臺灣博碩士論文加值系統

本篇研究目的共有三項，包括正常紅耳龜血液及血清生化數值、有食入魚鉤之紅耳龜血液及血清生化數值各項分析、內視鏡及外科手術和魚鉤相關因子比較。正常紅耳龜參考值的建立，使用18隻取自中部人工湖泊健康的紅耳龜，進行背側靜脈竇採血，分析各項血液及血清生化數值的數據，以95％的信賴區間作為參考值的範圍。有食入魚鉤之紅耳龜血液及血清生化數值各項分析，採用16隻取自中部人工湖泊有食入魚鉤的紅耳龜，於手術當日術前、手術後24小時以及手術後一週進行血液學檢查。結果顯示有食入魚鉤之紅耳龜手術前的血液數值相較於正常紅耳龜有白血球降低、淋巴球比例上升、異噬球比例下降，紅血球、血紅素、血容比下降，珈瑪麩胺酸轉氨酶（γGT）上升，球蛋白（Globulin）下降之情形，表示魚鉤存在紅耳龜體內會使其發生免疫力下降、慢性失血及脂肪肝等情形。紅耳龜手術後是否復原良好和手術前的血液數值無相關性，而內視鏡手術後可以看到紅耳龜異噬球、天門冬氨酸轉氨酶（AST）、氨基丙酸轉氨酶（ALT）、乳酸脫氫酶（LDH）、肌酸磷酸激酶（CK）、珈瑪麩胺酸轉氨酶（γGT）、血液尿素氮（BUN）、肌酸酐（Creatinine）和尿酸（Uric acid）上升，由此可知內視鏡手術會造成紅耳龜炎症、緊迫及肌肉組織損傷等情形。內視鏡及外科手術和魚鉤相關因子比較採用24隻有食入魚鉤之紅耳龜，其中21隻取自中部人工湖泊有食入魚鉤之紅耳龜，3隻由民眾拾獲有釣魚線於口腔，經放射線學檢查有食入魚鉤之紅耳龜。麻醉後先進行內視鏡檢查並取出魚鉤者為內視鏡手術組，內視鏡檢查後評斷無法使用內視鏡夾取之魚鉤，改以外科手術方式取出魚鉤為外科手術組，研究結果可知食道部份外科手術所需手術時間和內視鏡手術時間無顯著差異。無論是在食道部、賁門或是胃內之魚鉤，其手術成功機率和魚鉤長度、魚鉤寬度、魚鉤方向、是否有倒刺、釣魚線長度皆無顯著相關性。綜合上述結果得知野生龜種若食入魚鉤，建議將魚鉤取出，雖然魚鉤相關因子不影響內視鏡手術成功率和手術時間，但手術前的放射線學檢查可以預先知道魚鉤的方向和位置，用來輔助內視鏡手術之進行。若設備許可，異物取出的方式以內視鏡為優先選擇，一旦魚鉤深埋於組織之中就不能強迫拉出魚鉤，組織的破壞會直接造成紅耳龜死亡，需改以外科手術方式取出。當魚鉤位置靠近賁門處，且有大量硬實的結締組織包被時，外科手術並不適合此種龜類，建議只能讓龜類與魚鉤共存。

