Dr. Wei-Hung Liu Instructed Medical Students in Fu Jen Catholic University

劉威宏醫師指導輔仁大學醫學生

Dr. Liu instructed Fu Jen Catholic University medical students on how to deal with community medicine issues in outpatient clinics.

Dr. Wei-Hung Liu was invited to lecture at University of Taipei

劉威宏醫師受邀台北市立大學授課 

Integration and Diffusion of Medical-Elderly Care and Higher Education Perspectives: Constructing a Social Prescription and Linking Worker Innovation and Development Hub - When Disability Certification and Special Education Assessment Are Misaligned: A Case Study of Children with ADHD

原始網頁 Original webpage

แนะนำ นพ. เวยหง Dr. Wei-Hung Liu (泰文醫師)

นพ. เวยหง(Dr. Wei-Hung Liu)ได้รักษาชาวไทยมากกว่า 500 คนในไทเป และได้ตรวจสุขภาพให้แก่ชาวไทยกว่า 3,000 คนที่เมืองเถาหยวน เขาเคยนำพระพรของพระเจ้าในพระคัมภีร์ไปแบ่งปันแก่ชาวท้องถิ่นในกรุงเทพฯ เป็นภาษาไทย นอกจากนี้ เขาสามารถให้บริการทางการแพทย์แบบองค์รวมโดยใช้ภาษาไทยได้

2010 แพทยศาสตรบัณฑิต(พ.บ.)  Chang Gung University   

2013 อายุรศาสตร์                        Taipei Municipal Wanfang Hospital

2017 เวชศาสตร์ครอบครัว            Landseed Hospital 

2018 แพทย์ผู้ทำการรักษา            Landseed International Hospital 

ที่อยู่คลินิกจื้อเสียง

https://maps.app.goo.gl/9QUKEmGvPchzjxYt6

ที่อยู่คลินิกฝูกั๋วจื้อเสียง

https://maps.app.goo.gl/NSvNwcXEhjtoFKaC9

Introduction of Dr. Wei-Hung Liu

Languages

Mandarin, Taiwanese, English, Thai(ไทย)

Therapeutic Areas

Chronic eczema, Urticaria, Rosacea, Onychomycosis, 

Diabetes mellitus, Hypertension, Hyperlipidemia, 

Aging and disease, Community infectious disease prevention(COVID)

Education

Master program of dermatology and venereology in Anhui Medical University 

School of medicine in Chang Gung University

 

Experience

Adjunct instructor in University of Taipei, Master's Program of Transition and Leisure Education for Individuals with Disabilities, Taiwan

Partner physician, Zhixiang Clinic, Taiwan

Deputy director and acting director of health management center, Landseed Hospital in Shanghai, China

Attending physician, Landseed Hospital in Shanghai, China

Clinical instructor for resident doctors, Zhongshan Hospital affiliated with Fudan University, China

Instructor, Postgraduate year(PGY) medicine program, Landseed International Hospital, Taiwan 

Clinical mentor for medical students, Department of Family Medicine,  Landseed International Hospital, Taiwan

Attending physician, Department of Family Medicine, Landseed International Hospital, Taiwan

Attending physician, Medical Center at Taoyuan International Airport, Taiwan

Fellow, Department of Family Medicine, Landseed International Hospital, Taiwan

Resident doctor, Department of Internal Medicine, Taipei Municipal Wanfang Hospital, Taiwan

Resident doctor, Department of Neurology, Chang Gung Memorial Hospital, Taiwan

Internship, Department of Internal Medicine, National Taiwan University Hospital, Taiwan

Clinical Dermatology Course, National Skin Center (NSC), Singapore

Members of Professional Societies

Member of American Academy of Family Physicians (AAFP)

Member of American Geriatrics Society (AGS)

Member of Taiwan Gerontology and Geriatrics Society

Member of Taiwan Association of Family Medicine

Member of Aviation Medical Association

Publications

1. Wei-Hung Liu, Common Benign Skin Tumors, Family Medicine and Primary Medical Care, 2017

2. Hsin-Ju Lee, Wei-Ting Chang, Wei-Hung Liu, Hsiao-Yen Kang, Do races influence in hyperlipidemia prevalence in Taoyuan, Ping-zhen region? Results of the LION longitudinal cohort study, Taiwan association of family medicine, 2019

腺病毒(Adenovirus)

人類腺病毒是兒童疾病常見原因。此病毒常在封閉型社區或軍隊流行。全年都可能有腺病毒的蹤跡，秋冬至初夏期間特別活躍。

Human adenovirus is a common cause of childhood illness. The virus is often found in closed communities or in the military. Adenoviruses can be found throughout the year and are particularly active in the fall, winter and early summer.

