{"id":6177,"date":"2025-12-02T10:30:25","date_gmt":"2025-12-02T02:30:25","guid":{"rendered":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/?p=6177"},"modified":"2025-12-02T10:30:40","modified_gmt":"2025-12-02T02:30:40","slug":"%e5%85%a8%e7%90%83%e6%9c%80%e8%87%b4%e5%91%bd%e7%9a%84%e5%82%b3%e6%9f%93%e7%97%85%e4%b9%8b%e4%b8%80%e7%b5%90%e6%a0%b8%e7%97%85tb","status":"publish","type":"post","link":"https:\/\/web.csh.org.tw\/web\/cshmagazine\/?p=6177","title":{"rendered":"\u5168\u7403\u6700\u81f4\u547d\u7684\u50b3\u67d3\u75c5\u4e4b\u4e00\u7d50\u6838\u75c5(TB)"},"content":{"rendered":"\n

\u6587\uff0fTB\u500b\u7ba1\u5e2b<\/p>\n\n\n\n

\u3000\u3000\u622a\u81f32025\u5e74\uff0c\u7d50\u6838\u75c5\uff08TB\uff09\u4ecd\u662f\u5168\u7403\u6700\u81f4\u547d\u7684\u50b3\u67d3\u75c5\u4e4b\u4e00\uff0c\u5118\u7ba1\u5df2\u6709\u53ef\u9810\u9632\u548c\u53ef\u6cbb\u7642\u7684\u624b\u6bb5\u3002\u6839\u64da\u4e16\u754c\u885b\u751f\u7d44\u7e54\uff08WHO\uff09\u7684\u8cc7\u6599\uff0c2023\u5e74\u5168\u7403\u65b0\u8a3a\u65b7\u7d50\u6838\u75c5\u75c5\u4f8b\u9054820\u842c\u4f8b\uff0c\u6b7b\u4ea1\u4eba\u6578\u7d04125\u842c\u4eba\u3002\u70ba\u9054\u62102035\u5e74\u6d88\u9664\u7d50\u6838\u75c5\u7684\u76ee\u6a19\uff0c\u53f0\u7063\u7a4d\u6975\u63a8\u52d5\u6f5b\u4f0f\u7d50\u6838\u611f\u67d3\uff08LTBI\uff09\u7be9\u6aa2\u8207\u6cbb\u7642\u8a08\u756b\u30022025\u5e743\u6708\uff0c\u75be\u7ba1\u7f72\u555f\u52d5\u514d\u8cbbLTBI\u7be9\u6aa2\uff0c\u91dd\u5c0d\u8207\u7d50\u6838\u75c5\u60a3\u8005\u6709\u76f4\u63a5\u63a5\u89f8\u8005\uff0c\u63d0\u4f9b\u514d\u8cbb\u7be9\u6aa2\u8207\u653f\u5e9c\u8cc7\u52a9\u7684\u9810\u9632\u6027\u6cbb\u7642\u3002<\/p>\n\n\n\n

\u8a8d\u8b58\u7d50\u6838\u75c5<\/strong><\/p>\n\n\n\n

\u3000\u3000\u7d50\u6838\u75c5\u662f\u4e00\u7a2e\u7531\u7d50\u6838\u5206\u679d\u687f\u83cc\uff08Mycobacterium tuberculosis\uff09\u5f15\u8d77\u7684\u50b3\u67d3\u6027\u75be\u75c5\uff0c\u4e3b\u8981\u5f71\u97ff\u80ba\u90e8\uff0c\u4f46\u4e5f\u53ef\u80fd\u4fb5\u72af\u8eab\u9ad4\u7684\u5176\u4ed6\u90e8\u4f4d\uff0c\u5982\u6dcb\u5df4\u7d50\u3001\u9aa8\u9abc\u3001\u814e\u81df\u548c\u4e2d\u6a1e\u795e\u7d93\u7cfb\u7d71\u3002<\/p>\n\n\n\n

