{"id":814,"date":"2017-08-23T11:54:07","date_gmt":"2017-08-23T03:54:07","guid":{"rendered":"http:\/\/epaper.pch.org.tw\/?p=814"},"modified":"2017-08-23T11:54:07","modified_gmt":"2017-08-23T03:54:07","slug":"%e7%b3%96%e5%b0%bf%e7%97%85%e5%bc%95%e8%b5%b7%e7%9a%84%e6%84%9f%e6%9f%93%e5%95%8f%e9%a1%8c","status":"publish","type":"post","link":"http:\/\/epaper.pch.org.tw\/?p=814","title":{"rendered":"\u7cd6\u5c3f\u75c5\u5f15\u8d77\u7684\u611f\u67d3\u554f\u984c"},"content":{"rendered":"

\u25cf \u611f\u67d3\u79d1 \u00a0\u8521\u6587\u77f3 \u00a0\u91ab\u5e2b<\/p>\n

\u7cd6\u5c3f\u75c5\u6703\u5f15\u8d77\u514d\u75ab\u7d30\u80de\u529f\u80fd\u7f3a\u9677\uff0c\u5305\u62ec\u7d30\u80de\u6fc0\u7d20\uff08cytokine \u5982IL-12, IFN-r\uff09\u7684\u7522\u751f\uff0c\u6e1b\u5c11\u53ca\u6bba\u83cc\u7cfb\u7d71\uff08\u5982ROS, O-, NO-, H2O2\uff09\u7684\u904b\u4f5c\u53d7\u5230\u6291\u5236\uff0c\u56e0\u6b64\u7cd6\u5c3f\u75c5\u7684\u75c5\u4eba\u8f03\u6613\u5f97\u5230\u611f\u67d3\u3002\u7cd6\u5c3f\u75c5\u5f15\u8d77\u7684\u8840\u7ba1\u75c5\u8b8a\u6703\u9020\u6210\u5c0f\u8840\u7ba1\u963b\u585e\uff1b\u9032\u800c\u5f15\u8d77\u7d44\u7e54\u7f3a\u6c27\u3001\u58de\u6b7b\u3001\u7d30\u83cc\u611f\u67d3\u3002\u6297\u751f\u7d20\u4e5f\u56e0\u5c0f\u8840\u7ba1\u963b\u585e\uff0c\u4e0d\u6613\u5230\u9054\u5468\u908a\u7d44\u7e54\uff0c\u9020\u6210\u611f\u67d3\u4e0d\u6613\u63a7\u5236\u3002\u7cd6\u5c3f\u75c5\u5f15\u8d77\u7684\u795e\u7d93\u75c5\u8b8a\u6703\u9020\u6210\u611f\u89ba\u7570\u5e38\uff0c\u75c5\u4eba\u4e0d\u6613\u89ba\u5bdf\u5230\u53d7\u50b7\u5730\u65b9\u7684\u75bc\u75db\u611f\u89ba\uff0c\u5bb9\u6613\u7522\u751f\u91cd\u8986\u53d7\u50b7\u800c\u4e0d\u81ea\u89ba\uff0c\u7cd6\u5c3f\u75c5\u8db3\u5c31\u662f\u9019\u6a23\u7522\u751f\u7684\u3002
\n\u7cd6\u5c3f\u75c5\u6613\u5f15\u8d77\u90a3\u4e9b\u7d30\u83cc\u611f\u67d3\u5462\uff1f
\n(1)\u91d1\u9ec3\u8272\u8461\u8404\u7403\u83cc
\n\u7cd6\u5c3f\u75c5\u75c5\u4eba\u9f3b\u8154\u5167\u7684\u91d1\u9ec3\u8272\u8461\u8404\u7403\u83cc\u5e36\u83cc\u7387\u6bd4\u4e00\u822c\u4eba\u9ad8\uff0c\u6545\u5bb9\u6613\u9020\u6210\u611f\u67d3\uff0c\u5982\u76ae\u819a\u81bf\u75b1\u3001\u81bf\u760d\u53ca\u611f\u5192\u4e4b\u5f8c\u7684\u4e8c\u5ea6\u7d30\u83cc\u611f\u67d3\u80ba\u708e\u2026\u2026