在已知類型中，只有三分之一明顯與臨床疾病有關。一般透過呼吸道和糞口途徑傳染。常見臨床症狀如下：

Of the known types, only one-third are clearly associated with clinical disease. Transmission is usually via the respiratory and fecal-oral routes. Common clinical signs are listed below:

一、呼吸道感染：鼻塞、流鼻水、喉嚨痛、發燒。
二、眼部感染：結膜炎常是自限性，無須治療。
三、腸胃道感染：大約一成兒童有腹瀉情形，多為自限性。
四、泌尿道感染：血尿、排尿困難、細菌培養結果陰性，通常於二週內消失。
 

1. Respiratory tract infections: nasal congestion, runny nose, sore throat, fever.

2. Eye infections: conjunctivitis is often self-limiting and does not require treatment.

3. Gastrointestinal infections: about 10% of children have diarrhea, which is mostly self-limiting.

4. Urinary tract infections: hematuria, dysuria, negative bacterial culture results, usually disappear within two weeks.

診斷通常基於流行病學和臨床症狀。血清培養需要數天，對早期診斷並無幫助。支持性照護為主要的治療方式。洗手有助於減少此病毒的傳播。

Diagnosis is usually based on epidemiology and clinical symptoms. Serum cultures take several days and are not useful for early diagnosis. Supportive care is the mainstay of treatment. Hand washing helps to minimize the spread of the virus.

兒童急性鼻竇炎(Acute sinusitis)

急性鼻竇炎常見病原體包括病毒和細菌，而真菌引起的鼻竇炎在免疫功能正常者身上不常見。大約2％的病毒性上呼吸道感染會併發細菌性鼻竇炎。急性細菌性鼻竇炎的病原體有肺炎鏈球菌（約30％）、嗜血桿菌（約30％）和卡他莫拉菌（約10％）。四分之一的肺炎鏈球菌可能是具有青黴素抗性。金黃色葡萄球菌、其他鏈球菌和厭氧菌少見於兒童急性細菌性鼻竇炎。

Common pathogens of acute sinusitis include viruses and bacteria, while fungal sinusitis is uncommon in immunocompetent individuals. About 2% of viral upper respiratory infections are associated with bacterial sinusitis. The pathogens of acute bacterial sinusitis are Streptococcus pneumoniae (about 30%), Haemophilus (about 30%) and Catamonas (about 10%). One quarter of Streptococcus pneumoniae may be penicillin resistant. Staphylococcus aureus, other streptococci, and anaerobes are less common in children with acute bacterial sinusitis.

急性細菌性鼻竇炎常發生在病毒性上呼吸道感染、過敏性鼻炎和菸霧暴露有關。急性鼻竇炎定義為持續時間小於三十天，慢性鼻竇炎持續時間超則過三個月。在上呼吸道感染過程中，七成的兒童鼻竇會出現異常，包括黏膜增厚、水腫和發炎，這些將阻礙鼻竇引流，減少黏膜纖毛清除細菌，導致細菌大量生長。

Acute bacterial sinusitis often occurs in association with viral upper respiratory tract infections, allergic rhinitis and smoke exposure. Acute sinusitis is defined as lasting less than 30 days, while chronic sinusitis lasts longer than three months. During an upper respiratory infection, 70% of children have sinus abnormalities, including thickening, edema and inflammation of the mucous membranes, which can block sinus drainage and reduce the ability of mucous membrane cilia to clear bacteria, leading to bacterial growth.

