u5c3f\u75c5\u3001\u9aa8\u76c6\u81df\u5668\u624b\u8853\u53f2\u3001\u7761\u7720\u547c\u5438\u4e2d\u6b62\u75c7(\u662f\u5426\u6253\u9f3e) \u3001\u85e5\u7269\u4f7f\u7528\u7b49\u3002<\/p>\n\n\n\n


\u8eab\u9ad4\u7406\u5b78\u6aa2\u67e5
\u7537\u6027\u61c9\u505a\u809b\u9580\u6307\u8a3a\u8a55\u4f30\u651d\u8b77\u817a\uff0c \u5973\u6027\u61c9\u505a\u6703\u9670\u6aa2\u67e5\u8a55\u4f30\u662f\u5426\u6709\u9aa8\u76c6\u8154\u81df\u5668\u812b\u5782\uff0c \u4e5f\u53ef\u89c0\u5bdf\u75c5\u60a3\u662f\u5426\u6709\u80a5\u80d6\u8207\u77ed\u8116\u5b50\u53ef\u80fd\u5c0e\u81f4\u7761\u7720\u547c\u5438\u4e2d\u6b62\u75c7\uff0c \u4e26\u5b89\u6392\u76f8\u95dc\u6aa2\u67e5\u3002<\/p>\n\n\n\n

\u6392\u5c3f\u65e5\u8a8c
\u8acb\u75c5\u4eba\u7d00\u9304\u4e00\u6574\u5929\u7684\u559d\u6c34\u91cf\u3001\u6bcf\u6b21\u7684\u6392\u5c3f\u91cf\u3001\u6392\u5c3f\u7684\u983b\u7387\u53ca\u7761\u7720\u6642\u9593\u7b49\u8cc7\u6599\uff0c \u96d6\u7136\u6392\u5c3f\u65e5\u8a8c\u9700\u8981\u75c5\u4eba\u7684\u914d\u5408\uff0c \u4e5f\u7a0d\u8a31\u9ebb\u7169\uff0c\u4f46\u662f\u80fd\u63d0\u4f9b\u975e\u5e38\u91cd\u8981\u7684\u8cc7\u8a0a\uff0c \u4e00\u822c\u5efa\u8b70\u75c5\u4eba\u7d00\u9304\u4e09\u65e5\u4ee5\u4e0a\u7684\u6392\u5c3f\u60c5\u5f62\u3002<\/p>\n\n\n\n


\u5176\u4ed6\u6aa2\u67e5
1 . \u5c3f\u6db2\u6aa2\u67e5(Urine analysis): \u7528\u4f86\u6392\u9664\u6ccc\u5c3f\u9053\u611f\u67d3\u8207\u8840\u5c3f\u3002
2 . \u651d\u8b77\u817a\u7279\u7570\u6297\u539f(PSA): \u8a55\u4f30\u651d\u7537\u6027\u60a3\u8005\u662f\u5426\u6709\u651d\u8b77\u817a\u767c\u708e\u6216\u651d\u8b77\u817a\u764c\u7684\u53ef\u80fd\u3002
3 . \u9918\u5c3f(Post-void residual, PVR): \u53ef\u521d\u6b65\u8a55\u4f30\u60a3\u8005\u8180\u80f1\u6392\u7a7a\u7684\u80fd\u529b\u3002\u5982\u679c\u9918\u5c3f\u504f\u9ad8\uff0c \u5247\u5fc5\u9808\u8003\u616e\u9032\u4e00\u6b65\u8a55\u4f30\u60a3\u8005\u6392\u5c3f\u969c\u7919\u7684\u539f\u56e0\u3002<\/p>\n\n\n\n

\u591c\u5c3f\u7684\u75c5\u56e0\u5206\u985e\u8207\u9451\u5225\u8a3a\u65b7<\/p>\n\n\n\n

\u5168\u9762\u6027\u591a\u5c3f\u75c7
\u9867\u540d\u601d\u7fa9\uff0c \u5c31\u662f\u6574\u9ad4\u7522\u751f\u7684\u5c3f\u6db2\u904e\u591a\uff0c \u6839\u64da\u570b\u969b\u5c3f\u5931\u7981\u9632\u6cbb\u5354\u6703\u7684\u5b9a\u7fa9\uff0c \u75762 4 \u5c0f\u6642\u7684\u6392\u5c3f\u91cf\u7e3d\u548c\u8d85\u904e\u75c5\u60a3\u9ad4\u91cd( \u516c\u65a4) \u4e58\u4ee54 0\u6beb\u5347\u6642( \u5927\u65bc40 ml\/Kg) \uff0c \u5247\u53ef\u4ee5\u8a3a\u65b7\u70ba\u5168\u9762\u6027\u591a\u5c3f\u75c7\uff0c \u53ef\u80fd\u8ddf\u591a\u6e34\u75c7 (Polydipsia)\u3001\u7cd6\u5c3f\u75c5(Diabetes mellitus, DM)\u8207\u5c3f\u5d29\u75c7(Diabetesinsipidus, DI)\u6709\u95dc\u3002<\/p>\n\n\n\n


