症狀找原因
依症狀找可能疾病、看病科別及醫師
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<p class="MsoNormal" align="center" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; text-align: center;"><b><span style="font-size: 24pt;"><span style="color: rgb(255, 0, 0); text-decoration: inherit;"><span style="font-family: Arial, Helvetica, sans-serif;">海扶刀消融治療甲狀腺腫</span></span></span></b><b><span lang="EN-US" style="font-size: 22pt; font-family: 新細明體;"><o:p></o:p></span></b></p><p class="MsoNormal" align="center" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; text-align: center;"><b><span style="font-size: 24pt;"><span style="color: rgb(255, 0, 0); text-decoration: inherit;"><br></span></span></b></p><p class="MsoNormal" align="center" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; text-align: center;"><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 18pt;">王文弘醫師 </span></span><span style="font-family: Arial, Helvetica, sans-serif;"><span lang="EN-US"><span style="font-size: 18pt;">/ </span></span></span><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 18pt;">醫學博士 </span></span><span style="font-family: Arial, Helvetica, sans-serif;"><span lang="EN-US"><span style="font-size: 18pt;">/ </span></span></span><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 18pt;">美國外科學院院士</span></span><span style="font-family: Arial, Helvetica, sans-serif;"><span lang="EN-US"><o:p></o:p></span></span></p><p class="MsoNormal" align="center" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; text-align: center;"><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 18pt;">國泰醫院耳鼻喉科 </span></span><span style="font-family: Arial, Helvetica, sans-serif;"><span lang="EN-US"><span style="font-size: 18pt;">/ </span></span></span><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 18pt;">輔仁大學醫學系副教授</span></span><span style="font-family: Arial, Helvetica, sans-serif;"><span lang="EN-US"><o:p></o:p></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400;"><span lang="EN-US" style="font-size: 14pt; font-family: 新細明體;"><o:p> </o:p></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400;"><b><u><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">何謂海扶刀</span></span><span style="font-size: 18pt;"><span lang="EN-US"><o:p></o:p></span></span></u></b></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400;"><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">海扶刀是「高強度聚焦超音波</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;"> (High-intensity focused ultrasound)</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">」的譯稱，英文縮寫為「</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">HIFU</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">」。</span></span><span style="font-size: 18pt;"><span lang="EN-US"><o:p></o:p></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400;"><span lang="EN-US" style="font-size: 14pt; font-family: 新細明體;"><o:p> </o:p></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400;"><b><u><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">治療原理</span></span><span style="font-size: 18pt;"><span lang="EN-US"><o:p></o:p></span></span></u></b></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400;"><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">利用高能量超音波聚焦在一個點上會</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">產</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">生熱能的原理，把組織加熱到攝氏</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">60</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">℃</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">以上，破壞細胞中的蛋白質，使得腫瘤細胞</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">產</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">生凝固性壞死，再逐漸被周邊的正常組織吸收，達到消融的效果和緩解症狀的目的。</span></span><span style="font-size: 18pt;"><span lang="EN-US"><o:p></o:p></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400;"><span lang="EN-US" style="font-size: 14pt; font-family: 新細明體;"><o:p> </o:p></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400;"><b><u><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">操作方法</span></span><span style="font-size: 18pt;"><span lang="EN-US"><o:p></o:p></span></span></u></b></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400;"><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">採取靜脈舒眠麻醉方式，首先會使用超音波定位找出病灶的位置，再透過電腦計算預期的燒灼路徑，接著就能讓機器自動進行手術，機器會將檢</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">查</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">用超音波的強度提高，並聚焦在腫瘤的位置上，在同一平面依序燒灼病灶，藉由不斷改變燒灼位置，就能處理整個立體病灶完成手術。身體上並不會留下任何傷口，加上焦點外的超音波能量衰減大，在超音波傳遞路徑上組織所吸收的熱能低，不會破壞焦點外的正常組織。