急性鼻竇炎的症狀包括鼻塞、膿鼻涕、發燒和咳嗽。少見的症狀包括口臭、嗅覺減退、眼眶周圍水腫、頭痛和上頜牙齒不適。理學檢查可能會發現鼻黏膜紅腫伴隨膿鼻涕。青少年和成人可能有鼻竇壓痛。

Symptoms of acute sinusitis include nasal congestion, runny nose, fever and cough. Less common symptoms include bad breath, decreased sense of smell, periorbital edema, headache, and maxillary dental discomfort. Physical examination may reveal redness and swelling of the nasal mucosa with pus. Adolescents and adults may have sinus tenderness.

急性細菌性鼻竇炎的臨床診斷乃是根據病史。持續性流鼻涕和咳嗽超過十天未見改善，或嚴重的呼吸道症狀(包括體溫超過39°C及連續三至四天的膿鼻涕)，我們都需要懷疑急性細菌性鼻竇炎。鼻竇吸出培養是唯一準確的診斷方法，但對於免疫功能正常的患者常規使用並不實際。鑑別診斷考慮因素包括病毒性上呼吸道感染、過敏性鼻炎和鼻腔異物。病毒性上呼吸道感染的鼻涕通常清澈無膿，有咳嗽，一開始發燒，但症狀通常不會持續十至十四天。

The clinical diagnosis of acute bacterial sinusitis is based on history. A persistent runny nose and cough that does not improve for more than 10 days, or severe respiratory symptoms (including a temperature over 39°C and a purulent runny nose for three to four days in a row) warrant suspicion of acute bacterial sinusitis. Sinus aspirate culture is the only accurate diagnostic method, but is impractical to use routinely in immunocompetent patients. Identifying diagnostic considerations include viral upper respiratory tract infections, allergic rhinitis, and nasal foreign bodies. Viral upper respiratory tract infections usually have a clear, pus-free nasal discharge, a cough, and an initial fever, but the symptoms usually do not last more than ten to fourteen days.

現今尚不清楚急性細菌性鼻竇炎的抗菌治療是否提供實質益處。在成人進行的研究顯示，治療七天症狀將得到改善。主要指引建議，急性細菌性鼻竇炎嚴重發作或病情惡化需給予抗生素，雖然一半的急性細菌性鼻竇炎患兒童可能在沒有抗菌治療的情況下恢復。對於有風險因素的兒童，包括最近三個月內的抗生素治療、托兒所或年齡小於二歲的兒童，應考慮給予抗菌治療。適當治療時間尚未確定，個別化治療是合理的。一般建議至少十天或在症狀消退後至少七天。

It is not clear whether antimicrobial therapy for acute bacterial sinusitis provides substantial benefit. Studies in adults have shown that symptoms improve with seven days of treatment. The main guideline suggests that antibiotics should be given for severe exacerbations or worsening of acute bacterial sinusitis, although half of children with acute bacterial sinusitis may recover without antimicrobial treatment. Antimicrobial therapy should be considered for children with risk factors, including antibiotic treatment within the last three months, in daycare or for children younger than two years of age. The appropriate duration of treatment has not been determined and individualized treatment is reasonable. A minimum of ten days or at least seven days after symptoms subside is generally recommended.

最好的預防方式是經常洗手和避免感冒，並且每年接受流感疫苗注射。

The best prevention is frequent hand washing and avoiding colds, and getting a flu shot every year.

兒童急性咽炎(Acute pharyngitis)

最近天氣炎熱，卻有不少兒童因急性喉嚨疼痛來到門診就醫。父母來到門診總以為小孩大概是得到感冒，然而，喉嚨疼痛並不等於感冒。我們所稱的感冒是指急性上呼吸道的病毒感染，三分之一患者有喉嚨痛，或者說急性咽炎的表現，但引起急性咽炎卻有許多原因。

While the weather has been hot lately, many children have come to the outpatient clinic with acute sore throat. Parents always think that their children probably have a cold, but a sore throat is not the same as a cold. What we call a cold is an acute viral infection of the upper respiratory tract. One-third of the patients have a sore throat, or acute pharyngitis, but there are many causes of acute pharyngitis.