\u591c\u9593\u591a\u5c3f\u75c7
\u591c\u9593\u7684\u6392\u5c3f\u91cf\u5927\u65bc\u4e00\u6574\u5929\u6392\u5c3f\u91cf\u7684\u4e09\u6210\u4ee5\u4e0a\uff0c \u5373\u70ba\u591c\u9593\u591a\u5c3f\u75c7\uff0c \u53ef\u80fd\u8207\u591c\u9593\u98f2\u6c34\u904e\u91cf\u3001\u5468\u908a\u6c34\u816b(Peripheraledema)\u3001\u963b\u585e\u6027\u7761\u7720\u547c\u5438\u4e2d\u6b62\u75c7(Obstructive sleepapnea, OSA)\u3001\u7cd6\u5c3f\u75c5\u3001\u9b31\u8840\u6027\u5fc3\u8870\u7aed(Congestive heartfailure, CHF)\u3001\u85e5\u7269(Diuretics\u3001SSRI)\u76f8\u95dc\u3002<\/p>\n\n\n\n

\u8180\u80f1\u5bb9\u91cf\u6e1b\u4f4e(Diminished global or nocturnal bladder capacity)
1 . \u8207\u6ccc\u5c3f\u9053\u76f8\u95dc: \u8180\u80f1\u51fa\u53e3\u963b\u585e(Bladder outlet obstruction, BOO)\u3001\u8180\u80f1\u904e\u52d5\u75c7(Overactive bladder, OAB)\u3001\u8180\u80f1\u9806\u61c9\u6027\u4e0d\u4f73(Poor bladdercompliance)\u3001\u795e\u7d93\u6027\u8180\u80f1(Neurogenic bladder)\u3001\u8180\u80f1\u767c\u708e(Cystitis)(\u542b\u7d30\u83cc\u6027\u3001\u653e\u5c04\u6027\u3001\u9593\u8cea\u6027\u3001Ketamine\u7b49) \u3001\u8180\u80f1\u7d50\u77f3\u6216\u8f38\u5c3f\u7ba1\u7d50\u77f3\u3001\u6ccc\u5c3f\u9053\u816b\u7624\u3002
2 . \u8207\u6ccc\u5c3f\u9053\u8f03\u7121\u76f8\u95dc: \u85e5\u7269(\u03b2-blockers\u3001Theophylline\u7b49)\u3001\u5496\u5561\u56e0
(Caffeine)\u3001\u7126\u616e\u75c7(Anxiety disorder)\u3002
\u7761\u7720\u969c\u7919(Sleep disturbance)\u539f\u767c\u6027\u7761\u7720\u5931\u8abf(Primary sleep disorders)\u3001\u7e8c\u767c\u6027\u7761\u7720\u5931\u8abf(Secondarysleep disorders)\u3001\u795e\u7d93\u5b78\u56e0\u7d20\u5982\u5931\u667a\u75c7(dementia)\u8207\u7672\u7647(Epilepsy)\u3001
\u7cbe\u795e\u56e0\u7d20\u5982\u7126\u616e\u75c7(Anxiety)\u6216\u6182\u9b31\u75c7(Depression)\u3001\u9152\u7cbe\u6216\u85e5\u7269\u7b49\u3002<\/p>\n\n\n\n

\u591c\u5c3f\u7684\u6cbb\u7642<\/p>\n\n\n\n

\u751f\u6d3b\u7fd2\u6163\u8abf\u6574
1 . \u6e1b\u5c11\u7761\u524d\u56db\u5c0f\u6642\u5167\u7684\u6c34\u5206\u651d\u53d6\uff0c \u6709\u52a9\u65bc\u6e1b\u5c11\u591c\u9593\u7684\u6392\u5c3f\u91cf\uff0c \u53ef\u6539\u5584\u591c\u5c3f\u7684\u767c\u751f\u3002
2 . \u508d\u665a\u7684\u5496\u5561\u56e0\u8207\u9152\u7cbe\u651d\u53d6\u4e5f\u5bb9\u6613\u589e\u52a0\u591c\u9593\u6392\u5c3f\u91cf\uff0c \u61c9\u8a72\u76e1\u91cf\u907f\u514d\u3002
3 . \u4e86\u89e3\u6b63\u78ba\u7684\u559d\u6c34\u7fd2\u6163\uff0c \u78ba\u4fdd\u5408\u7406\u7684\u559d\u6c34\u91cf\u8207\u6392\u5c3f\u91cf\u3002<\/p>\n\n\n\n