\u7d50\u6838\u5206\u679d\u687f\u83cc<\/strong><\/p>\n\n\n\n

\u3000\u3000\u7d50\u6838\u5206\u679d\u687f\u83cc\u662f\u4e00\u7a2e\u9769\u862d\u6c0f\u967d\u6027\u3001\u9700\u6c27\u3001\u975e\u904b\u52d5\u6027\u7684\u687f\u72c0\u7d30\u83cc\uff0c\u5c6c\u65bc\u5206\u679d\u687f\u83cc\u5c6c\uff08Mycobacterium\uff09\u3002\u5b83\u662f\u5f15\u8d77\u7d50\u6838\u75c5\u7684\u4e3b\u8981\u81f4\u75c5\u83cc\u3002\u7d30\u83cc\u5f62\u614b\u8207\u7279\u6027\uff0c\u5916\u89c0\u5448\u73fe\u7d30\u9577\u7684\u687f\u72c0\u83cc\u3002\u5c6c\u65bc\u6297\u9178\u83cc\u7279\u6027\u751f\u9577\u7de9\u6162\uff0c\u56e0\u800c\u57f9\u990a\u6642\u9593\u901a\u5e38\u9700\u6578\u9031\uff08\u7d043\uff5e6\u9031\uff09\u3002<\/p>\n\n\n\n

\u50b3\u67d3\u9014\u5f91<\/strong><\/p>\n\n\n\n

\u3000\u3000\u7d30\u83cc\u85c9\u7531\u4e3b\u8981\u7d93\u7531\u7a7a\u6c23\u98db\u6cab\u50b3\u64ad\uff0c\u7576\u5e36\u83cc\u8005\u54b3\u55fd\u3001\u6253\u5674\u568f\u6642\uff0c\u91cb\u653e\u51fa\u7684\u98db\u6cab\u4e2d\u542b\u6709\u83cc\u9ad4\uff0c\u5176\u4ed6\u4eba\u5438\u5165\u5f8c\u53ef\u80fd\u88ab\u611f\u67d3\u3002<\/p>\n\n\n\n

\u3000\u3000\u901a\u5e38\u4e3b\u8981\u611f\u67d3\u90e8\u4f4d\uff1a\u80ba\u90e8\uff0c\u4f46\u4e5f\u53ef\u80fd\u64f4\u6563\u5230\u6dcb\u5df4\u7d50\u3001\u9aa8\u9abc\u3001\u814e\u81df\u3001\u8166\u819c\u7b49\u5176\u4ed6\u90e8\u4f4d\u3002<\/p>\n\n\n\n

\u81e8\u5e8a\u75c7\u72c0<\/strong><\/p>\n\n\n\n

    \n
  1. \u54b3\u55fd\uff1a\u6301\u7e8c\u54b3\u55fd\u8d85\u904e\uff12\uff5e\uff13\u9031\uff0c\u5e38\u70ba\u4e7e\u54b3\uff0c\u5f8c\u671f\u53ef\u80fd\u5e36\u6709\u75f0\u3002<\/li>\n\n\n\n
  2. \u54b3\u8840\uff08\u75f0\u4e2d\u5e36\u8840\u7d72\u6216\u54b3\u51fa\u9bae\u8840\uff09\u3002<\/li>\n\n\n\n
  3. \u80f8\u75db\uff1a\u5c24\u5176\u662f\u547c\u5438\u6216\u54b3\u55fd\u6642\u80f8\u75db\u3002<\/li>\n\n\n\n
  4. \u767c\u71d2\uff1a\u901a\u5e38\u70ba\u4f4e\u71d2\uff0c\u5e38\u5728\u4e0b\u5348\u6216\u665a\u4e0a\u767c\u4f5c\u3002<\/li>\n\n\n\n
  5. \u591c\u9593\u76dc\u6c57\uff1a\u7761\u89ba\u6642\u5927\u91cf\u51fa\u6c57\u3002<\/li>\n\n\n\n
  6. \u9ad4\u91cd\u6e1b\u8f15\uff1a\u7121\u660e\u986f\u539f\u56e0\u7684\u9ad4\u91cd\u6e1b\u8f15\u548c\u98df\u617e\u4e0d\u632f\u3002<\/li>\n\n\n\n
  7. \u75b2\u5026\u4e4f\u529b\uff1a\u9577\u671f\u611f\u89ba\u7121\u529b\u6216\u75b2\u5026\u3002<\/li>\n<\/ol>\n\n\n\n

