今天醫療保健單元,邀請老朋友、陽明大學神經藥理所兼任教授 潘懷宗來到空中,進行一個月一次的醫療新知單元,本集主題為《精細的子宮內手術挽救胎兒生命》
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◎精細的子宮內手術挽救胎兒生命
英國第四頻道電視台製播了一系列健康教育的影片,就如同筆者一直以來的健康界節目一樣,推廣基礎醫學常識。近期該節目介紹了倫敦的一個醫療團隊,該團隊可以執行精細的胎兒手術,給未出生的嬰兒一個健康活下去的機會。與此同時,英國每日郵報健康版記者奈特女士(Kathryn Knight)也在2021年4月底,寫了一篇專欄來介紹這項已經相當成熟的手術,大家可以想像一下,對於一位懷孕的準媽媽來說,當產檢醫師說,對不起,您的寶寶有嚴重問題,恐怕會危及生命時,他的心情可想而知。
胎兒手術是對子宮內未出生的胎兒所進行的一項手術,目的是想要改善患有特定先天缺陷嬰兒的出生結局,或給予活下去的機會。由於這些缺陷通常隨著胎兒的發育而加重,所以及早發現或早治療是不二法門。醫學界早在十多年前,就已經開始嘗試胎兒手術,但因為這項手術不僅僅是對手掌大小的胎兒風險很高,甚至對於母體都是相當危險的,風險包括子宮破裂、胎兒死亡、手術感染、早期分娩等等,由於需要極其精準的動作,所以英國政府早在多年前就贊助科學界,研發專門進行子宮內手術的機器手臂,讓執刀醫生能夠精準的執行各項動作,不會傷及胎兒和母親。由於機器手臂的商業化和手術的成熟度,目前已經可以執行非常多種類的不同手術。
現階段,利用胎兒手術可以治療子宮內胎兒的許多先天性缺陷,包括:羊膜帶綜合症(Amniotic band syndrome)、先天性肺囊性腺瘤樣畸形(CCAM)、先天性橫膈膜肌疝氣(Congenital diaphragmatic hernia)、先天性高氣道阻塞綜合症(Congenital high airway obstruction syndrome)、胎兒貧血、下尿路梗阻(Lower urinary tract obstruction)等等,無法全部列舉,我們期待更多的醫學進步,造福生命,筆者當持續用功為大家報告。
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《South China Morning Post》
Which Chinese zodiac sign will have the best 2021? Year of the Ox predictions for love, health, career and wealth
https://www.scmp.com/lifestyle/arts-culture/article/3121172/which-chinese-zodiac-sign-will-have-best-2021-year-ox
• Those born in the year of the tiger and rabbit will prosper this year and Hong Kong’s luck will improve overall, a feng shui expert says
• But those born in the year of the ox, horse, sheep and dog can expect a difficult and challenging year
• Those who feel beaten down by the coronavirus pandemic and economic downturn that plagued the Year of the Rat, take heart.
• Starting on Friday, which marks the first day of the Year of the Ox, Hong Kong’s collective fortune is about to change – for the better.
• According to feng shui expert Yunwenzi, or Master Cloud, the new year will be one of nourishment and healing. However, while the city’s overall luck is expected to improve, what the Year of the Ox has in store for us individually will largely depend on the Chinese zodiac sign we were born under.
• To help you navigate through the coming year, here are some tips on the dos and don’ts from Yunwenzi that promise to help each animal sign find health, love and prosperity.
Ox
For those born in the Year of Ox, take heed. This is also a year in which your zodiac sign is at odds with the guardian god Tai Sui (or Fan Tai Shui), who determines the fortunes and setbacks of mortals.
Oxen will face a number of issues in their career in the coming year. Beware of back-stabbing colleagues or getting into disputes. Focus on your work to avoid unnecessary mistakes at work.
“The ox should beware of the risk of getting fired in the coming year. They’ll lack luck and it may be hard for them to get a new job,” warns Yunwenzi. “It is also difficult for them to accumulate wealth this year as they may make bad investment decisions. They should not invest in projects which they are unfamiliar with.”