There are three objects of this study: to establish hematologic and biochemical reference values in red-eared sliders, hematologic and biochemical data analysis in hooked red-ear sliders, factors associated with successful retrieval fishhook by endoscopy or surgery. In hematologic and biochemical reference values establishment, eighteen normal red-eard sliders from artificial lakes in central region were used in this research. Blood samples were obtained from caudal venous sinus. 95% confidence interval was used for reference interval. Blood samples from sixteen hooked red-eared sliders from artificial lakes in central region were used for hematologic and biochemical analysis. Blood was taken before surgery, one day, and seven days after surgery. When the hematologic and biochemical data from hooked red-eared sliders before surgery to normal ones were compared, it showed significant elevations of lymphocyte ratio and γGT; reductions of white blood cell count, heterophil ratio, red blood cell count, hemoglobin, packed cell volume and globulin. It suggested the existence of fishhook in red-eared sliders would cause reduction of immunity, chronic blood loss and fatty liver. Prognosis was not related to preoperative blood values. After endoscopic surgery, elevations of heterophils, AST, ALT, LDH, CK, γGT, BUN, creatinine and uric acid were observed in hooked red-eared sliders. These results indicated that endoscopic surgery can cause inflammation, stress and tissue damage. In the part of factors associated with successful retrieval fishhook by endoscopy or surgery, twenty-four hooked turtles were examined during the study period. Twenty-one of these were obtained from artificial lakes in central region. Three of these were found with a fishing line extended from the oral cavity and radiographs diagnosed fishhook ingested. Techniques used to remove fishhooks were classified as endoscopic removal and surgical removal. Duration of endoscopic retrieval of fishhook from either esophagus, cardia and stomach has no significant difference when compared to duration of surgical retrieval of fishhook from esophagus. In esophagus, cardia and stomach, whether a fishhook could be endoscopically successfully retrieved was not related to its length, width, orientation, barb, or length of fishing line. Surgical successful rate was also not related to the depth of fishhook. Endoscopic retrieval time and fishhook- related factors were not significantly related. Once the fishhooks are ingested by wild chelonian, we still suggest that the fishhook should be removed. Although the endoscopic successful rate and the duration of retrieval were not related to all fishhook-related factors, preoperative radiology examinations still provide the orientation and location of fishhooks, which helps to retrieve fishhooks by endoscopy. Endoscopic retrieval of foreign body is the first choice if the equipments are available. Fishhooks should not be forced removed by endoscopy when they are embedded deeply in the tissue, otherwise it may lead to death. Surgical removal is then recommended if endoscopic retrieval is unsuccessful. However, when fishhook located near cardia and surrounded by a lot of hard connective tissue, surgery is then not suitable for this kind of chelonian. The coexistence of chelonian and the fishhook would be suggested.

中文摘要 i
Abstract ii
表次 vi
圖次 vii
第一章 緒言 1
第二章 文獻探討 2
第一節 巴西龜的介紹 2
第二節 龜類血液及血清生化學特性 3
一、 影響龜類血液及血清生化數值因子 3
二、 血液特性 5
三、 血清生化學分析 7
第三節 參考值的建立 10
一、 參考值的定義 10
二、 參考值的來源 10
三、 數據統計方式 11
第四節 龜類麻醉方式 11
一、 麻醉前準備 11
二、 麻醉方式 13
三、 麻醉監控 14
四、 麻醉深度評估 16
五、 麻醉甦醒 16
第五節 魚鉤引致之龜類消化道異物症 17
第六節 龜類消化道異物手術方式 17
一、 開殼手術 17
二、 股骨前窩或腋窩手術 18
三、 內視鏡手術 19
第七節 龜類手術後照護方式 20
第三章 材料與方法 21
第一節 正常紅耳龜血液及血清生化值 21
一、 研究目的 21
二、 研究對象 21
三、 飼養管理 21
四、 研究方法 21
五、 統計分析方法 23
第二節 有食入魚鉤之紅耳龜血液及血清生化數值各項分析 24
一、 研究目的 24
二、 研究對象 24
三、 飼養管理 24
四、 研究方法 24
五、 統計分析方法 25
第三節 內視鏡、外科手術及魚鉤相關因子比較 26
一、 研究目的 26
二、 研究對象 26
三、 研究方法 26
四、 統計分析方法 30
第四章 結果 31
第一節 正常紅耳龜血液及血清生化值 31
第二節 有食入魚鉤之紅耳龜血液及血清生化數值各項分析 32
一、 食入魚鉤與正常紅耳龜血液及血清生化數值分析 32
二、 有食入魚鉤紅耳龜手術前血液及血清生化數值和手術後存活率的相關性 35
三、 內視鏡手術對紅耳龜血液及血清生化數值的影響 36
第三節 內視鏡、外科手術及魚鉤相關因子比較 41
一、 內視鏡和外科手術比較 41
二、 魚鉤相關因子和內視鏡手術成功率、手術時間之相關性 41
第五章 討論 43
參考文獻 53
附錄 61

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