{"id":4865,"date":"2017-03-13T00:00:00","date_gmt":"2017-03-12T16:00:00","guid":{"rendered":"\/\/www.afterroberto.com\/?guid=7625127cee6d9414f8b5e6afa019460b"},"modified":"2023-10-05T14:36:21","modified_gmt":"2023-10-05T06:36:21","slug":"%e6%9c%80%e4%bd%b3%e7%94%b7%e4%b8%bb%e8%a7%92-%e5%bf%83%e8%87%9f%e7%97%85%e4%ba%ba%e6%8e%92%e8%a1%80%e5%b0%bf-%e8%86%80%e8%83%b1%e7%99%8c%e5%85%88%e5%85%86","status":"publish","type":"post","link":"\/\/www.afterroberto.com\/%e6%9c%80%e4%bd%b3%e7%94%b7%e4%b8%bb%e8%a7%92-%e5%bf%83%e8%87%9f%e7%97%85%e4%ba%ba%e6%8e%92%e8%a1%80%e5%b0%bf-%e8%86%80%e8%83%b1%e7%99%8c%e5%85%88%e5%85%86\/","title":{"rendered":"\u6700\u4f73\u7537\u4e3b\u89d2\uff1a\u5fc3\u81df\u75c5\u4eba\u6392\u8840\u5c3f \u8180\u80f1\u764c\u5148\u5146\uff1f"},"content":{"rendered":"

\"\"<\/p>\n

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\u3010\u660e\u5831\u5c08\u8a0a\u3011\u8180\u80f1\u764c\u8f03\u5e38\u51fa\u73fe\u5728\u7537\u6027\u8eab\u4e0a\uff0c\u6210\u75c5\u539f\u56e0\u591a\u8207\u907a\u50b3\u6709\u95dc\uff0c\u53e6\u5916\u7d93\u5e38\u63a5\u89f8\u5316\u5b78\u88fd\u54c1\u5982\u67d3\u9aee\u5291\uff0c\u4ea6\u53ef\u589e\u52a0\u60a3\u75c5\u98a8\u96aa\uff1b\u6709\u5438\u7159\u7fd2\u6163\u7684\u4eba\u58eb\uff0c\u66f4\u53ef\u589e\u52a0\u5e7e\u500d\u60a3\u75c5\u98a8\u96aa\u3002\u4e0d\u904e\uff0c\u4ea6\u6709\u4e9b\u500b\u6848\u662f\u96e3\u4ee5\u8fa8\u660e\u539f\u56e0\u7684\uff0c\u60a3\u8005\u5fc5\u9808\u5c0d\u5fb5\u72c0\u63d0\u9ad8\u8b66\u89ba\uff0c\u624d\u53ef\u907f\u514d\u60e1\u5316\u3002<\/p>\n

\u4e94\u5341\u6b72\u7684Peter\uff08\u5316\u540d\uff09\uff0c\u751f\u6d3b\u7fd2\u6163\u6b63\u5e38\uff0c\u6c92\u6709\u5438\u7159\u7fd2\u6163\uff0c\u6700\u8fd1\u7121\u6545\u51fa\u73fe\u8840\u5c3f\uff0c\u7121\u5176\u4ed6\u5fb5\u72c0\uff0c\u4e00\u661f\u671f\u5f8c\u4ed6\u6025\u6025\u6c42\u8a3a\uff0c\u5b89\u6392\u5165\u9662\uff0c\u5728\u9ebb\u9189\u79d1\u5c08\u79d1\u91ab\u751f\u76e3\u5bdf\u9ebb\u9189\u7684\u5b89\u5168\u3001\u7121\u75db\u60c5\u51b5\u4e0b\uff0c\u7d93\u5c3f\u9053\u9032\u884c\u8180\u80f1\u5167\u8996\u93e1\u6aa2\u67e5\uff0c\u767c\u73fe\u8180\u80f1\u6709\u4e09\u5398\u7c73\u7684\u816b\u7624\uff0c\u6191\u7d93\u9a57\u8a55\u4f30\u5f88\u5927\u53ef\u80fd\u662f\u60e1\u6027\u816b\u7624\uff0c\u65bc\u662f\u5b89\u6392Peter\u7fcc\u65e5\u7acb\u5373\u505a\u624b\u8853\u3002Peter\u7684\u816b\u7624\u96d6\u7136\u5927\uff0c\u4f46\u672a\u5165\u4fb5\u808c\u8089\u5c64\uff0c\u6240\u4ee5\u6bcb\u9808\u6574\u500b\u8180\u80f1\u5207\u9664\uff0c\u53ef\u4ee5\u7528\u5167\u7aba\u93e1\u5272\u6389\u816b\u7624\uff0c\u96a8\u5373\u9032\u884c\u5316\u7642\uff0c\u6e1b\u4f4e\u5fa9\u767c\u98a8\u96aa\u2014\u2014\u8180\u80f1\u764c\u7684\u5fa9\u767c\u7387\u751a\u9ad8\uff0c\u53ef\u9054\u4e03\u81f3\u516b\u6210\uff0c\u56e0\u6b64\u60a3\u8005\u5728\u6cbb\u7642\u5f8c\uff0c\u6bcf\u4e09\u81f3\u56db\u500b\u6708\u8981\u6aa2\u67e5\u4e00\u6b21\uff0c\u5169\u5e74\u5f8c\u6bcf\u516d\u500b\u6708\u6aa2\u67e5\u4e00\u6b21\uff0c\u6bd4\u8d77\u5176\u4ed6\u764c\u75c7\u6aa2\u67e5\u983b\u5bc6\u5f97\u591a\u3002<\/p>\n