    \u3000\u3000\u5982\u679c\u5df2\u7d93\u767c\u73fe\u4ee5\u4e0b\u75c7\u72c0\uff0c\u5efa\u8b70\u8d95\u5feb\u56de\u80f8\u8154\u5167\u79d1\u6216\u611f\u67d3\u79d1\u9580\u8a3a\u9032\u4e00\u6b65\u8ffd\u8e64\u6aa2\u67e5\u3002<\/p>\n\n\n\n

    \u7d50\u6838\u75c5\u8a3a\u65b7\u65b9\u6cd5<\/strong><\/p>\n\n\n\n

    \u3000\u3000\u91ab\u5e2b\u6703\u5148\u6839\u64da\u75c5\u4eba\u662f\u5426\u6709\u5178\u578b\u7684\u7d50\u6838\u75c5\u75c7\u72c0\u4f86\u5224\u65b7\u662f\u5426\u9700\u8981\u9032\u4e00\u6b65\u6aa2\u67e5\u3002<\/p>\n\n\n\n

    1. <\/strong>\u5f71\u50cf\u5b78\u6aa2\u67e5\uff1a<\/strong><\/p>\n\n\n\n

      \n
    • \u80f8\u90e8\uff38\u5149\uff08Chest X-ray\uff09<\/li>\n\n\n\n
    • \u80f8\u90e8\u96fb\u8166\u65b7\u5c64\u6383\u63cf\uff08CT\uff09<\/li>\n<\/ul>\n\n\n\n

      2. <\/strong>\u5fae\u751f\u7269\u5b78\u6aa2\u67e5\uff1a<\/strong><\/p>\n\n\n\n

        \n
      • \u75f0\u6db2\u5857\u7247\u6297\u9178\u67d3\u8272<\/li>\n\n\n\n
      • \u75f0\u6db2\u57f9\u990a<\/li>\n\n\n\n
      • \u6838\u9178\u64f4\u589e\u6aa2\u6e2c\uff08NAAT\uff0c\u5982PCR\uff09<\/li>\n<\/ul>\n\n\n\n

        3. <\/strong>\u514d\u75ab\u5b78\u6aa2\u6e2c\uff1a<\/strong><\/p>\n\n\n\n

          \n
        • \u7d50\u6838\u83cc\u7d20\u76ae\u819a\u8a66\u9a57\uff08Tuberculin Skin Test, TST\uff09<\/li>\n\n\n\n
        • \u5e72\u64fe\u7d20\u91cb\u653e\u8a66\u9a57\uff08Interferon-Gamma Release Assays, IGRA\uff09<\/li>\n<\/ul>\n\n\n\n

          4. <\/strong>\u5176\u4ed6\u6aa2\u67e5\uff1a<\/strong><\/p>\n\n\n\n

            \n
          • \u7d44\u7e54\u5207\u7247\u6d3b\u6aa2\u3002<\/li>\n<\/ul>\n\n\n\n

            \u6cbb\u7642\u65b9\u6cd5<\/strong><\/p>\n\n\n\n

            \u3000\u3000\u7576\u6211\u5011\u88ab\u8a3a\u65b7\u70ba\u7d50\u6838\u75c5\uff0c\u6700\u95dc\u5fc3\u7684\u4e0b\u4e00\u500b\u554f\u984c\uff0c\u6211\u8981\u5982\u4f55\u6cbb\u7642\uff1f<\/p>\n\n\n\n