Oxen will not enjoy much romance either over the next 12 months; try not to look for partners in clubs or at parties. Illnesses will be a problem too, owing to their weak immune system, so they need to take extra care of themselves.
Tiger
Contrary to those born in the Year of the Ox, the tiger is the luckiest of all the 12 zodiac animals this year. They will encounter plenty of gui ren – helpful people – who will help them realise their plans. Tigers should take advantage of the momentum and explore different possibilities. It will be a good time to start a business.
They are also lucky in love this year. For those seeking a relationship, seize the opportunities and enjoy the many pleasant romantic encounters.
“Widening their social circle not only brings them unexpected rewards but also boosts their overall luck in the year,” Yunwenzi explains.
But she reminds the tigers not to be arrogant and opinionated, as having good fortune does not necessarily mean all their actions are without consequences. For those who frequently attend social events, try not to overeat or else risk suffering from cardiovascular diseases.
Rabbit
The Year of the Ox is good for those born under the Rabbit sign. Everything will be quite rosy and they will be able to bounce back from rock bottom. Filled with positivity and optimism, this is a good year for them to set goals and go in new directions.
However, unlike the tigers, there are not many gui ren around for the rabbits and they pretty much have to rely on themselves to get things done. At work, their effort will be recognised by their superior and there might be a chance of promotion.
Romance is also in the air for the rabbits – but mind that large age gap. Patience and mutual understanding are needed if they want to establish a strong relationship.
The rabbit should avoid strenuous exercise to prevent injuries to the limbs.
Dragon
A stable and average year ahead for those born in the Year of the Dragon: their career will come to a standstill, which will make them doubt their working abilities. Yet, a twist of fate is expected after mid-autumn so it’s worth waiting for the opportunity to present itself.
Although dragons will have many romantic encounters this year, they may still end up unsatisfied as they are not devoting much time to nurture their relationship(s). Their impulsiveness also means they easily fall in love with the wrong person.
The dragon will have a weak lung this year, associated with respiratory diseases. They may also be prone to bad skin.
Snake
It will be a year filled with both fortune and risk for snakes. Since you will be surrounded by people, unexpected opportunities will arise from your growing social network.
“Their rising popularity may also attract people who speak with a ‘forked tongue’. They should work more and talk less. Their hard work will pay off,” says Yunwenzi.
Unmarried snakes will stay single this year because they are too picky. They are advised to lower their requirements when looking for a partner.
Beware of health problems such as spinal disc hernia, frozen shoulder and bony spur.
Horse
This will be a roller coaster year for those born in the Year of the Horse. Their long-awaited plans will be postponed or even halted due to unexpected variables, but as the saying goes, “amid every crisis lies a great opportunity”, and career opportunities will arise during the winter.
They should stay calm and sincerely tackle difficulties faced by their colleagues and company. This will gain their boss’s trust and confidence in them.
Apart from work, sincerity is also key to success in relationships. Just be true to yourself and the right person will be attracted by your charisma. Beware of eye and head problems; headaches and dizziness may occur frequently throughout the year.
Sheep
Those born in the Year of the Sheep should expect a difficult and challenging year. They will face a lot of obstacles in all aspects of life. The Year of the Ox is not one for them to make any important decisions such as starting a business or changing jobs as their mind might be clouded with confusion.
The sheep should stop finding excuses and acting like an otaku. Actively expanding and engaging in their social circles will bring them romantic luck.
“This is a Xing Tai Sui year for sheep, which means that they should also care for their safety as it is foreseen that they may have traffic accidents within the year,” warns Yunwenzi.
Monkey
The monkey foresees a flourishing year full of opportunities and good fortune. They should be receptive to new ideas and seize golden opportunities. They will get help from a female gui ren which will help them get better results.
They will also have a breakthrough in their career. They will easily get approval from their boss and promotion is on the horizon. For those who wish to start their own business, it is a good year to test the water by setting up a low-cost online business.
