太久沒有超音波文，今天要來說的是有經典超音波特徵的十二指腸閉鎖，還有胎兒腸阻塞相關問題~

🔎全文參見
https://drjessicakang.blogspot.com/2021/06/blog-post.html

#十二指腸閉鎖 Duodenal atresia

#超音波主要特徵
1. Double bubble sign
2. 羊水過多

✏️但是這兩個超音波特徵，通常在"高層次"的週數是不會發現的! 很多都是超過24週才出現。所以高層次沒有異常發現，不代表之後一定沒問題的喔!

✏️Duodenal atresia超音波診斷並不會太難，但是一旦發現了，後續染色體檢查是需要安排的切勿忘記!

#強烈建議染色體檢查 (karyotyping):
約25~30%的十二指腸閉鎖病患也是唐氏症患者；反之，約有5-15%唐氏症患者會有十二指腸閉鎖。

#其他合併異常:
1. 50-70%十二指腸閉鎖的案例會有其他心臟或腸胃道異常。
2. 以單一器官來說，先天性心臟病最常見(大約有20%會合併)。
3. VACTERL: 腎臟、脊椎也要特別注意。
4. 其他腸胃道異常，環形胰臟等。

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🔎Double bubble sign就一定是十二指腸閉鎖嗎?

不一定，也會出現假的也就是Pseudo-double-bubble sign。

假的Double bubble鑑別診斷有很多，文章有詳細說明。

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🔎產前腸子脹，還有哪些鑑別診斷呢?

空回腸閉鎖 (Jejunoileal atresia)
腸道轉位異常/腸扭轉 (Malrotation with volvulus)
胎糞性腸阻塞(Meconium ileus)

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但是回顧了一些研究文獻，產前診斷有沒有界定 #腸子要多寬? #是不是一定會有羊水過多? 這都還沒有一定的標準。

🔎哪些超音波特徵來診斷腸阻塞最準?
超音波診斷率很差。
有研究發現，超過32週，腸子寬度>1.7公分 + 羊水過多 -> 腸阻塞的偵測率較高

🔎如果胎兒沒有出現超音波異常，是不是就不會有腸阻塞?
錯。
有部分胎兒是產前羊水量正常，而且腸子或胃也沒有特別脹。

🔎如果產前沒有診斷出來，會不會影響寶寶出生後的預後?
研究發現，產前沒有出現超音波異常的案例，出生後開刀住院天數、ICU天數、死亡率等和有出現超音波異常的案例比較，是差不多的。
閉鎖的種類，還有診斷的時間(產前、出生後)，也對預後沒有太大影響。

以上供大家參考囉

#十二指腸閉鎖
#十二指腸狹窄
#DoubleBubbleSign
#腸阻塞
#產前超音波

【合時湯水】口中味覺與臟腑健康息息相關
⭐口苦是因為膽汁上溢
⭐代表肝膽有火需要清熱
#星期五湯水

瞓醒口乾又口苦？
西洋菜湯清熱利濕

一覺醒來，覺得口裡有朕苦味？如伴隨口渴但不想喝水、口中黏膩、小便黃且不暢順的問題，就代表你有濕熱問題。常暴飲暴食、嗜吃生冷食物、嗜甜嗜辣、喝酒太多或本身屬痰濕體質人士特別容易出現濕熱症狀，「濕蘊於中，濕鬱化熱」，濕與熱同時結合於脾胃裡阻礙氣機運行，這種口乾口苦，即使喝再多水也無補於事，需要清熱利濕以紓緩症狀。 西洋菜是冬春兩季常食蔬菜之一，從中醫角度看，西洋菜性涼，有清熱潤肺的功效，適合身體有熱像時食用，例如口乾、口苦、便秘、暗瘡等。要注意西洋菜是水生植物，或會藏有水蛭，所以烹煮前必須以清水加鹽反覆浸泡清洗數次。

食材小貼士： 猴頭菇性平，有養胃健脾、助消化的功效，適合胃脹、胃痛、噯氣泛酸、慢性胃炎、胃及十二指腸潰瘍、胃癌人士食用。

西洋菜猴頭菇芡實湯
功效：清熱健脾利濕，幫助消化，紓緩口苦口乾、胃脹、胃部不適。
材料：西洋菜600克、猴頭菇1個、芡實15克、生薏米30克、無花果乾2枚、蜜棗2枚

做法：
1. 所有材料洗淨，西洋菜以清水加鹽反覆浸泡數次瀝乾備用。
2. 鍋中加入2500毫升水，放入全部材料，武火煮至水滾，調文火煮2小時，最後下鹽調味即可。

留言或按讚👍🏻支持一下我們吧！❤️ 歡迎 Follow 我們獲得更多養生資訊。 Watercress soup can clear heat and dispel dampness
Have you ever had a bitter taste in the mouth after waking up? If it comes with other accompanying symptoms such as feeling thirsty but do not want to drink water, sticky feeling in the oral cavity, and yellow urine or urine retention, then your body is experiencing the damp heat condition.

