一位守宮木導致閉塞性細支氣管炎患者肺移植手術後呼吸治療及照護經驗：病例報告

Respiratory therapy experience of a Sauropus androgynus -induced bronchiolitis obliterans patient after lung transplantation: a case report

周騰慶(Teng-Ching Chou) ； 羅乾鳴(Chien-Ming Lo) ； 王逸熙(Yi-Hsi, Wang) ； 劉婷婷(Ting-Ting Liu) ； 張惠娟(Hui-Chuan Chang)

《呼吸治療》 22卷1期 (2023/01) Pp. 49-64

https://doi.org/10.6269/JRT.202301_22(1).0005

摘要

守宮木（Sauropus androgynus,SA）於1994年引進到台灣，然而同年的8月至1995年12月期間約80位病患因食用生的守宮木葉後開始出現呼吸困難、胸悶、心悸、皮疹、咳嗽或震顫，此為守宮木導致閉塞性細支氣管炎（sauropus androgynus-induced bronchiolitis obliterans syndrome, SABO）症候群。由於不可逆的病生理機轉，儘管使用類固醇、細胞毒劑、支氣管擴張劑、免疫抑制劑仍無法完全改善嚴重阻塞型肺病而最終死亡，而肺移植是至今最好的處置。然而肺臟最直接受到外在環境威脅而導致肺移植後感染等其他肺部併發症造成術後死亡率上升，肺移植為所有器官移植中最低的存活率。呼吸治療師在肺移植照護中扮演重要的角色，以此個案報告分享呼吸治療臨床評估、問題、治療計畫及成效。

關鍵字

守宮木 ； 閉塞性細支氣管炎 ； 肺移植 ； 六分鐘行走測試 ； 肺部復原

並列摘要

Sauropus androgynus (SA) was introduced to Taiwan in 1994. However, about 80 patients began to experience dyspnea, chest tightness, upset, worries, and tremor after eating raw SA leaves from August 1994 to December 1995. Sauropus androgynus-induced bronchiolitis obliterans syndrome, so-called SABO syndrome, was diagnosed. Due to the irreversible mechanism and caused severe obstructive lung disease, patients who were diagnosed eventually died even use of corticosteroids, cytotoxic agents, bronchodilators and immunosuppressant. Lung transplantation is the best resolution to date; however, several complications, like primary graft dysfunction, chronic lung allograft dysfunction, infection and post-transplantation lymphoproliferative disorder, cause increase in mortality rate and make it the lowest survival rate in all organ transplantation. Respiratory therapists play an important role in lung-transplantation team. This case report is used to share clinical assessment, problems, plans and evaluation of respiratory therapy.

並列關鍵字

Sauropus androgynus ； bronchiolitis obliterans ； lung transplantation ； six minutes walking test ； pulmonary rehabilitation