Monkeys will also have a fruitful social life this year. They will have opportunities to make new friends who have charming personalities. Thanks to the monkey’s attractiveness and social popularity, sparks may fly. It is wise for monkeys to make their intentions clear from the start to avoid ambiguous signals that could damage their reputation and friendships.
Kidney deficiency is likely to emerge in the Year of the Ox. They should also be aware of lower back pain.
Rooster
Roosters will have better fortune this year. This will be a “learning year” for them so they should stop being passive and start actively fighting for opportunities. Although the outcome may be unexpected or unsatisfying, each challenge is a golden learning opportunity.
The rooster also receives blessings from Wen Chang, the god that oversees the intelligence and wisdom of mortals. They should use their time for further studies.
People born under the sign of the rooster will not have much luck in love this year. They may feel tired and lose interest in searching for love. The rooster will not suffer from any major health problems this year, though they are prone to catching minor infections.
Dog
The dog is looking at a troubling year ahead as, like those born in the Year of the Sheep, they will go through a Xing Tai Sui year. It will result in an unstable year filled with trouble and difficulties in relationships. Brace yourselves for the worst during the middle of the year.
Accumulated stress means dogs may lose their temper. Bad fortune will come knocking with all that pent-up negativity.
They will also not have any luck in relationships this year. They should choose their partner wisely and only start a relationship when they have a better understanding of their lover. Dogs should also look after their mental health. Poor stress-induced sleep quality will increase the risk of developing mental illness such as depression.
Pig
Fortune shines on the pigs this year. They are always at their best and are quick-witted. They should attend more social gatherings to broaden their network and develop new job and business opportunities. Pigs could also set a more ambitious goal this year.
Those born in the Year of the Pig may be attracted to a number of people simultaneously, and this could even develop into multiple affairs. The complicated relationships will harm their hopes for romance in the long run.
Their health is hugely improved this year, and there is no major health problem predicted.
Rat
After experiencing a terrible Year of the Rat, those born under this animal zodiac sign will see a boost in their fortunes. But they must be persistent and persevere as their luck will remain average for the first half of the year.
They are advised not to set their goals too high but keep their feet on the ground and be prepared to face any challenges. They will be able to achieve their goals in the second half of 2021.
The rat tends to be indecisive in relationships. They lack security when it comes to love, especially when potential new partners emerge on the horizon. It will make them passive and unable to devote themselves to maintaining the relationship, which will not last.
They have a weak reproductive system this year. A regular check-up is advised.
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Brendan Rodgers confirms Leicester City will be missing Jamie Vardy due to a hernia operation for a few weeks!
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疝氣(小腸氣) - 李志毅外科專科醫生@FindDoc.com
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(一)什麼是疝氣(小腸氣)?有哪些不同位置的疝氣?00:06
(二)疝氣會導致什麼後果?有什麼治療方法? 01:31
(三)手術有什麼風險? 03:17
(本短片作健康教育之用,並不可取代任何醫療診斷或治療。治療成效因人而異,如有疑問,請向專業醫療人士諮詢。)
參考資料:
1 Kavic M. S. (2005). Hernias as a source of abdominal pain: a matter of concern to general surgeons, gynecologists, and urologists. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 9(3), 249–251.
2 Kulaçoğlu H. (2015). Current options in umbilical hernia repair in adult patients. Ulusal cerrahi dergisi, 31(3), 157–161. https://doi.org/10.5152/UCD.2015.2955
3 Agbakwuru, E., Olabanji, J., Alatise, O., Okwerekwu, R., & Esimai, O. (2009). Incisional Hernia in Women: Predisposing Factors and Management Where Mesh is not Readily Available. The Libyan journal of medicine, 4(2), 66–69. https://doi.org/10.4176/081105
4 Appleby PW, et al. Umbilical hernia repair: Overview of approaches and review of literature. Surgical Clinics of North America. 2018; doi:10.1016/j.suc.2018.02.001.
5 Chowbey, P. K., Pithawala, M., Khullar, R., Sharma, A., Soni, V., & Baijal, M. (2006). Complications in groin hernia surgery and the way out. Journal of minimal access surgery, 2(3), 174–177. https://doi.org/10.4103/0972-9941.27734
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