\n(2)\u514b\u96f7\u767d\u6c0f\u83cc
\n\u6703\u5f15\u8d77\u80ba\u708e\u3001\u809d\u81bf\u760d\u3001\u8166\u819c\u708e\u3001\u773c\u5167\u708e\u7b49\u3002\u570b\u5167\u7684\u809d\u81bf\u760d\u7d55\u5927\u591a\u6578\u662f\u514b\u96f7\u767d\u6c0f\u83cc\u9020\u6210\u7684\uff0c\u5176\u4e2d\u6709\u4e03\u516b\u6210\u662f\u7cd6\u5c3f\u75c5\u60a3\u8005\u3002
\n(3)\u80ba\u7d50\u6838
\n\u7cd6\u5c3f\u75c5\u4eba\u56e0\u5148\u5929\u514d\u75ab\u529f\u80fd\u7f3a\u9677\u5982 IL-12, IFN-r, ROS \u7684\u7522\u751f\u90fd\u8f03\u5c11\uff0c\u56e0\u6b64\u5f97\u80ba\u7d50\u6838\u7684\u6a5f\u6703\u8f03\u9ad8\u3002\u70ba\u4e00\u822c\u4eba\u76842\u52303\u500d\u4e14\u75c5\u6cc1\u5e38\u8f03\u56b4\u91cd\uff0c\u6613\u6709\u80ba\u90e8\u958b\u6d1e\u3001\u4e0b\u80ba\u6d78\u6f64\u3001\u75f0\u967d\u7387\u8f03\u9ad8\u3002\u6cbb\u7642\u6210\u529f\u7387\u8f03\u5dee\uff0c\u6b7b\u4ea1\u7387\u8f03\u9ad8\uff0c\u5e38\u9700\u5ef6\u9577\u6cbb\u7642\u6642\u9593\u3002\u7136\u800c\u8840\u7cd6\u63a7\u5236\u4f73\uff0c\u9019\u4e9b\u72c0\u6cc1\u90fd\u6703\u6539\u5584\u3002\u7cd6\u5c3f\u75c5\u63a7\u5236\u4e0d\u4f73\u4e5f\u6703\u5f15\u8d77\u80ba\u7d50\u6838\u85e5\u7269\u6fc3\u5ea6\u4e0b\u964d\uff1b\u800c\u80ba\u7d50\u6838\u85e5\u7269\u4e5f\u6703\u5f15\u8d77\u7cd6\u5c3f\u75c5\u7528\u85e5\uff08\u5982sulfonylurea, meglitinide, thiazolidinedione\uff09\u6fc3\u5ea6\u6e1b\u4f4e\uff0c\u5169\u8005\u6cbb\u7642\u6703\u4e92\u76f8\u5f71\u97ff\u3002
\n(4)\u767d\u8272\u5ff5\u73e0\u83cc\u611f\u67d3
\n\u5982\u53e3\u8154\u3001\u6703\u9670\u90e8\u3001\u76ae\u819a\u76ba\u8936\u8655\u7684\u76ae\u819a\u611f\u67d3\u3002
\n(5)\u767d\u9ef4\u83cc\u611f\u67d3
\n\u4e3b\u8981\u4fb5\u72af\u7cd6\u5c3f\u75c5\u916e\u9178\u4e2d\u6bd2\u7684\u75c5\u4eba\uff0c\u4e0a\u984e\u6703\u6709\u9ed1\u8272\u7126\u75c2\uff1b\u4e43\u56e0\u767d\u9ef4\u83cc\u4fb5\u72af\u8166\u90e8\u9f3b\u5b50\u7684\u8840\u7ba1\u3001\u9020\u6210\u6813\u585e\u3001\u7d44\u7e54\u58de\u6b7b\u3002
\n\u7cd6\u5c3f\u75c5\u6613\u5f15\u8d77\u90a3\u4e9b\u90e8\u4f4d\u7684\u7d30\u83cc\u611f\u67d3\u5462?