Individuals who binge eat, those who indulge in raw, cold, spicy, and sweet food and alcoholic drinks, and people who have the phlegm-dampness body constitution will develop damp heat symptoms more easily. The combination of dampness and heat in the spleen and stomach can stagnate the circulation of the qi, and this is what causes dryness and bitterness in the mouth.

We cannot solve this problem even by drinking a lot of water. The most effective way to relieve the symptoms is to clear heat and dispel dampness from the body.

Watercress is one of the common vegetables during winter and spring. From the perspective of Chinese Medicine, watercress is cool in nature, and it can clear heat and moisten the lungs. It is suitable for individuals to consume when they feel heaty. Some of the common symptoms are dry mouth, bitter taste in the mouth, constipation, and acne. Do note that watercress is an aquatic plant, so leeches might hide in between the leaves. Before cooking them, be sure to wash and submerge them in salted water several times first.

Tip on the ingredients: Monkey head mushroom is mild in nature, can strengthen the spleen and stomach and aid digestion. It is suitable for those with abdominal bloating, stomach pain, burping, acid reflux, chronic gastritis, stomach and duodenal ulcers, and patients with stomach cancer.

Watercress and Monkey head mushroom soup with Fox nut
Effects: Clears heat, strengths the spleen and promotes diuresis. Aids digestion. Relieves bitter mouth and dry mouth, bloating.

Ingredients: 600g watercress, 1 monkey head mushroom, 15g fox nuts, 30g coix seeds, 2 dried figs, 2 candied dates

Preparation:
1. Rinse all ingredients thoroughly. Soak watercress in salted water, drain and repeat a few times.
2. Combine all ingredients with 2500ml of water in a pot and cook on high heat until boiling. Turn to low heat and simmer for 2 hours. Add salt to taste.

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【養生食材】猴頭菇美味且益處多

⭐明明是菇口感卻很像肉
⭐難怪有素中葷的稱號
#星期三CheckCheckMail

猴頭菇養胃佳品
新手人妻：「最近煲湯不想放肉，聽說加入猴頭菇可以增加口感又有益，不過有股苦味呀，怎麼辦？」

CheckCheckCin：猴頭菇和其它菇菌很不一樣，多數菇菌表面光滑，而猴頭菇在球形菇體上長滿細絨毛，遠望就像猴子頭一樣，原來它對消化系統毛病很有裨益，從中醫角度來看它有利五臟、助消化的作用，亦能養胃健脾，特別適合有胃脹、胃痛、噯氣泛酸、慢性胃炎、胃及十二指腸潰瘍人士食用，也適合胃癌病人食用。猴頭菇可用來煲湯或炆煮，新鮮猴頭菇味道較為清甜但比較難買到，乾品容易買到但煲湯會帶少許苦味，想去除苦味，建議要充分浸泡及剪去菇蒂，反覆搓洗以及汆水後才使用。

猴頭菇 — 性平，養胃健脾、助消化，適合胃脹、胃痛、噯氣泛酸、慢性胃炎，胃及十二指腸潰瘍、胃癌人士食用。

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Benefits of monkey head mushroom 
“Lately I prefer to cook soup without meat. I heard monkey head mushroom is a great soup ingredient to enhance the flavor and it is good for health. But I can’t bear its bitter taste. What can I do? ”

CheckCheckCin: Monkey head mushroom is very different from other mushrooms. Most mushrooms have a smooth surface, and monkey head mushroom is covered with fine hairs. It looks like a monkey head from a distance. It is actually very helpful for digestive system symptoms. From the point of view of Chinese medicine, it is beneficial to the five internal organs, can aid digestion and strengthen the stomach and spleen. It is especially suitable for those with abdominal bloating, stomach pain, burping, acid reflux, chronic gastritis, stomach and duodenal ulcers, and it is also suitable for patients with stomach cancer. Monkey head mushroom can be used in soups or stews. Fresh monkey head mushroom tastes sweeter but is more difficult to buy. Dry monkey head mushroom is easy to buy but has a slight biter taste. To remove the bitterness, it is recommended to fully soak it and cut the mushroom stems. Blanch after repeated scrubbing to use.

Monkey head mushroom - mild in nature, can strengthen the spleen and stomach and aid digestion. It is suitable for those with abdominal bloating, stomach pain, burping, acid reflux, chronic gastritis, stomach and duodenal ulcers, and patients with stomach cancer. 

Comment below or like 👍🏻 this post to support us. ❤️ Follow us for more healthy living tips.

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