            \u3000\u3000\u7d50\u6838\u75c5\u5927\u90e8\u5206\u6cbb\u7642\u539f\u5247\u70ba\u85e5\u7269\u6cbb\u7642\uff0c\u9700\u8981\u9577\u671f\u670d\u7528\u591a\u7a2e\u6297\u7d50\u6838\u85e5\u7269\uff0c\u4ee5\u78ba\u4fdd\u5fb9\u5e95\u6bba\u6b7b\u7d50\u6838\u83cc\uff0c\u9632\u6b62\u5fa9\u767c\u8207\u6297\u85e5\u6027\u7522\u751f\u3002\u6cbb\u7642\u901a\u5e38\u5206\u70ba\u5169\u671f\uff1a\u521d\u671f\u5bc6\u96c6\u6cbb\u7642\uff082\u500b\u6708\uff09\u548c\u7dad\u6301\u6cbb\u7642\uff084\uff0d7\u500b\u6708\uff09\uff0c\u6574\u9ad4\u7642\u7a0b\u81f3\u5c116\u500b\u6708\u3002<\/p>\n\n\n\n

            \u5e38\u7528\u6297\u7d50\u6838\u85e5\u7269\uff1a<\/strong><\/p>\n\n\n\n

            (1)Isoniazid, INH\u3001(2)Rifampin, RIF\u3001(3)Ethambutol, EMB\u3001(4)Pyrazinamide, PZA\uff0c\u9019\u56db\u7a2e\u85e5\u7269\u7d44\u5408\u662f\u521d\u671f\u6a19\u6e96\u6cbb\u7642\uff0c\u901a\u5e38\u7a31\u70ba\u300c\uff14\u5408\u4e00\u6cbb\u7642\u300d\u3002\u6574\u9ad4\u7642\u7a0b\u901a\u5e38\u70ba\uff16\u500b\u6708\uff0c\u67d0\u4e9b\u8907\u96dc\u6216\u8010\u85e5\u75c5\u4f8b\u53ef\u80fd\u9700\u8981\u66f4\u9577\u6642\u9593\uff0c\u90a3\u5728\u6cbb\u7642\u904e\u7a0b\u4e2d\uff0c\u6703\u6301\u7e8c\u505a\u7d30\u83cc\u57f9\u990a\uff0c\u76e3\u6e2c\u662f\u5426\u70ba\u6297\u85e5\u6027\u7d50\u6838\uff0c\u82e5\u771f\u7684\u70ba\u6297\u85e5\u6027\u7d50\u6838\uff0c\u7528\u85e5\u90e8\u5206\uff0c\u6703\u518d\u7528\u65bc\u5f8c\u7dda\u6297\u751f\u7d20\uff0c\u66f4\u9700\u8981\u5c08\u79d1\u91ab\u5e2b\u6307\u5c0e\u3002<\/p>\n\n\n\n

            \u6cbb\u7642\u671f\u9593\u7684\u76e3\u6e2c<\/strong><\/p>\n\n\n\n

            \u3000\u3000\u670d\u7528\u85e5\u7269\u5f8c\uff0c\u6703\u5b9a\u671f\u6aa2\u67e5\u809d\u529f\u80fd\u8207\u8996\u529b\u975e\u5e38\u91cd\u8981\uff0c\u4ee5\u4fbf\u53ca\u65e9\u767c\u73fe\u526f\u4f5c\u7528\u3002\u85e5\u7269\u5f15\u8d77\u7684\u5468\u908a\u795e\u7d93\u708e\u53ef\u4f7f\u7528\u7dad\u751f\u7d20B6\u9810\u9632\u3002\u60a3\u8005\u61c9\u9075\u5b88\u91ab\u56d1\u6309\u6642\u670d\u85e5\uff0c\u907f\u514d\u6cbb\u7642\u4e2d\u65b7\uff0c\u4ee5\u964d\u4f4e\u6297\u85e5\u6027\u98a8\u96aa\u3002\u9075\u5b88\u670d\u85e5\u8a08\u5283\u975e\u5e38\u91cd\u8981\uff0c\u907f\u514d\u4e2d\u65b7\u6cbb\u7642\uff0c\u9632\u6b62\u6297\u85e5\u6027\u7522\u751f\u3002<\/p>\n\n\n\n