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\u975e\u4fb5\u8755\u6027\u8180\u80f1\u764c\uff08non-muscle invasive bladder cancer\uff09\u4e3b\u8981\u662f\u9032\u884c\u8180\u80f1\u5167\u5316\u5b78\u6cbb\u7642\uff08intravesical instillation chemotherapy\uff09\uff0c\u7d93\u5c3f\u9053\u63d2\u5165\u8edf\u7ba1\uff0c\u704c\u9032\u85e5\u6c34\uff0c\u76f4\u63a5\u6d78\u6ce1\u8180\u80f1\uff0c\u8853\u5f8c\u9032\u884c\u4e00\u6b21\u5373\u53ef\u3002\u6b64\u5916\uff0c\u6709\u90e8\u5206\u9ad8\u5371\u60a3\u8005\u4ea6\u8981\u9032\u884c\u8180\u80f1\u5167\u5361\u4ecb\u82d7\uff08BCG\uff09\u514d\u75ab\u7642\u6cd5\uff0c\u662f\u4e00\u7a2e\u514d\u75ab\u7cfb\u7d71\u6cbb\u7642\uff0c\u65bc\u624b\u8853\u5f8c\u516d\u661f\u671f\u958b\u59cb\uff0c\u516d\u6b21\u70ba\u4e00\u500b\u7642\u7a0b\uff0c\u4ee5\u5c0e\u7ba1\u5c07\u5361\u4ecb\u82d7\u8f38\u9001\u5230\u8180\u80f1\uff0c\u85c9\u4ee5\u4ee4\u8eab\u9ad4\u7522\u751f\u514d\u75ab\u529b\u6bba\u6b7b\u764c\u7d30\u80de\u3002\u8180\u80f1\u5167\u5316\u5b78\u6cbb\u7642\u53ca\u8180\u80f1\u5167\u5361\u4ecb\u82d7\u514d\u75ab\u7642\u6cd5\u5747\u8981\u628a\u85e5\u76f4\u63a5\u704c\u9032\u8180\u80f1\uff0c\u4f46\u5fc5\u9808\u5206\u958b\u9032\u884c\uff0c\u624d\u6709\u7642\u6548\u3002\u9019\u7a2e\u5316\u7642\u6c92\u4ec0\u9ebc\u526f\u4f5c\u7528\uff0c\u4f46\u8180\u80f1\u5167\u5361\u4ecb\u82d7\u514d\u75ab\u7642\u6cd5\u53ef\u80fd\u4ee4\u60a3\u8005\u8180\u80f1\u8d64\u75db\u6216\u767c\u71d2\uff0c\u6709\u9700\u8981\u6642\u53ef\u4f7f\u7528\u6b62\u75db\u85e5\u8f14\u52a9\uff0c\u662f\u9ad8\u5371\u8180\u80f1\u764c\u7684\u6a19\u6e96\u6cbb\u7642\u3002<\/p>\n

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\u670d\u8584\u8840\u85e5 \u8840\u5c3f\u5fb5\u72c0\u63d0\u65e9\u986f\u9732<\/h2>\n

