「產兒科護理學」垂直感染、遺傳疾病和醫療院所相關政策


新生兒感染治療

治療新生兒感染最好的選擇藥物:
Best medication choice for treating newborn infections:

A. Chloramphenicol氯黴素:
這是廣效型抗生素,但副作用有再生性不良性貧血(骨隨衰竭)和灰孩子症候群(可能導致死亡的神經系統疾病)
This is a broad-spectrum antibiotic, but its side effects include aplastic anemia (bone marrow failure) and Gray Baby Syndrome (a neurological disorder that can lead to death).

B. Penicillin G青黴素:
對革蘭氏陽性菌非常有效,副作用較少。
It is highly effective against Gram-positive bacteria, which are the most common cause of newborn infections, and has fewer side effects.

C. Sulfamethoxazole磺胺甲氧:
這是廣效型抗生素,但可能會有過敏反應,且無法對所有菌株有效。
This is a broad-spectrum antibiotic, but it can cause allergic reactions and may not be effective against all bacterial strains.

D. 四環素Tetracycline:
這是廣效型抗生素,可能對嬰兒牙齒和骨骼染色。
This is a broad-spectrum antibiotic that may stain infants' teeth and bones.

垂直感染

B型肝炎和D型肝炎

B型肝炎可經由垂直感染,如果僅為核心抗原呈陰性,醫療措施則會在新生兒出生24小時內的時候注射免疫球蛋白,往後再接受B肝疫苗預防,即可預防B肝遺傳的憾事產生。

D型肝炎病毒(hepatitis D virus)必須有B型肝炎病毒(hepatitis B virus)存在才能感染人體
Hepatitis D virus (HDV) can only infect humans if hepatitis B virus (HBV) is also present.

D型肝炎病毒缺乏完整的基因組(只包含一個環狀RNA),故還需要HBV 的表面抗原基因。
Hepatitis D virus (HDV) has an incomplete genome (it only contains a circular RNA), so it also needs the surface antigen gene of HBV.
HDV 自身無法合成衣殼蛋白,需要借助HBV 的衣殼蛋白來形成完整的病毒顆粒。
HDV cannot synthesize its own envelope protein, so it needs to use the envelope protein of HBV to form complete virions.
HDV 自身無法合成複製酶,需要借助HBV 的複製酶來完成病毒的複製。
HDV cannot synthesize its own replication enzyme, so it needs to use the replication enzyme of HBV to complete the replication of the virus.

而D型肝炎的垂直感染是可能的,但並不常見。
根據世界衛生組織(WHO)的數據,D型肝炎的垂直感染率約為5%-20%。
While vertical transmission of HDV is possible, it is not common. 
According to the World Health Organization (WHO), the vertical transmission rate of HDV is about 5%-20%.

預防D型肝炎垂直感染的最佳方法是接種HBV疫苗。
The best way to prevent vertical transmission of HDV is to vaccinate against HBV.

小知識補充:下呼吸道-包括細支氣管、肺泡間通道及肺泡,肺泡是吸入氣體與血液行氣體交換的位置。

遺傳疾病Genetic disease

體染色體隱性遺傳疾病

體染色體隱性遺傳疾病為地中海型貧血(thalassemia)
Autosomal recessive genetic disease is thalassemia.

體染色體顯性遺傳疾病

體染色體顯性遺傳疾病有第一型神經纖維瘤症、馬凡氏症(Marfan syndrome)、結節性硬化症(tuberous sclerosis)
Autosomal dominant genetic diseases include neurofibromatosis type 1, Marfan syndrome, and tuberous sclerosis.

侏儒症中最常見的原因是軟骨發育不全(achondroplasia),而軟骨發育不全為體染色體顯性遺傳疾病,Fibroblast growth factor receptor 3基因在骨骼生長中起著重要作用,約90%的病人與此基因突變有關。
Achondroplasia is the most common cause of dwarfism. It is an autosomal dominant genetic disorder. The Fibroblast growth factor receptor 3 gene plays an important role in bone growth. Mutations in this gene are associated with about 90% of cases of achondroplasia.

醫療院所政策

有關醫療院所提供以家庭為中心照護之策略如下:
1. 推動準爸爸陪產制
2. 提供待產、分娩、恢復室合而為一的樂得兒產房
3. 協助產檯上母嬰早期肌膚接觸

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