模糊綜合評估肝硬化患者之存活率

本研究以模糊數學理論對肝硬化患者的肝功能作一綜合性的評估，藉以全面瞭解其肝功能及存活率，提供主治醫師對患者病情之參考，並能採取適當的治療手段。對肝硬化患者肝功能的等級分類，醫學界常採用Child-Pugh分類法，本文擬以模糊綜合評估法進行等級分類，評估用的指標模糊集合，以抽血報告的數據如白蛋白(Albumin)、總膽紅素(T-Bilirubin)、GOT，PT及腹部超音波判別有無腹水。由於案例取得不易，因此，採用作者本人九份病歷報告為案例，以模糊綜合評估肝硬化患者之存活率進行研究，其結果顯示在一般條件（膽紅素在3.0以下、白蛋白在3.0以上、GOT在120以下、中等以下的腹水、腦病變屬於輕微以下），其存活率多在70%以上。經模糊綜合評估肝硬化患者之存活率與Child-Pugh分類法評估之存活率相互比較，顯然，本文評估之結果較能作合理的等級分類，並能全面反應肝功能情形。

關鍵字

模糊數學；模糊綜合評估； Child-Pugh分類法

並列摘要

The research, based on the fuzzy theory, is a comprehensive survey on the patients with cirrhosis of liver, which helps us with the understanding both the liver function and the survival rate. It also offers a good reference to the patients' pathology, and the attending doctor will take proper action on the therapy thus. In the medical, the Child-Pugh Classification is frequently used to classify the patients with cirrhosis of liver. In the text, the classification is made by the ”Fuzzy Comprehensive Evaluation”. The index in the fuzzy set consists of the results from the blood data, such as GOT, GPT, Albumin, T-Bilirubin, and the belly ultrasonic wave sweeping for ascites. For the sake of inaccessibility of such kind of instance, the analysis of the research was according to 9 instances from the author's (Dr. Chao) anamnesis. It shows that the survival rate is above 70% under the general conditions. (i.e, Bilirubin below 4.0, Albumin above 3.0 GOT below 120, Ascites better than average and a slight Brain pathology.) With the contrast between both the Fuzzy Comprehensive Evaluation and the Child-Pugh Classification, it is easy to perceive that the former is not only more suitable for reasonable classification but also can fully indicate the respects of liver function.