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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 張美惠(Mei-Hwei Chang) | |
dc.contributor.author | Cheng-Hui Hsiao | en |
dc.contributor.author | 蕭正輝 | zh_TW |
dc.date.accessioned | 2021-06-13T15:24:48Z | - |
dc.date.available | 2008-08-08 | |
dc.date.copyright | 2008-08-08 | |
dc.date.issued | 2008 | |
dc.date.submitted | 2008-07-19 | |
dc.identifier.citation | 1. Otte JB, Goyet J, Reding R, Hausleithner V, Sokal E, Chardot C, et al. Sequential treatment of biliary atresia with Kasai portoenterostomy and liver transplantation: a review. Hepatology 1994; 20(suppl): 41S-48S.
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Surgery 1963; 54: 373-375. 8. Kasai M, Kimura S, Asakura Y, Suzuki Y, Taira Y, Obashi E. Surgical treatment of biliary atresia. J Pediatr Surg 1968; 3: 665-675. 9. Laurent J, Gauthier F, Bernard O, Hadchouel M, Odievre M, Valayer J, et al. Long-term outcome after surgery for biliary atresia. Study of 40 patients surviving more than 10 years. Gastroenterology 1990; 99: 1793-1797. 10. Schoen BT, Lee H, Sullivan K, Ricketts RR. The Kasai portoenterostomy: When is it too late? J Pediatr Surg 2001; 36: 97-99. 11. Chardot C, Carton M, Spire-Bendelac N, Pommelet CL, Golmard JL, Auvert B. Prognosis of biliary atresia in the era of liver transplantation: French national study from 1986 to 1996. Hepatology 1999; 30: 606-611. 12. Karrer FM, Lilly JR, Stewart BA, Hall RJ. Biliary atresia registry, 1976-1989. J Pediatr Surg 1990; 25: 1076-1081. 13. Ibrahim M, Miyano T, Ohi R, Saeki M, Shiraki K, Tanaka K, et al. Japanese biliary atresia registry, 1989 to 1994. Tohoku J Exp Med 1997; 181: 85-95. 14. Chiba T, Hanamatsu M, Kasai M. Follow-up studies on the long-term survivors of biliary atresia-clinical aspects. In: kasai M, ed. Biliary atresia and related disorders. Excerpta Medica, Amsterdam, 1983; 239-248. 15. Ohi R, Nio M, Chiba T, Endo N, Goto M, Ibrahim M. Long-term follow-up after surgery for patients with biliary atresia. J Pediatr Surg 1990; 25: 442-445. 16. Ohi R. Surgery for biliary atresia. Liver 2001; 21: 175-182. 17. Mieli-Vergani G, Howard ER, Portman B, Mowat AP. Late referral for biliary atresia--missed opportunities for effective surgery. Lancet 1989; 223: 421-423. 18. Bernard O, Gauthier F. Progrès récents en hépatologie pédiatrique. Arch Fr Pediatr 1990; 48: 53-56. 19. Balistreri WF, Grand R, Hoofnagle JH, Suchy FJ, Ryckman FC, Perlmutter DH, et al. Biliary atresia: current concepts and research directions. Summary of a symposium. Hepatology 1996; 23: 1682-1692. 20. Whitington PF, Balistreri WF. Liver transplantation in pediatrics: indications, contraindications, and pre-transplant management. J Pediatr 1991; 118: 169-177. 21. Tagge DU, Tagge EP, Drongowski RA, Oldham KT, Coran AG. A long-term experience with biliary atresia. Reassessment of prognostic factors. Ann Surg 1991; 214: 590-598. 