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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 孫家棟 | |
dc.contributor.author | Chii-Hong Lee | en |
dc.contributor.author | 李啟弘 | zh_TW |
dc.date.accessioned | 2021-06-16T16:39:47Z | - |
dc.date.available | 2013-03-04 | |
dc.date.copyright | 2013-03-04 | |
dc.date.issued | 2012 | |
dc.date.submitted | 2012-09-06 | |
dc.identifier.citation | 1. Beckwith JB. Discussion of terminology and definition of sudden infant death syndrome. in Proceedings of the Second International Conference on Causes of Sudden Deaths in Infants, 1970, University of Washington Press: Seattle, WA (USA).
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Cot death in Hong Kong: a rare problem? Lancet 1985;2(8468):1346-9. 36. Lee NN, et al. Sudden infant death syndrome in Hong Kong: confirmation of low incidence. BMJ 1989;298(6675):721. 37. Weber MA, et al. The role of post-mortem investigations in determining the cause of sudden unexpected death in infancy. Arch Dis Child 2008;93(12):1048-53. 38. Iyasu S, et al. Proceedings of 'Workshop on Guidelines for Scene Investigation of Sudden Unexplained Infant Deaths'--July 12-13, 1993. J Forensic Sci 1994;39(4):1126-36. 39. Iyasu S, et al. Guidelines for death scene investigation of sudden, unexplained infant deaths: recommendations of the interagency panel on sudden infant death syndrome. MMWR Morb Mortal Wkly Rep 1996;45:1-6. 40. Mitchell E, et al. An analysis of the usefulness of specific stages in the pathologic investigation of sudden infant death. Am J Forensic Med Pathol 2000;21(4):395-400. 41. Arnestad M, et al. Evaluation of diagnostic tools applied in the examination of sudden unexpected deaths in infancy and early childhood. Forensic Sci Int 2002;125(2-3): 262-8. 42. Baraff LJ, et al. Possible temporal association between diphtheria-tetanus toxoid-pertussis vaccination and sudden infant death syndrome. Pediatr Infect Dis 1983;2(1):7-11. 43. Hoffman HJ, et al. Diphtheria-tetanus-pertussis immunization and sudden infant death: results of the National Institute of Child Health and Human Development Cooperative Epidemiological Study of Sudden Infant Death Syndrome risk factors. Pediatrics 1987;79(4):598-611. 44. Griffin RM, et al. Risk of sudden infant death syndrome after immunization with the diphtheria-tetanus-pertussis vaccine. N Engl J Med 1988;319(10):618-23. 45. Brotherton JM, et al. Probability of coincident vaccination in the 24 or 48 hours preceding sudden infant death syndrome death in Australia. Pediatrics 2005;115(6):e643-6. 46. von Kries R, et al. Sudden and unexpected deaths after the administration of hexavalent vaccines (diphtheria, tetanus, pertussis, poliomyelitis, hepatitis B, Haemophilius influenzae type b): is there a signal? Eur J Pediatr 2005;164(2):61-9. 47. Mitchell EA, et al. Immunisation and the sudden infant death syndrome. New Zealand Cot Death Study Group. Arch Dis Child 1995;73(6):498-501. 48. Fleming PJ, et al. The UK accelerated immunisation programme and sudden unexpected death in infancy: case-control study. BMJ 2001;322(7290):822. 49. Jonville-Bera AP, et al. Sudden unexpected death in infants under 3 months of age and vaccination status- -a case-control study. Br J Clin Pharmacol 2001;51(3):271-6. 50. Vennemann MM, et al. Sudden infant death syndrome: no increased risk after immunisation. Vaccine 2007;25(2):336-40. 51. Ottaviani G, et al. Sudden infant death syndrome (SIDS) shortly after hexavalent vaccination: another pathology in suspected SIDS? Virchows Arch 2006;448(1):100-4. 52. D'Errico S, et al. Beta-tryptase and quantitative mast-cell increase in a sudden infant death following hexavalent immunization. Forensic Sci Int 2008;179(2-3):e25-9. 53. Matturri L, et al. Severe hypoplasia of medullary arcuate nucleus: quantitative analysis in sudden infant death syndrome. Acta Neuropathol 2000;99(4):371-5. 54. Matturri L, et al. Brain stem lesions in the sudden infant death syndrome: variability in the hypoplasia of the arcuate nucleus. Acta Neuropathol 2002;104(1):12-20. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/63407 | - |