\u8840\u5c3f\u662f\u8180\u80f1\u764c\u7684\u660e\u986f\u5fb5\u72c0\uff0cPeter\u7684\u816b\u7624\u751f\u9577\u8fc5\u901f\uff0c\u5e78\u597d\u4ed6\u6c92\u6709\u62d6\u62c9\uff0c\u76e1\u5feb\u6c42\u91ab\uff1b\u4f46\u5c0f\u738b\uff08\u5316\u540d\uff09\u4fbf\u5341\u5206\u5927\u610f\uff0c\u4ed6\u672c\u8eab\u6709\u5fc3\u81df\u75c5\uff0c\u9577\u671f\u670d\u7528\u8584\u8840\u85e5\uff0c\u6392\u8840\u5c3f\u5df2\u9054\u4e00\u5e74\uff0c\u6700\u8fd1\u624d\u4f5c\u6aa2\u67e5\uff0c\u767c\u73fe\u8180\u80f1\u6709\u4e00\u5398\u7c73\u7684\u816b\u7624\u3002\u6216\u8a31\u4f60\u6703\u5947\u602a\uff0c\u5c0f\u738b\u6709\u5fb5\u72c0\u9054\u4e00\u5e74\uff0c\u70ba\u4f55\u816b\u7624\u9ad4\u7a4d\u53cd\u800c\u6bd4Peter\u5c0f\uff1f\u4e3b\u56e0\u662f\u5c0f\u738b\u6b63\u670d\u7528\u5fc3\u81df\u79d1\u5c08\u7528\u7684\u8584\u8840\u85e5\uff0c\u4ee4\u4ed6\u8840\u5c3f\u5fb5\u72c0\u63d0\u65e9\u986f\u9732\uff0c\u65bc\u662f\u5728\u75c5\u767c\u521d\u671f\u4fbf\u53ef\u63ed\u767c\u75c5\u60c5\u3002\u82e5\u7136\u60a3\u8005\u670d\u7528\u7684\u662f\u6297\u8840\u5c0f\u677f\u85e5\uff0c\u4ea6\u53ef\u4ee5\u6709\u76f8\u540c\u60c5\u51b5\u3002\u56e0\u6b64\uff0c\u6709\u670d\u7528\u5fc3\u81df\u79d1\u85e5\u7269\u7684\u4eba\u58eb\uff0c\u7121\u6545\u6392\u8840\u5c3f\uff0c\u5c31\u8981\u591a\u60f3\u4e00\u5c64\uff0c\u8d95\u5feb\u5411\u91ab\u751f\u67e5\u8a62\uff0c\u52ff\u803d\u8aa4\u75c5\u60c5\u3002<\/p>\n

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\u6587\ufe30\u5085\u9326\u5cef\uff08\u6ccc\u5c3f\u5916\u79d1\u5c08\u79d1\u91ab\u751f\u3001\u9999\u6e2f\u7537\u58eb\u5065\u5eb7\u5b78\u6703\u53ec\u96c6\u4eba\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

【明報專訊】膀胱癌較常出現在男性身上，成病原因多與遺傳有關，另外經常接觸化學製品如染髮劑，亦可增加患病風險；有吸煙習慣的人士，更可增加幾倍患病風險。不過，亦有些個案是難以辨明原因的，患者必須對徵狀提高警覺，才可避免惡化。<\/p>\n

五十歲的Peter（化名），生活習慣正常，沒有吸煙習慣，最近無故出現血尿，無其他徵狀，一星期後他急急求診，安排入院，在麻醉科專科醫生監察麻醉的安全、無痛情况下，經尿道進行膀胱內視鏡檢查，發現膀胱有三厘米的腫瘤，憑經驗評估很大可能是惡性腫瘤，於是安排Peter翌日立即做手術。Peter的腫瘤雖然大，但未入侵肌肉層，所以毋須整個膀胱切除，可以用內窺鏡割掉腫瘤，隨即進行化療，減低復發風險——膀胱癌的復發率甚高，可達七至八成，因此患者在治療後，每三至四個月要檢查一次，兩年後每六個月檢查一次，比起其他癌症檢查頻密得多。<\/p>\n

非侵蝕性膀胱癌（non-muscle invasive bladder cancer）主要是進行膀胱內化學治療（intravesical instillation chemotherapy），經尿道插入軟管，灌進藥水，直接浸泡膀胱，術後進行一次即可。此外，有部分高危患者亦要進行膀胱內卡介苗（BCG）免疫療法，是一種免疫系統治療，於手術後六星期開始，六次為一個療程，以導管將卡介苗輸送到膀胱，藉以令身體產生免疫力殺死癌細胞。膀胱內化學治療及膀胱內卡介苗免疫療法均要把藥直接灌進膀胱，但必須分開進行，才有療效。這種化療沒什麼副作用，但膀胱內卡介苗免疫療法可能令患者膀胱赤痛或發燒，有需要時可使用止痛藥輔助，是高危膀胱癌的標準治療。<\/p>\n

服薄血藥 血尿徵狀提早顯露<\/p>\n

血尿是膀胱癌的明顯徵狀，Peter的腫瘤生長迅速，幸好他沒有拖拉，盡快求醫；但小王（化名）便十分大意，他本身有心臟病，長期服用薄血藥，排血尿已達一年，最近才作檢查，發現膀胱有一厘米的腫瘤。或許你會奇怪，小王有徵狀達一年，為何腫瘤體積反而比Peter小？主因是小王正服用心臟科專用的薄血藥，令他血尿徵狀提早顯露，於是在病發初期便可揭發病情。若然患者服用的是抗血小板藥，亦可以有相同情况。因此，有服用心臟科藥物的人士，無故排血尿，就要多想一層，趕快向醫生查詢，勿耽誤病情。<\/p>\n

文︰傅錦峯（泌尿外科專科醫生、香港男士健康學會召集人）<\/p>\n

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