22. Dolgin SE. Answered and unanswered controversies in the surgical management of extra hepatic biliary atresia. Pediatr Transplantation 2004; 8: 628-631. 23. Newell KA, Alonso EM, Whitington PF, Bruce DS, Millis JM, Piper JB, et al. Posttransplant lymphoproliferative disease in pediatric liver transplantation. Transplantation 1996; 62: 370-375. 24. Carceller A, Blanchard H, Alvarez F, St-Vil D, Bensoussan AL, Lorenzo MD. Past and future of biliary atresia. J Pediatr Surg 2000; 35: 717-720. 25. Lai MW, Chang MH, Hsu SC, Hsu HC, Su CT, Kao CL, et al. Differential diagnosis of extrahepatic biliary atresia from neonatal hepatitis: a prospective study. J Pediatr Gastroenterol Nutr 1994; 18: 121-127. 26. Mowat AP, Davidson LL, Dick MC. Early identification of biliary atresia and hepatobiliary disease: selective screening in the third week of life. Arch Dis Child 1995; 72: 90-92. 27. Mushtaq I, Logan S, Morris M, Johnson AW, Wade AM, Kelly D, et al. Screening of newborn infants for cholestatic hepatobiliary disease with tandem mass spectrometry. Br Med J 1999; 319: 471-477. 28. Tazawa Y, Konno T. Semiquantitative assay of serum lipoprotein-X in differential diagnosis of neonatal hepatitis and congenital biliary atresia. Tohoku J Exp Med 1980; 130: 209-217. 29. Matsui A, Kasano Y, Yamauchi Y, Momoya T, Shimada T, Ishikawa T, et al. Direct enzymatic assay of urinary sulfated bile acids to replace serum bilirubin testing for selective screening of neonatal cholestasis. J Pediatr 1996; 129: 306-308. 30. Akiyama T, Yamauchi Y. Use of near infrared reflectance spectroscopy in the screening for biliary atresia. J Pediatr Surg 1994; 29: 645-647. 31. MacGillivray TE, Adzick NS. Biliary atresia begins before birth. Pediatr Surg Int 1994; 9: 116-117. 32. Matsui A, Dodoriki M. Screening for biliary atresia. Lancet 1995; 345: 1181. 33. Maki T, Sumasaki R, Matsui A. Mass screening for biliary atresia. Jpn J Pediatr Surg 1999; 31: 242-246. 34. Chen SM, Chang MH, Du JC, Lin CC, Chen AC, Lee HC, et al. Screening for biliary atresia by infant stool color card in Taiwan. Pediatrics 2006; 117: 1147-1154. 35. Hung PY, Chen CC, Chen WJ, Lai HS, Hsu WM, Lee PH, et al. Long-term prognosis of patients with biliary atresia: a 25 year summary. J Pediatr Gastroenterol Nutr 2006; 42: 190-195. 36. Lin JN, Wang KL, Chuang JH. The efficacy of Kasai operation for biliary atresia: a single institutional experience. J Pediatr Surg 1992; 27: 704-706. 37. Serinet MO, Broue P, Jacquemin E, Lachaux A, Sarles J, Gottrand F, et al. Management of patients with biliary atresia in France : results of a decentralized policy 1986-2002, Hepatology 2006; 44: 75-84. 38. Schreiber RA, Barker CC, Roberts EA, Martin SR, Alvarez F, Smith L, et al. Biliary atresia: the Canadian experience. J Pediatr 2007; 151: 659-665. 39. Shneider BL, Brown MB, Haber B, Whitington PF, Schwarz K, Squires R, et al. A multicenter study of the outcome of biliary atresia in the United States, 1997 to 2000. J Pediatr 2006; 148: 467-474. 