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【明報專訊】聯合醫院因為「開漏藥」,導致43歲女病人鄧桂思肝衰竭,兩度換肝仍未見起色。因急性肝衰竭而要緊急換肝的個案常有聽聞,致病原因很多,服用過量止痛藥、亂服中藥或錯吃有毒菇菌,當中以乙、丙型肝炎導致肝衰竭最常見,鄧桂思亦是乙型肝炎帶菌者。<\/p>\n
香港十分之一人口是乙型肝炎帶菌者,隨時由慢性肝炎演變成急性肝衰竭,猶如身上埋藏計時炸彈。究竟有什麼預防方法?一旦出現肝衰竭,肝臟移植是否唯一生路?<\/p>\n
肝臟是人體最重要器官之一,負責消化代謝、分解毒素、儲存養分、製造蛋白等,責任重大。明德國際醫院外科專科醫生吳晉傑指出﹕「肝臟細胞有自我修復功能,即肝臟細胞受損後會自行慢慢康復。肝衰竭是因為肝臟細胞大量死亡,無法應付身體需要。」<\/p>\n
乙、丙肝炎 常見肝衰竭原因<\/p>\n
在香港,導致肝臟細胞發炎受損的因素很多(見表)。「最常見是乙、丙型肝炎引起肝衰竭,另外,因自殺服用過量安眠藥、止痛藥而導致肝臟受損亦不少見。」吳晉傑指出,常用止痛藥撲熱息痛,每日上限為八粒(4000毫克),過量會影響肝臟。常見有人因情緒困擾求死,將家中一整盒止痛藥吃掉,即使盡快送到急症室洗胃,也未必完全清洗所服用劑量。<\/p>\n
如果是中藥、菇菌或藥物導致肝細胞受損,只要立即停止食用,肝臟大多數會慢慢復元,「 只要有三分之一肝臟細胞正常,都不足以致命」。肝衰竭病人送院後,首要找出病因,截斷源頭後,就要讓肝臟自己慢慢修復。其間醫生要注意兩項要點,隨時給予支援性治療﹕<\/p>\n
◆監察血凝固功能<\/p>\n
肝衰竭病人血凝固功能受影響,或有出血風險,要隨時準備輸血。另外,亦可透過監察血凝固指數INR指標,追蹤肝臟康復進度。<\/p>\n
◆保持病人神志清醒<\/p>\n
肝衰竭會影響病人神志,語無倫次,甚至昏迷不醒,影響呼吸,嚴重者需要插喉輔助,此舉會增加感染或引發不同併發症的風險;為了讓病人保持清醒,避免插喉,醫生或會考慮處方支鏈氨基酸( Branched Chain Amino Acid)。<\/p>\n
最頭痛是乙、丙型肝炎導致肝衰竭,因為不能像藥物或毒物般截斷源頭,病毒會不停破壞肝臟。吳晉傑指出,對於嚴重的個案,政府醫院的深切治療部近年增設「洗肝」儀器,「原理像洗腎一樣,透過儀器過濾血液。不過,洗肝的效果不及洗腎,但對病情嚴重的病人,可以暫時支持一段短時間,希望肝臟能恢復功能,或等待到合適的肝臟移植」。<\/p>\n
表面無事 其實逐秒傷肝<\/p>\n
乙、丙型肝炎患者屬肝衰竭、肝硬化、肝癌高危群,吳晉傑提醒,乙、丙型肝炎帶菌者要定期追蹤檢查,「很多人知道自己是帶菌者,但過去一直相安無事,沒有定期檢查。其實肝炎病毒每分每秒都在破壞肝臟細胞,是一個慢性破壞」。所以應定期驗血和照超聲波,監察病毒的活躍度。<\/p>\n
■香港肝臟發炎受損5大成因<\/p>\n
◆乙、丙型肝炎<\/p>\n
病毒潛伏體內,慢慢演變成慢性肝炎,甚至出現急性肝衰竭<\/p>\n
◆過量藥物<\/p>\n
服用過量的止痛藥物或安眠藥,甚至以酒精送服藥物,令肝臟負荷大增<\/p>\n
◆中藥/菇菌中毒<\/p>\n
食用有毒菇菌或亂服中藥,或有類似迷幻藥成分的「迷幻蘑菇」,可致肝臟受損<\/p>\n
◆肥胖<\/p>\n
肥胖導致脂肪肝,令肝臟長期發炎和結疤<\/p>\n
◆酒精<\/p>\n
肝臟負責處理酒精,過量酒精會引致酒精性肝炎<\/p>\n
文:鄭寶華、許朝茵<\/p>\n
圖:資料圖片<\/p>\n
統籌:鄭寶華<\/p>\n
編輯:王翠麗<\/p>\n
https:\/\/health2.mingpao.com\/ftp\/Health2\/20170515\/news\/_15YD001_.jpg肝衰竭——聯合醫院因為「開漏藥」,導致43歲女病人鄧桂思肝衰竭。(資料圖片);<\/inline><\/p>\n","protected":false},"author":2,"featured_media":4625,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"rank_math_lock_modified_date":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[2,3600,3619,1894],"tags":[861,862,1895,193],"class_list":["post-4626","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-2","category-3600","category-3619","category-1894","tag-861","tag-862","tag-1895","tag-193"],"publishpress_future_action":{"enabled":false,"date":"2026-11-16 12:39:53","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/posts\/4626"}],"collection":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/comments?post=4626"}],"version-history":[{"count":0,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/posts\/4626\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/media\/4625"}],"wp:attachment":[{"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/media?parent=4626"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/categories?post=4626"},{"taxonomy":"post_tag","embeddable":true,"href":"\/\/www.afterroberto.com\/wp-json\/wp\/v2\/tags?post=4626"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}