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研究生:徐國基
論文名稱:心肌對慢性血行動力過度負荷的效應
論文名稱(外文):Cardiac Muscle response to Chronic Hemodynamic Overload
指導教授:連文彬連文彬引用關係王寧王寧引用關係
學位類別:博士
校院名稱:國立臺灣大學
系所名稱:臨床醫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:1995
畢業學年度:83
語文別:中文
論文頁數:171
中文關鍵詞:心肌血行動力
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  本研究的主旨在探討經食道超音波心圖檢查所引發之菌血症的發生率及意義。在11個月期間,連續共有132位病人,年齡由17歲至73歲,接受經食道超音波心圖檢查,他們在接受檢查前,沒有一個病人有任何的感染病症。在每次檢查前的30到60分鐘,檢查後立即及檢查後3到4小時,抽2套血做細菌培養。每次抽血量約10毫升,分別平均注入含氧及厭氧菌的培養瓶內,我們以微波測量系統測定細菌的生長,培養瓶一共擺在保溫箱內7天。在檢查之前,270次的細菌培養當中,有3次長出細菌,這些細菌分別是臘桿菌、類葡萄球菌及鏈球菌。在檢查後立即抽血做培養的研究當中,沒有一瓶長出細菌中。在檢查後的3到4小時所抽的血當中,有2次的培養在同一位病人長出表皮葡萄球菌。由血液細菌培養所分離之細菌與由喉嚨細菌細培養所分離出之細菌種類不同。在追蹤期間,病人並沒有感染心內膜炎的跡象。因此我們做以下的結論:因經食道超音波心圖檢查所發生之菌血症,其發生率相當低,同時不建議作經食道超音波心圖檢查時,常規性地給予預防性抗生素。
  To sacertain the incidence and significance of bacteremia associated with transesophageal echocardiography( TEE ), 132 consecutive patients ( aged 17 to 73 years ) free of apparent infection who were undergoing 135 transesophageal echocardiographic procedures from October 1990 to August 1991, were prospectively stuied. For each procedure, two sets of blood cultures were obtained for culture 30 to 60 minutes before TEE, immediatelly after, and 180 to 240 minutes after the procedure. For each blood culture, 10 ml of venous blood was evenly inoculated into aerobic and anaerobic culture bottles and incubated for 7 days using a ragiometric system. A throat swab was obtained immediately before each procedure. Three of 270 preprocedure blood cultures were positive for Bacillus cereus, Staphylococcus simulans, and Peptostreptococcus species, respectively. No blood culture was positive in the immediate postprocedure period. Two of 270 late blood samples orew Staphylococcus epidermids in the same patient. Nevertheless, the microorganisms isolated from blood cultures were different from those isolated from the throat wasb. No patients had fever or evidence of infective endocarditis after TEE during the follow-up period. It is concluded that the incidence of TEE-related bacteremia is extremely low, and universal for antibiotic prophylsaxis during TEE is not warranted.
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