            \u75be\u75c5\u9810\u9632<\/strong><\/p>\n\n\n\n

              \n
            1. \u63a5\u7a2e\u75ab\u82d7\uff1a\u5361\u4ecb\u82d7\uff08BCG\u75ab\u82d7\uff09\uff1a\u76ee\u524d\u552f\u4e00\u53ef\u7528\u65bc\u9810\u9632\u7d50\u6838\u75c5\u7684\u75ab\u82d7\u3002\u4e3b\u8981\u91dd\u5c0d\u5b30\u5e7c\u5152\uff0c\u80fd\u6709\u6548\u6e1b\u5c11\u56b4\u91cd\u7d50\u6838\u4f75\u767c\u75c7\u7684\u767c\u751f\u3002\u5c0d\u65bc\u6210\u4eba\u80ba\u7d50\u6838\u7684\u4fdd\u8b77\u6548\u679c\u6709\u9650\u3002<\/li>\n\n\n\n
            2. \u65e9\u671f\u767c\u73fe\u8207\u6cbb\u7642\u3002<\/li>\n\n\n\n
            3. \u6f5b\u4f0f\u7d50\u6838\u611f\u67d3\u7684\u6cbb\u7642\u3002\u5c0d\u9ad8\u98a8\u96aa\u4eba\u7fa4\u9032\u884c\u6f5b\u4f0f\u611f\u67d3\u6aa2\u6e2c\uff08TST\u6216IGRA\uff09\u3002<\/li>\n\n\n\n
            4. \u516c\u5171\u885b\u751f\u63aa\u65bd\uff0c\u52a0\u5f37\u7d50\u6838\u75c5\u60a3\u8005\u7684\u9694\u96e2\uff0c\u7279\u5225\u662f\u6709\u50b3\u67d3\u6027\u7684\u80ba\u7d50\u6838\u60a3\u8005\u3002\u63d0\u5021\u826f\u597d\u7684\u901a\u98a8\u8207\u885b\u751f\u7fd2\u6163\uff0c\u6e1b\u5c11\u75c5\u83cc\u5728\u7a7a\u6c23\u4e2d\u7684\u6fc3\u5ea6\u3002\u52a0\u5f37\u793e\u5340\u5065\u5eb7\u6559\u80b2\uff0c\u63d0\u9ad8\u5c0d\u7d50\u6838\u75c5\u7684\u8a8d\u8b58\u3002<\/li>\n<\/ol>\n\n\n\n

              \u3000\u3000\u9810\u9632\u52dd\u65bc\u6cbb\u7642\uff0c\u65e9\u4e00\u6b65\u8655\u7406\uff0c\u5c31\u80fd\u4fdd\u8b77\u81ea\u5df1\u548c\u5bb6\u4eba\u3002\u82e5\u4f60\u66fe\u63a5\u89f8\u904e\u7d50\u6838\u75c5\u60a3\u8005\u3001\u6216\u5728\u5065\u6aa2\u6642\u767c\u73fe\u7570\u5e38\uff0c\u5efa\u8b70\u4e3b\u52d5\u8aee\u8a62\u91ab\u5e2b\uff0c\u770b\u770b\u662f\u5426\u9700\u8981\u9032\u4e00\u6b65\u6aa2\u67e5\u6216\u9810\u9632\u6027\u6cbb\u7642\u3002<\/p>\n\n\n\n

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

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