\n(1)\u6ccc\u5c3f\u9053\u611f\u67d3
\n\u7cd6\u5c3f\u75c5\u5973\u6027\u60a3\u8005\u6ccc\u5c3f\u9053\u7684\u5e36\u83cc\u7387\u8f03\u4e00\u822c\u4eba\u9ad8\uff1b\u53e6\u5916\u7cd6\u5c3f\u75c5\u4e5f\u6703\u5f71\u97ff\u8180\u80f1\u7684\u81ea\u4e3b\u795e\u7d93\u7cfb\u7d71\uff0c\u9020\u6210\u5c3f\u6db2\u6392\u4e0d\u4e7e\u6de8\uff0c\u5bb9\u6613\u9020\u6210\u6ccc\u5c3f\u9053\u611f\u67d3\u3002
\n\u6ccc\u5c3f\u9053\u611f\u67d3\u75c7\u72c0\u6709:\u767c\u71d2\u3001\u89e3\u5c3f\u75bc\u75db\u3001\u89e3\u5c3f\u71d2\u707c\u611f\u3001\u7015\u5c3f\u3001\u8170\u75db\u3001\u6065\u9aa8\u4e0a\u75bc\u75db\u3002
\n\u8655\u7406\u5247\u662f\uff1a\u5982\u6709\u5c0e\u5c3f\u7ba1\uff0c\u8acb\u65e9\u62ff\u6389(\u5982\u7121\u6cd5\u79fb\u9664\uff0c\u81f3\u5c11\u8981\u66f4\u63db)\uff0c\u53ef\u7528\u92a8\u57fa\u914d\u7cd6\u9ad4\u6297\u751f\u7d20\u6cbb\u7642(\u5982\u75c5\u4eba\u814e\u529f\u80fd\u6b63\u5e38)\u3002
\n\u885b\u6559\u5247\u8acb\u60a3\u8005\u591a\u559d\u6c34\u3001\u5c11\u618b\u5c3f\u3001\u6d17\u6fa1\u5118\u91cf\u7528\u6dcb\u6d74\u3001\u4e0d\u8981\u6ce1\u6fa1\u3001\u6ce8\u610f\u6703\u9670\u90e8\u6e05\u6f54\u3001\u5982\u5ec1\u5f8c\u8acb\u7531\u524d\u5f80\u5f8c\u64e6\u62ed\u3002
\n(2)\u80ba\u90e8\u611f\u67d3
\n\u7cd6\u5c3f\u75c5\u60a3\u8005\u6bd4\u8f03\u5bb9\u6613\u5f97\u5230\u91d1\u9ec3\u8272\u8461\u8404\u7403\u83cc\uff0c\u9769\u862d\u6c0f\u9670\u6027\u83cc\u7684\u80ba\u708e\uff1b\u800c\u5f97\u5230\u80ba\u708e\u93c8\u7403\u83cc\uff0c\u9000\u4f0d\u8ecd\u4eba\u75c7\u80ba\u708e\u6216\u6d41\u611f\u6642\uff0c\u75c7\u72c0\u5e38\u8f03\u56b4\u91cd\uff0c\u6b7b\u4ea1\u7387\u8f03\u9ad8\u3002\u6d41\u611f\u53ca\u80ba\u708e\u93c8\u7403\u83cc\u80ba\u708e\u53ef\u65bd\u6253\u75ab\u82d7\u9810\u9632\u611f\u67d3\u3002
\n(3)\u60e1\u6027\u5916\u8033\u708e
\n\u5e38\u56e0\u7da0\u81bf\u687f\u83cc\u5f15\u8d77\u5916\u8033\u56b4\u91cd\u816b\u75db\u53ca\u5206\u6ccc\u7269\uff0c\u5982\u4e0d\u6cbb\u7642\u6703\u4fb5\u72af\u8166\u90e8\uff0c\u9700\u8033\u9f3b\u5589\u79d1\u7dca\u6025\u8655\u7406\u4e26\u7528\u4e0a\u6cbb\u7642\u7da0\u81bf\u687f\u83cc\u7684\u6297\u751f\u7d20\u3002
\n(4)\u7522\u6c23\u6027\u81bd\u56ca\u708e
\n\u7d04\u670935-55%\u7684\u75c5\u4eba\u6709\u7cd6\u5c3f\u75c5,\u4e43\u56e0\u81bd\u56ca\u7f3a\u6c27\u58de\u6b7b\u7d30\u83cc\u7522\u6c23\u800c\u767c\u751f\uff0c\u75c5\u4eba\u6703\u6709\u53f3\u4e0a\u8179\u75bc\u75db\u767c\u71d2\u6b7b\u4ea1\u7387\u8f03\u4e00\u822c\u81bd\u56ca\u708e\u9ad8\u3002
\n(5)\u7522\u6c23\u6027\u814e\u76c2\u814e\u708e
