不定時炸彈 肝硬化脾臟腫大逾2公斤

[MK]

http://tw.news.yahoo.com/article/url/d/ ... 1l3kl.html
更新日期:2009/06/11 19:03
（中央社記者趙宏進台中縣11日電）正常人脾臟約一個拳頭般大小，但林先生卻因肝硬化導致脾臟腫大，為一般人的近4倍，在體內形同是顆「不定時炸彈」隨時危及生命，經台中慈濟醫院順利摘除重逾2公斤的脾臟。


林先生上個月因肚子劇痛，到台中慈濟醫院求醫，肝膽腸胃科醫師黃吉宏檢查發現，脾臟腫大到十分緊急的地步。


一般外科主任吳永康醫師會診發現，林先生的白血球、紅血球、血小板嚴重偏低，顯示大部分的白血球、紅血球、血小板在脾臟受到嚴重破壞。


正常人的血小板量至少20、30萬/UL，起碼10萬/UL才能發揮凝血功能，但林先生卻只有4、5萬/UL，連刷牙都會流血。白血球更只有1000多/立方毫米，隨時可能因小感染，或是跌倒導致脾臟破裂，在凝血功能太差情形下，造成大量失血而危及生命。


吳永康表示，屆時患者即使緊急開刀，也可能因預防感染的措施難完善而難保性命，形同身上隨時帶著一個「不定時炸彈」，什麼時候會爆開都沒有人知道。


慈濟醫療團隊在手術前提升林先生的白血球量，手術中則克服脾臟靜脈血管薄如蟬翼的困難，小心翼翼的以4小時完成手術。


「心裡的大石頭終於放下來了！」林先生甦醒後第一句話就是感恩。吳永康指出，林先生才40幾歲而已，太太年輕，孩子幼小，救他一命，等於是救了全家人。


吳永康說，肝硬化的民眾很多，嚴重的合併症包括：脾臟腫大、肝昏迷與食道靜脈曲張出血，一旦脾臟持續長大到一定的階段，只要不是身體太差、還有機會，就要趕快處理掉。


吳永康建議肝病病人不要太勞累、多吃營養新鮮的東西，生活起居習慣儘量正常，戒除菸、酒與檳榔等刺激性的東西，請醫師評估用藥，避免胡亂吃藥增加肝負荷，感覺不對就要定期就醫追蹤檢查。980611

[surgmania]

這類患者脾臟切除後白血球數就會rebound回來,跟本就不需術前去提升白血球,要先打vaccine預防postsplenectomy sepsis才是真的

[DR.HSU]

新成立的醫院都會藉機上新聞打廣告.

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