40. Shneider BL, Mazariegos GV. Biliary atresia: a transplant perspective. Liver Transpl 2007; 13: 1482-1495. 41. Shneider BL. Screening for biliary atresia: a ray of hope. Hepatology 2008; 47: 1105-1107. 42. Mack CL. The pathogenesis of biliary atresia: evidence for a virus-induced autoimmune disease. Semin Liver Dis 2007; 27: 233-242. 43. Sokol RJ, Shepherd RW, Superina R, Bezerra JA, Robuck P, Hoofnagle JH. Screening and outcomes in biliary atresia: summary of a National Institutes of Health workshop. Hepatology 2007; 46: 566-581. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/37336 | - |
dc.description.abstract | 研究背景:膽道閉鎖是兒童肝病最常見的死亡原因。雖然病童在出生60天內接受葛西手術能顯著地改善這些病童的預後,但是由於對膽道閉鎖與常見的良性延長性黃疸之鑑別診斷缺乏認知,膽道閉鎖病童的延遲轉診及延遲手術治療,仍是一個全球性的重要問題。
目的:利用嬰兒大便顏色卡,建立一個膽道閉鎖全國性篩檢系統,以促成膽道閉鎖的早期診斷及治療。 方法:從西元2002-2003年,我們已陸續在台灣的北中南東四區共95家醫療院所,完成嬰兒大便顏色卡的區域篩檢。我們設計的嬰兒大便顏色卡,內含1~6號共六種不同大便顏色的照片。從西元2004年起,嬰兒大便顏色卡已經全面性放入兒童健康手冊內,嬰兒大便顏色卡的全國性篩檢就此展開。一旦家屬或醫護人員發現如卡片所示1~3號異常大便顏色,需在24小時內以電話或傳真通報大便卡諮詢中心。本研究的篩檢對象,是西元2004年至2005年出生於台灣的全國新生嬰兒,共計422,273名。此外,回溯性分析西元1976年至2000年,在台大醫院住院且追蹤超過一歲的膽道閉鎖病童,以比較嬰兒大便顏色卡篩檢前後的差異。 結果:西元2004年及2005年之膽道閉鎖的年發生率,分別為每一萬名活產嬰兒數中1.85(40/216,419)及1.70(35/205,854)。利用嬰兒大便顏色卡於出生60天內篩檢出膽道閉鎖的敏感度,由2004年的72.5%,進步至2005年的97.1%。全國膽道閉鎖嬰兒於出生60天內接受葛西手術的比率,由2004年的60%,進步到2005年的74.3%,且西元2005年於出生60天內手術的比率顯著地高於西元1976-2000年的47.2%(68/144, P值為0.004)。在西元2004-2005年的膽道閉鎖病童,於葛西手術後三個月的黃疸消退率(血清總膽紅素值<2 mg/ dL)為59.5%(44/74),顯著地高於嬰兒大便顏色卡篩檢前於西元1976-2000年的37.0%(50/135, P值為0.002)。 結論:利用嬰兒大便顏色卡全面性的篩檢新生兒,有助於膽道閉鎖病童的早期轉診,進而提升及時葛西手術的比率,以及較佳的手術預後。 | zh_TW |
dc.description.abstract | BACKGROUND: Biliary atresia is the most common cause of death from liver disease in children. Although the Kasai operation before 60 days of age can significantly improve prognosis, delay in referral and surgery remains a formidable problem worldwide because of difficulties in differentiating it from benign prolonged neonatal jaundice.
AIMS: To establish a universal screening system using an infant stool color card to promote the early diagnosis and treatment of biliary atresia. SUBJECTS AND METHODS: After a pilot regional study in 2002-2003, a national stool color screening system was established by integrating the infant stool color card into the child health booklet given to every neonate in Taiwan since 2004. Within 24 hours of the discovery of an abnormal stool color, this event is reported to the registry center. Our participants included 422,273 neonates who were born in 2004-2005 in Taiwan. Furthermore, we retrospectively reviewed the medical records of infants with biliary atresia who were admitted to the National Taiwan University Hospital from January 1976 to December 2000, but excluding those infants lost to follow-up before 1 year of age. RESULTS: The annual incidence of biliary atresia per 10,000 live births in 2004 and 2005 was 1.85 (40/216,419) and 1.70 (35/205,854), respectively. The sensitivity of detecting biliary