{"id":4716,"date":"2017-05-01T00:00:00","date_gmt":"2017-04-30T16:00:00","guid":{"rendered":"\/\/www.afterroberto.com\/?guid=18adfdd1102b0903f19120a96ff13b6e"},"modified":"2018-08-21T12:35:28","modified_gmt":"2018-08-21T04:35:28","slug":"%e5%95%8f%e9%86%ab%e7%94%9f%ef%bc%9a%e8%82%ba%e7%99%86%e4%b8%8d%e4%bc%bc%e7%b2%b5%e8%aa%9e%e7%89%87-%e4%b8%8d%e6%9c%83%e9%ab%98%e7%87%92%e5%92%b3%e5%87%ba%e8%a1%80","status":"publish","type":"post","link":"\/\/www.afterroberto.com\/%e5%95%8f%e9%86%ab%e7%94%9f%ef%bc%9a%e8%82%ba%e7%99%86%e4%b8%8d%e4%bc%bc%e7%b2%b5%e8%aa%9e%e7%89%87-%e4%b8%8d%e6%9c%83%e9%ab%98%e7%87%92%e5%92%b3%e5%87%ba%e8%a1%80\/","title":{"rendered":"\u554f\u91ab\u751f\uff1a\u80ba\u7646\u4e0d\u4f3c\u7cb5\u8a9e\u7247 \u4e0d\u6703\u9ad8\u71d2\u54b3\u51fa\u8840"},"content":{"rendered":"

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\/\/www.afterroberto.com\/wp-content\/uploads\/2017\/07\/M70515k.jpg;<\/inline><\/p>\n","protected":false},"excerpt":{"rendered":"

【明報專訊】鄭：鄭志文醫生 陳：陳偉文醫生 觀：Facebook Live 觀眾<\/p>\n

觀﹕持續咳嗽，會否導致肺炎？<\/p>\n

陳﹕持續咳嗽（或者慢性咳嗽）有好多原因，肺炎是其中一個可能性。持續咳嗽、氣促等也可以是支氣管炎的病徵，支氣管炎和肺炎有一定相似程度，但支氣管炎患者可能沒有胸痛，痰液不濃也沒血絲。<\/p>\n

另外，大家不要忽略肺癆。香港每年有5000宗肺結核新症。肺癆不會高燒，也不會好像粵語長片的主角般，咳出鮮血。肺癆徵狀包括疲累、消瘦、時常咳嗽、有痰等。如果持續咳嗽超過兩個星期，盡快看醫生做檢查。另外，流感也可以引致繼發性肺炎，需要小心留意。<\/p>\n

鄭﹕咳嗽是疾病的徵狀。如果沒有肺炎病原，不會咳到變成肺炎。不過，如果本身患有長期病症、呼吸系統較弱（如：支氣管擴張）或受到呼吸道感染，感染肺炎的風險較高。因此，留意病徵有否轉變。如有疑問，盡快求醫。<\/p>\n

■打針仍感染 不如不打？<\/p>\n

觀﹕早前，有一名3歲女童因為感染侵入性肺炎球菌導致死亡。據知女童已接種肺炎球菌結合疫苗，為何仍受感染？<\/p>\n

陳﹕按照「香港兒童免疫接種計劃」，幼兒都會接種「兒童13價肺炎球菌結合疫苗」。發生不幸事件，有多個可能性，疫苗不能預防所有血清型，女童的病原可能不在保護範圍之內。<\/p>\n

根據世界衛生組織的資料，疫苗的保護率約70至90%，絕對不是100%。接種疫苗，能否達到預防效果，也要視乎個人產生抗體的能力。一些體質較弱、年紀較大或長期病患人士，產生的抗體也可能較弱。<\/p>\n

鄭﹕記得一次看症的經歷：我懷疑小朋友感染肺炎，需要進一步檢查確診。家長立即說：「我的小朋友打了肺炎球菌結合疫苗，所以不會患上肺炎。」這也是錯誤的觀念。疫苗可以預防特定血清型所引致的肺炎，但仍可以有其他病原引致肺炎。我想藉此帶出一個信息：不要因為有不幸個案而產生「打預防針都無用」、「不如不打」這些錯誤想法。疫苗雖不是百分百保護，但至少有一定的保障。<\/p>\n

■老幼弱中招 或不咳不燒<\/p>\n

鄭﹕大家可能不知，有些肺炎病人，特別是嬰兒或長者，未必有咳嗽。可否講解一下？<\/p>\n

陳﹕其實不止沒有咳嗽，有些病人也可以沒有發燒徵狀。病徵的出現，視乎病人的身體狀况。發燒是身體對抗外敵的警號。如果病人本身患有糖尿、慢性腎病或者免疫系統出了問題，肺炎可以沒有發燒，甚至其他徵狀也不明顯。如果不是X光照肺或進一步檢查，根本不會察覺他們患上肺炎。因此，對於幼兒、長者、長期病患、免疫力差人士，醫生的警覺性是會提高。<\/p>\n

■感冒上高原 會否易肺炎？<\/p>\n

觀﹕我明天出發前往高原行山，但剛患上感冒，會否容易出現肺炎？<\/p>\n

陳﹕高原跟肺炎沒有直接關係。我們不擔心高原引致肺炎，反而擔心高原空氣稀薄引致高山反應。高山上的空氣比平地稀薄；隨着高度增加，可能出現呼吸困難。出發前應看醫生，準備預防高山症的藥物。如果本身沒有肺病（如：支氣管擴張、慢性阻塞性肺病），只是一般普通傷風感冒，毋須過分擔心。萬一出現高燒，則不建議外遊。<\/p>\n

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