\n\u7d04\u670990%\u7684\u75c5\u4eba\u6709\u7cd6\u5c3f\u75c5\uff0c\u53ef\u80fd\u4f34\u96a8\u6709\u8f38\u5c3f\u7ba1\u963b\u585e\uff0c20%\u6703\u5f15\u8d77\u814e\u4e73\u982d\u58de\u6b7b\uff08renal papillary necrosis\uff09\uff0c\u75c5\u60c5\u56b4\u91cd\uff0c\u5e38\u9700\u5916\u79d1\u624b\u8853\u6216\u5f15\u6d41\uff0c\u518d\u52a0\u4e0a\u6297\u751f\u7d20\u3002
\n(6)\u56b4\u91cd\u7684\u8edf\u7d44\u7e54\u611f\u67d3
\n\u5982\u58de\u6b7b\u6027\u7b4b\u819c\u708e, Fournier’s gangrene \uff08\u5728\u6703\u9670\u90e8\u7684\u58de\u6b7b\u6027\u7b4b\u819c\u708e\uff09\uff0c\u81bf\u6027\u808c\u708e\u7b49\u5e38\u9700\u5916\u79d1\u7dca\u6025\u6e05\u5275\u3002
\n\u7cd6\u5c3f\u75c5\u4e0d\u597d\u597d\u63a7\u5236\uff0c\u4e0d\u50c5\u5bb9\u6613\u9020\u6210\u5927\u8840\u7ba1\u75c5\u8b8a\uff0c\u5982:\u51a0\u72c0\u52d5\u8108\u75be\u75c5\u3001\u8166\u4e2d\u98a8\uff1b\u5c0f\u8840\u7ba1\u75be\u75c5\uff0c\u5982\uff1a\u814e\u8870\u7aed\u3001\u8996\u7db2\u819c\u75c5\u8b8a\u3001\u795e\u7d93\u75c5\u8b8a\uff1b\u4e5f\u5bb9\u6613\u9020\u6210\u5404\u6a23\u7684\u611f\u67d3\u75c7\uff0c\u5982:\u80ba\u7d50\u6838\u3001\u767d\u8272\u5ff5\u73e0\u83cc\u3001\u91d1\u9ec3\u8272\u8461\u8404\u7403\u83cc\u76ae\u819a\u611f\u67d3\u3001\u514b\u96f7\u767d\u6c0f\u83cc\u809d\u81bf\u760d\u3001\u6ccc\u5c3f\u9053\u611f\u67d3\uff0c\u800c\u8840\u7cd6\u63a7\u5236\u662f\u5426\u826f\u597d\u4e5f\u6703\u5f71\u97ff\u611f\u67d3\u75c7\u7684\u6cbb\u7642\u6548\u679c\u3002\u5e0c\u671b\u5404\u4f4d\u9109\u89aa\u670b\u53cb\u8d95\u7dca\u627e\u60a8\u7684\u91ab\u5e2b\u597d\u597d\u63a7\u5236\u60a8\u7684\u8840\u7cd6\u5427\uff01<\/p>\n","protected":false},"excerpt":{"rendered":"

\u25cf \u611f\u67d3\u79d1 \u00a0\u8521\u6587\u77f3 \u00a0\u91ab\u5e2b \u7cd6\u5c3f\u75c5\u6703\u5f15\u8d77\u514d\u75ab\u7d30\u80de\u529f\u80fd\u7f3a\u9677\uff0c\u5305\u62ec\u7d30\u80de\u6fc0\u7d20\uff08cyt … \u95b1\u8b80\u5168\u6587 →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[109],"tags":[92],"class_list":["post-814","post","type-post","status-publish","format-standard","hentry","category-85201707-08","tag-topic"],"_links":{"self":[{"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/posts\/814","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=814"}],"version-history":[{"count":1,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/posts\/814\/revisions"}],"predecessor-version":[{"id":815,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/posts\/814\/revisions\/815"}],"wp:attachment":[{"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=814"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=814"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=814"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}