dc.description.abstract | 本文針對民國八十五年至九十四年間臺灣嬰兒猝死症案例進行回溯性的描述流行病學調查。研究材料的來源與內容包括行政院內政部統計處公布的出生人口資料、行政院衛生署公布的死因統計、法務部法醫研究所的解剖及死因鑑定報告書,包含未接受司法解剖與經司法解剖後確診之個案。所收集的資料經分類整理與統計分析後發現,該十年間臺灣嬰兒猝死症的發生率無明顯消長,維持平均0.60‰的水準。臺灣嬰兒猝死症好犯於滿一個月但未滿三個月大的嬰兒,以氣温較低的春冬兩季(尤其是十二月至三月間)最為常見。個案接受司法解剖的比率平均為6.03%。該十年間解剖率雖有上昇的趨勢,但最高仍僅佔所有案例之一成左右。此外,臺灣部份行政區域嬰兒猝死症的發生率及解剖率與整體相比具統計學上的顯著差異,但各行政區域間發生率及解剖率的差異間無統計學上的關連性。經司法相驗解剖後確診為嬰兒猝死症的個案共九十六名。按警方筆錄記載,個案死亡發生的地點以雙親住家及保姆家為主,且多半發生於死者睡眠的過程之中。其他可能與嬰兒猝死症相關的危險因子(例如睡姿、社經地位等),因泰半案例並未載明,該因子在本土案例中是否具備重要性亦不得而知。解剖案例之病理發現以多重器官的鬱血及水腫、胸腺與心肋膜的點狀出血、局部肺泡出血為主,大致與文獻記載相符。然而,少數個案於死亡前三天內曾接受疫苗注射且表現特殊的病理變化(輕度缺血性腦神經細胞損傷與心肌淋巴球浸潤),其臨床意義或許值得更進一步的研究以獲得釐清。經司法解剖確診的案例與未接受解剖的案例相比較,兩者於性別、年齡、死亡月份的分布等存在統計學上的顯著差異,顯示接受司法解剖與否可能會影響診斷的精確性乃至於流行病學研究的可信度。如何提昇嬰兒猝死個案的解剖率、建立標準作業流程及跨機構的合作模式、進而完整本土嬰兒猝死症的流行病學研究,將有賴相關單位的重視。 | zh_TW |
dc.description.abstract | A retrospective descriptive epidemiological survey was conducted on those cases registered as sudden infant death syndrome (SIDS) in Taiwan from 1996 to 2005. Relevant information was obtained from the Institute of Forensic Medicine, Ministry of Justice, as well as from the Statistical Yearbooks published by the Department of Statistics, Ministry of Interior and by the Department of Health, Executive Yuan, including all registered SIDS cases with and without forensic autopsy. Data were analyzed and examined by standard statistical tests. From 1996 to 2005, the incidence rate of SIDS in Taiwan was 0.60‰ in average and remained stable. Most SIDS deaths in Taiwan occurred between 1 and 3 months of age and in cool season, especially from December to March. Only 6.03% of SIDS cases were diagnosed after forensic autopsy. Although there was an inclining trend, the rate of forensic autopsy was still low. Besides, there were differences in the incidence rate and autopsy rate of SIDS between administrative regions in Taiwan, and there seemed to be no correlation between the incidence rates and autopsy rates of different regions. Totally 96 SIDS cases were diagnosed after forensic autopsy, most of them died in parent’s or nanny’s places, and the fatal episode apparently occurred during sleep. However, the information of most of the possible risk factors of SIDS (e.g. sleep position and socioeconomic status, etc.) was not available. Autopsy findings in major cases were consistent with those reported in the literature, including congestion and edema in multiple organs, petechiae in the thymus, pericardium and pleura, and focal alveolar hemorrhage. Although some particular pathologic findings, such as mild ischemic neuronal injury and lymphocytic infiltrate in the myocardium, were noted in a few cases who received immunization within 3 days before death, their clinical significance should be further clarified by more studies. In comparison between SIDS cases with and without forensic autopsy, there were some differences in distributions of gender, age and month of death of the deceased. It could be said that to make a diagnosis of SIDS without forensic autopsy may influence the quality of diagnoses and further compromise the reliability of epidemiological researches. It is worthy of our best efforts to increase the rate of forensic autopsy among SIDS cases, to establish specification of procedures for case investigation and inter-institution cooperation, and to complete the local SIDS epidemiological studies. | en |
dc.description.provenance | Made available in DSpace on 2021-06-16T16:39:47Z (GMT). No. of bitstreams: 1 ntu-101-R95452003-1.pdf: 1060691 bytes, checksum: b11a70f5bacaeb3c3df839ac0c823418 (MD5) Previous issue date: 2012 | en |
dc.description.tableofcontents | 口試委員會審定書 (i)
中文摘要 (ii) 英文摘要 (iii) 目錄 (v) 附表目錄 (vi) 附圖目錄 (vii) 前言 (1) 材料與方法 (3) 結果 (4) 討論 (7) 結語 (11) 參考文獻 (12) 附表 (17) 附圖 (29) | |
dc.language.iso | zh-TW | |
dc.title | 臺灣嬰兒猝死症之流行病學與司法解剖案例的比較 | zh_TW |
dc.title | Sudden Infant Death Syndrome in Taiwan: A comparative epidemiological survey on cases with and without forensic autopsy | en |
dc.type | Thesis | |
dc.date.schoolyear | 101-1 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 蔡崇宏,郭宗禮 | |
dc.subject.keyword | 嬰兒猝死症,臺灣,描述流行病學,司法解剖,病理,疫苗, | zh_TW |
dc.subject.keyword | Sudden infant death syndrome (SIDS),Taiwan,descriptive epidemiology,forensic autopsy,pathology,immunization, | en |
dc.relation.page | 30 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2012-09-10 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 法醫學研究所 | zh_TW |
顯示於系所單位: | 法醫學科所 |
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