\u85e5\u7269\u6cbb\u7642
1 . \u964d\u4f4e\u591c\u9593\u6392\u5c3f\u91cf: \u964d\u4f4e\u60a3\u8005\u7684\u591c\u9593\u6392\u5c3f\u91cf\u80fd\u6709\u6548\u6539\u5584\u591c\u5c3f\u767c\u751f\u7684\u6b21\u6578\u3002
\u6297\u5229\u5c3f\u6fc0\u7d20(Desmopressin): \u6fc3\u7e2e\u5c3f\u6db2\u3002
\u4e09\u74b0\u6297\u6182\u9b31\u5291(Imipramine): \u6e1b\u5c11\u5c3f\u6db2\u7522\u751f\u3002
\u5229\u5c3f\u5291(Furosemide): \u5354\u52a9\u6392\u51fa\u591a\u9918\u7684\u6c34\u5206\u3002
2 . \u6cbb\u7642\u8180\u80f1\u51fa\u53e3\u963b\u585e\u8207\u8180\u80f1\u904e\u52d5\u75c7:
\u7532\u578b\u4ea4\u611f\u795e\u7d93\u963b\u65b7\u5291(Silodosin\u3001Tamsulosin): \u8212\u7de9\u651d\u8b77\u817a\u5e73\u6ed1\u808c\u6539\u5584\u5c0d\u5c3f\u9053\u7684\u58d3\u8feb\u3002
5 \u03b1 – \u9084\u539f\u9176\u6291\u5236\u5291(proscar\u3001avodart): \u963b\u65b7DHT\u7684\u751f\u6210\uff0c \u4f7f\u80a5\u5927\u7684\u651d\u8b77\u817a\u7e2e\u5c0f\u3002
\u6297\u81bd\u9e7c\u985e\u85e5\u7269(oxybutynin)\u8207\u03b2 3 \u814e\u4e0a\u817a\u7d20\u53d7\u9ad4\u4fc3\u6548\u5291(betmiga)\uff1a\u6cbb\u7642\u8180\u80f1\u904e\u52d5\u75c7\u3002<\/p>\n\n\n\n

\u5176\u4ed6\u6cbb\u7642
1 . \u7cd6\u5c3f\u75c5\u63a7\u5236\uff1a \u826f\u597d\u7684\u8840\u7cd6\u63a7\u5236\u53ef\u4ee5\u6709\u6548\u6539\u5584\u60a3\u8005\u7684\u591a\u5c3f\u75c7\u72c0\u3002
2 . \u6301\u7e8c\u6027\u547c\u5438\u9053\u6b63\u58d3\u547c\u5438\u5668(Continuous positive airway pressure,CPAP)\uff1a \u7814\u7a76\u8b49\u5be6\u6539\u5584\u60a3\u8005\u7684\u963b\u585e\u6027\u7761\u7720\u547c\u5438\u4e2d\u6b62\u75c7(OSA)\u80fd\u6709\u6548\u964d\u4f4e\u591c\u5c3f\u75c7\u72c0\u3002
3 . \u4fc3\u9032\u7761\u7720\u85e5\u7269(Agent to promote sleep)\uff1a \u6709\u52a9\u65bc\u6e1b\u5c11\u56e0\u7761\u7720\u54c1\u8cea\u4e0d\u4f73\u800c\u63d0\u524d\u8d77\u4f86\u6392\u5c3f\u7684\u6b21\u6578\uff0c \u4e5f\u53ef\u4ee5\u5e6b\u52a9\u60a3\u8005\u6392\u5c3f\u5f8c\u56de\u5fa9\u5230\u7761\u7720\u7684\u72c0\u614b\u3002<\/p>\n\n\n\n

\"\"<\/figure>\n","protected":false},"excerpt":{"rendered":"

\u6ccc\u5c3f\u79d1 \u5f6d\u81f4\u51f1 \u4f4f\u9662\u91ab\u5e2b \u591c\u5c3f\u662f\u500b\u5e38\u898b\u7684\u75c7\u72c0\uff0c \u96d6\u7136\u4e4d\u770b\u4e0b\u4e0d\u662f\u4ec0\u9ebc\u56b4\u91cd\u7684\u75be\u75c5\uff0c \u4f46\u662f\u537b\u6703\u5927\u5927\u7684\u5f71\u97ff\u7761\u7720\u54c1\u8cea\uff0c […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[19],"tags":[123,170],"class_list":["post-4536","post","type-post","status-publish","format-standard","hentry","category-19","tag-123","tag-170"],"_links":{"self":[{"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/posts\/4536"}],"collection":[{"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4536"}],"version-history":[{"count":3,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/posts\/4536\/revisions"}],"predecessor-version":[{"id":4549,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=\/wp\/v2\/posts\/4536\/revisions\/4549"}],"wp:attachment":[{"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4536"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=4536"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=4536"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}