hansem668 2012-4-23 15:41
過胖者呼吸困難 恐患通氣不良
<p style="LINE-HEIGHT: 190%; MARGIN: 0cm 0cm 0pt; mso-pagination: widow-orphan" class="MsoNormal"><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">【聯合報</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 細明體; COLOR: #414141; FONT-SIZE: 11.5pt; mso-bidi-font-family: 細明體; mso-font-kerning: 0pt" lang="EN-US">╱</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">記者蔡容喬/高雄報導】</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: dimgray; FONT-SIZE: 10pt" lang="EN-US"></span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 10pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US"><o:p></o:p></span></p>
<p style="LINE-HEIGHT: 190%; MARGIN: 0cm 0cm 0pt; mso-pagination: widow-orphan; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto" class="MsoNormal"><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">高雄榮總醫師最近發現,急診出現多名「重量級」病患,因呼吸困難、意識不清送醫,甚至嚴重到須插管治療,體重都超過百公斤,推測是國外常見的「肥胖通氣不良症候群」,因過胖影響肺功能。</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US"> <o:p></o:p></span></p>
<p style="LINE-HEIGHT: 190%; MARGIN: 0cm 0cm 0pt; mso-pagination: widow-orphan; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto" class="MsoNormal"><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">高榮指出,這些病患沒有肺病病史,也不是肺阻塞或腦中風,純粹是肥胖引起,台灣最近近幾年來,類似的患者越來越多。</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US"> <o:p></o:p></span></p>
<p style="LINE-HEIGHT: 190%; MARGIN: 0cm 0cm 0pt; mso-pagination: widow-orphan; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto" class="MsoNormal"><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">高雄榮總呼吸治療科主治醫師李錦中指出,國外研究顯示,肥胖通氣不良症候群患者近</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">30</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">年來在美國逐漸增加,因過度肥胖者胸、腹部脂肪細胞多,胸腔容積小,肺部通氣功能長期受限,心臟、神經系統功能也逐漸受損,不少患者白天常有注意力不集中、嗜睡等現象,旁人多以「胖子本來就這樣」,忽略其中風、心肺衰竭等危險性。</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US"> <o:p></o:p></span></p>
<p style="LINE-HEIGHT: 190%; MARGIN: 0cm 0cm 0pt; mso-pagination: widow-orphan; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto" class="MsoNormal"><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">李錦中說,體重破百、身體質量指數</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US"> (BMI)</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">超過</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">30</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">者,需要更多氧氣消耗量,但肺部通氣功能又受限,長期下來便出現氣喘、心悸、下肢水腫、白天嗜睡等症狀,嚴重者還會缺氧、呼吸窘迫、夜間睡眠呼吸中止等,許多病患一直撐到急診入院,才被診斷出來有此症候群。</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US"> <o:p></o:p></span></p>
<p style="LINE-HEIGHT: 190%; MARGIN: 0cm 0cm 0pt; mso-pagination: widow-orphan; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto" class="MsoNormal"><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">一般而言,若患血抽血檢測血中二氧化碳大於</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">45mmHg</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">、氧氣小於</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">70mmHg</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">,並排除慢性肺阻塞、阻塞性睡眠中止、先天中樞通氣不良症候群、甲狀腺功能低下等可能病症,又有肥胖、睡眠障礙等特徵,罹患肥胖通氣不良的可能性極高。</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US"> <o:p></o:p></span></p>
<p style="LINE-HEIGHT: 190%; MARGIN: 0cm 0cm 0pt; mso-pagination: widow-orphan; mso-margin-top-alt: auto; mso-margin-bottom-alt: auto" class="MsoNormal"><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">李錦中表示,患者每天必須以呼吸器輔助治療</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">6</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">小時,持續</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US">1</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: '新細明體','serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-ascii-font-family: Arial; mso-hansi-font-family: Arial; mso-bidi-font-family: Arial; mso-font-kerning: 0pt">個月就可大大改善身體及精神狀況。</span><span style="LINE-HEIGHT: 190%; FONT-FAMILY: 'Arial','sans-serif'; COLOR: #414141; FONT-SIZE: 11.5pt; mso-font-kerning: 0pt; mso-fareast-font-family: 新細明體" lang="EN-US"> <o:p></o:p></span></p>