醫學五 第7題
我的申覆內容
此題問「inguinal hernia理想的手術年齡」, 考選部給的正解為(D)任何年齡, 引用
Sabiston Textbook of Surgery, 18th ed.的CHAPTER 71 - Pediatric Surgery的
ABDOMINAL WALL-- Inguinal Hernia文中的原句：「The timing of IH repair in
premature infants is controversial. Early repair may be associated with a
higher risk for injury to the cord structures, greater recurrence rate,
and anesthetic-related apnea. These factors must be weighed against the
higher risk for incarceration and strangulation, the potential for losing
the patient during follow-up, and the development of a larger IH with loss
of domain in the abdominal cavity. Taking these factors into account, most
pediatric surgeons perform herniorrhaphy before the neonate is discharged home
from the nursery.If the infant has already been discharged home, most
pediatric surgeons wait until the infant is older than 50 weeks postconception
(gestational age+postnatal age). After this age, the risk for postoperative
apnea is diminished.」,
以上有mark起來的文字, 意思為：「較早年紀就做的疝氣修補手術(Early repair),
會有較高risk傷害到臍帶構造, 較高的復發率, 和麻醉相關的apnea」、「若是嬰兒已
經過了待在育嬰室的年齡, 那麼大部份的小兒外科醫師會等到這個小孩超過50星期的年
齡(約1歲), 才進行inguinal hernia的修補手術, 而過了1歲的這個年齡後, 術後的
apnea就會減少」。
綜合以上原文的說法,「嬰兒在一歲以後做的疝氣修補手術, 就會相對上比較保險」、
「一歲之前做, 好處或壞處都有, 所以the timing of inguinal hernia repair in
premature infants is controversial.」, 故筆者認為此題正解為(C)一歲以後或(D)
任何年齡
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參考佐證 ：
Sabiston Textbook of Surgery, 18th ed.
CHAPTER 71 - Pediatric Surgery的ABDOMINAL WALL-- Inguinal Hernia
如果身旁有Sabiston第18版的 麻煩一下 順便幫忙申覆這一題 感恩~~
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※ 編輯: hiphopforeve 來自: 210.66.48.162 (01/28 15:22)