</span></span><span style="font-size: 18pt;"><span lang="EN-US"><o:p></o:p></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400;"><span lang="EN-US" style="font-size: 14pt; font-family: 新細明體;"><o:p> </o:p></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400;"><b><u><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">治療效果</span></span><span style="font-size: 18pt;"><span lang="EN-US"><o:p></o:p></span></span></u></b></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400;"><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">根據研究報告顯示，在海扶刀治療</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">甲狀腺結節</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">後追蹤兩年的結果發現</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">6</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">個月體積減少</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">62.99± 22.05%</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">，</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">12</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">個月體積減少</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">68.66 ± 18.48%</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">，</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">24</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">個月體積減少</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">70.41 ± 17.39%</span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">。</span></span><span lang="EN-US" style="font-size: 14pt; font-family: 新細明體;"><o:p></o:p></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400;"><span lang="EN-US" style="font-size: 14pt; font-family: 新細明體;"><o:p> </o:p></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0.0001pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400;"><b><u><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">治療對象</span></span><span style="font-size: 18pt;"><span lang="EN-US"><o:p></o:p></span></span></u></b></p><p class="MsoListParagraph" style="margin: 0cm 0cm 0.0001pt 18pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; text-indent: -18pt;"><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">1.</span></span><span style="font-size: 18pt;"><span style="font: 7pt "Times New Roman";"> </span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">甲狀腺良性結節</span></span><span style="font-size: 18pt;"><span lang="EN-US"><o:p></o:p></span></span></p><p class="MsoListParagraph" style="margin: 0cm 0cm 0.0001pt 18pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; text-indent: -18pt;"><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">2.</span></span><span style="font-size: 18pt;"><span style="font: 7pt "Times New Roman";"> </span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">副甲狀腺增生及腫瘤</span></span><span lang="EN-US" style="font-size: 14pt; font-family: 新細明體;"><o:p></o:p></span></p><p class="MsoListParagraph" style="margin: 0cm 0cm 0.0001pt 18pt; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; text-indent: -18pt;"><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">3.</span></span><span style="font-size: 18pt;"><span style="font: 7pt "Times New Roman";"> </span></span><span class="style1723"><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">毒性甲狀腺腫（</span></span><span style="font-size: 18pt;"><span lang="EN-US"><span style="font-family: Arial, Helvetica, sans-serif;">Toxic Goiter</span></span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">）</span></span><span style="font-size: 18pt;"><span lang="EN-US"><span style="font-family: Arial, Helvetica, sans-serif;">:</span></span></span></span><span style="font-size: 18pt;"><span style="font-family: Arial, Helvetica, sans-serif;">具有甲狀腺功能亢進症狀的甲狀腺組織增生。</span></span><span style="font-size: 18pt;"><span lang="EN-US"><o:p></o:p></span></span></p><h1 style="margin: 6pt 0cm 6pt 72pt; font-size: 24pt; font-family: "Times New Roman"; font-weight: bold; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; text-indent: -54pt; line-height: 15pt; background-image: initial; background-position: initial; background-size: initial; background-repeat: initial; background-attachment: initial; background-origin: initial; background-clip: initial;"><div class="pasteContent" style="display:inline;" _ngcontent-c36=""><p><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 14pt;">（1）持續性或復發性瀰漫性毒性甲狀腺腫（Diffuse Toxic Goiter）：又稱葛瑞夫茲氏病(Graves disease)，是由對抗甲促素結合體(TSH receptor, TSHR)的自體抗體所引起是一種自身免疫性甲狀腺疾病，為甲狀腺功能亢進最常見的原因。根據研究報告顯示，在海扶刀治療持續性或復發性Graves病後追蹤兩年的結果發現初期成功率可達96.7%，追蹤12個月有26.7%經歷復發，24個月有41.3%經歷復發。其中TSHR自體抗體血中濃度越高，復發的機會越高。</span></span></p><p><span style="font-family: Arial, Helvetica, sans-serif;"><span style="font-size: 14pt;">（2）毒性結節性甲狀腺腫（Toxic Nodular Goiter）: 又稱繼發性甲亢、或Plummer病，約佔甲亢的10～30%，通常發生於原來已有多年多結節性甲狀腺腫的病人，一般在40歲以上後逐漸產生甲狀腺機能亢進的症狀，較彌漫性毒性甲狀腺腫的發病年齡爲大，且比較少出現眼突的症狀。</span></span></p></div><br></h1><p style="margin-right: 0cm; margin-left: 0cm; font-size: 12pt; font-family: "Times New Roman"; color: rgb(0, 0, 0); font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400;"><span lang="EN-US" style="font-size: 14pt; font-family: 新細明體;"></span><span lang="EN-US" style="font-size: 14pt; font-family: 新細明體;"><o:p></o:p></span></p>
王文弘
2020:06:27
最新療法
依症狀找可能疾病、看病科別及醫師