- 期刊
一位42歲男性接受兩階段肝切除術後發燒表現
A 42-Year-Old Man With Postoperative Fever After Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy
摘要
肝癌為國人不可忽視的重要健康議題，其治療方式包括手術治療及非手術治療。接受肝臟切除手術常見的併發症有肝衰竭、出血、急性腎損傷、膽汁滲漏及肋膜積液等，若介入治療時機適當，能減少嚴重併發症而降低生命危險，故術後的照護為重要的目標。本個案是一位42歲男性，為B型肝炎帶原，因診斷為巨大肝臟腫瘤接受兩階段肝切除手術，於第二階段術後第13天出現高燒、引流液呈黃褐色液，相關臆測診斷有腹內感染及肋膜積水等，一一排除後，經由腹部超音波及胸部X光檢查，確立有膽汁滲漏及肋膜積液等複雜性併發症，透過給予胸腔穿刺、腹部引流管置放及抗生素治療一週後病情穩定且併發症獲得控制，照護期間為2020年7月11日至2020年8月10日，期望藉此經驗能做為日後照護此類個案之參考。
並列摘要
Hepatocellular carcinoma is undoubtedly a significant health issue. The medical treatments of the disease include operative and non-operative management. The most common complications after hepatic resection are liver failure, hemorrhage, acute kidney injuries, bile leakage, and pleural effusion. However, the possibility of severe complications could be decreased if proper postoperative care is provided. This can, meanwhile, reduce the threats to lives. Thus, careful postoperative care plays a vital role. The case in this study is a forty-two-year-old male hepatitis B carrier. He was diagnosed with giant hepatocellular carcinoma after clinical physical examinations and imaging tests and then received a two-stage hepatectomy. He had a postoperative fever on the thirteenth day after liver resection with brownish-yellow fluid from drainage. Therefore, postoperative intra-abdominal infection with pleural effusion were suspected. After receiving an abdominal ultrasound and chest X-ray, it was confirmed that he had complications of bile leakage and pleural effusion. His condition was well-controlled after a week under the treatment of thoracentesis, abdominal drainage as well as antibiotics. The period of postoperative care was provided from July 11 to August 10, 2020. This case could be a reference for taking care of patients with similar issues.