atresia using stool cards before 60 days of age was 72.5% in 2004, which improved to 97.1% in 2005. The national rate of the Kasai operation before 60 days of age increased from 60% in 2004 to 74.3% in 2005, which was significantly higher than the historical data of 47.2% in 1976-2000 (68/144, P=0.004). The jaundice-free rate (<2 mg/dL) at 3 months after the Kasai operation among infants with biliary atresia in 2004-2005 was 59.5% (44/74), significantly higher than the historical data of 37.0% in 1976-2000 before the stool card screening program (50/135, P=0.002). CONCLUSION: Universal screening using the stool color cards can enhance earlier referral, which may ultimately lead to timely performance of the Kasai operation and better postoperative outcome in infants with biliary atresia. | en |
dc.description.provenance | Made available in DSpace on 2021-06-13T15:24:48Z (GMT). No. of bitstreams: 1 ntu-97-P95421022-1.pdf: 565530 bytes, checksum: 6c45bb065bdfa9e073859aecd2843e1c (MD5) Previous issue date: 2008 | en |
dc.description.tableofcontents | 口試委員會審定書……………………………......…...…..… i
誌謝………………………………………………….……..….... ii 中文摘要……………………………………………..……..…... iii 英文摘要……………………………………………..….…..….. iv 第一章 緒論……………………………………………….……… 1 第一節、 延長性新生兒黃疸與膽道閉鎖..……………..….... 1 第二節、 膽道閉鎖的治療與預後..………............….... 1 第三節、 膽道閉鎖及時轉診治療的困境…………………….... 3 第四節、 膽道閉鎖的篩檢現況……………………………….... 4 第五節、 台灣推行嬰兒大便顏色卡篩檢膽道閉鎖………..….. 5 第二章 研究材料與方法…………………………………….... 7 第一節、 嬰兒大便顏色卡………………………………….…... 7 第二節、 研究篩檢對象…………………………………...…... 8 第三節、 嬰兒大便顏色卡篩檢膽道閉鎖的方法………………… 9 第四節、 膽道閉鎖嬰兒的全國通報系統………………………… 10 第五節、 嬰兒大便顏色卡成功篩檢膽道閉鎖的定義………….. 11 第六節、 膽道閉鎖嬰兒於1976-2000年的歷史資料……...…… 12 第七節、 統計分析………………………………………………….12 第三章 結果…………………………………………………….. 13 第一節、 全國通報的膽道閉鎖嬰兒………………………..….. 13 第二節、 全國通報有異常大便顏色的嬰兒………………..…… 14 第三節、 嬰兒大便顏色卡篩檢膽道閉鎖的結果……………….. 15 第四節、 西元1976-2000年的膽道閉鎖嬰兒歷史資料…………. 16 第五節、 接受葛西手術的年紀………………………....…..… 16 第六節、 葛西手術的預後………………………………..……… 18 第七節、 發現異常大便顏色、第一次住院評估、及葛西手術的平 均年紀…………….. ……………………………..………...…. 19 第八節、 比較嬰兒大便顏色卡長期推廣地區與新推廣地區的差異19 第九節、 延遲接受葛西手術的原因…………………...…....… 19 第四章 討論………………………………………………………. 21 第五章 展望……………………………………………………... 26 第六章 論文英文簡述………………………………………………30 參考文獻…………………………………………………………….…40 | |
dc.language.iso | zh-TW | |
dc.title | 嬰兒大便卡在台灣之全國性篩檢膽道閉鎖兒的研究 | zh_TW |
dc.title | Universal Screening for Biliary Atresia
Using an Infant Stool Color Card in Taiwan | en |
dc.type | Thesis | |
dc.date.schoolyear | 96-2 | |
dc.description.degree | 碩士 | |
dc.contributor.coadvisor | 倪衍玄(Yen-Hsuan Ni) | |
dc.contributor.oralexamcommittee | 高嘉宏,許宏遠 | |
dc.subject.keyword | 膽道閉鎖,嬰兒大便顏色卡,篩檢,發生率,葛西手術, | zh_TW |
dc.subject.keyword | biliary atresia,infant stool color card,screening,incidence,Kasai operation, | en |
dc.relation.page | 43 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2008-07-21 | |
dc.contributor.author-college | 醫學院 | zh_TW |
dc.contributor.author-dept | 臨床醫學研究所 | zh_TW |
顯示於系所單位: | 臨床醫學研究所 |
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