急性咽炎是指咽部的急性發炎，包括紅斑、水腫、滲液、潰瘍或水泡。咽炎可能與環境暴露有關，如香菸、空氣污染、過敏原、腐蝕性物質、熱食、熱湯和傳染性病原體。

Acute pharyngitis is an acute inflammation of the pharynx that includes erythema, edema, oozing, ulcers or blisters. Pharyngitis may be associated with environmental exposures such as cigarette smoke, air pollution, allergens, corrosive substances, hot foods, hot soups and infectious agents.

病毒是急性咽炎的主要原因，常通透過口腔接觸或飛沫傳染，常發生在秋天至春天。可能引起急性咽炎的病毒包括：鼻病毒、呼吸道融合病毒、冠狀病毒、腸病毒、流感病毒、腺病毒、EB病毒、巨細胞病毒、單純皰疹病毒。大多數病毒引起的咽炎常在後來伴隨流鼻水或咳嗽症狀，另外，病毒性染也易導致細菌性中耳感染和細菌性鼻竇炎。對多數病毒引起的咽炎採症狀治療，包括退燒和止痛藥物。麻醉噴霧劑可以提供局部緩解作用。雖然類固醇常用於患有咽炎的成人，但在兒童身上仍缺乏大規模研究在安全性和療效性的證實。

Viruses are the main cause of acute pharyngitis, which is often transmitted through oral contact or droplet infection and often occurs in the fall to spring. Viruses that may cause acute pharyngitis include: rhinovirus, respiratory fusion virus, coronavirus, enterovirus, influenza virus, adenovirus, EBV, cytomegalovirus, and herpes simplex virus. Most viral pharyngitis is often followed by a runny nose or cough, and viral infections can also lead to bacterial middle ear infections and bacterial sinusitis. Symptomatic treatment for most viral pharyngitis includes medications to reduce fever and relieve pain. Anesthetic sprays can provide local relief. Although steroids are commonly used in adults with pharyngitis, there is a lack of large-scale studies in children to confirm safety and efficacy.

細菌引起的急性咽炎不容忽視，特別是A型鏈球菌。鏈球菌咽炎在二至三歲前相對少見，在五至十五歲兒童卻相當常見。全年都有機會感染，其中冬天至春天最為普遍。腹瀉、咳嗽、流鼻水、潰瘍、聲音嘶啞、結膜炎與鏈球菌性咽炎無關，若有以上症狀，應懷疑病毒感染引起。鏈球菌咽炎採用抗生素治療，早期抗生素治療能加速恢復十二至二十四小時，減少化膿或併發症，以及預防急性風濕熱。

Acute pharyngitis caused by bacteria, especially Streptococcus A, should not be ignored. Streptococcal pharyngitis is relatively uncommon before the age of 2 to 3 years, but is quite common in children aged 5 to 15 years. It is a year-round infection, with winter to spring being the most common. Diarrhea, cough, runny nose, ulcers, hoarseness, and conjunctivitis are not associated with streptococcal pharyngitis, but viral infection should be suspected. Streptococcal pharyngitis is treated with antibiotics. Early antibiotic therapy speeds recovery by 12 to 24 hours, reduces suppuration or complications, and prevents acute rheumatic fever.

黴漿菌肺炎(Mycoplasma pneumonia)

一位年輕女性，因反覆咳嗽一個月而至本院看診。最近否認發燒，但咳嗽症狀逐漸加劇，由乾咳轉為帶有淡黃色痰液。她的工作為小學行政人員，一個月內無出國旅遊紀錄，家中成員除孩子這二週感冒外，無其他特別接觸史或群聚史。第一次至門診時，診斷為社區性肺炎，給予經驗性抗生素安滅菌和短效氣管擴張劑。三天後返診時，咳嗽更加厲害，並出現胸痛及呼吸困難之情形，故建議住院治療。入院後，聽診發現略有喘音，X光片未見明顯實質化。除原有安滅菌外，再加以巨環類抗生素，並使用吸入型氣管擴張劑。隔日，她覺得症狀改善，追蹤血清報告，證實為黴漿菌感染。建議繼續服用完巨環類抗生素療程，並安排支氣管激發試驗，釐清是否有氣喘。第三日，因病況大幅好轉，完整留完痰液後，建議出院，並回門診追蹤。

A young woman presented to our hospital with a one-month history of recurrent cough. She denied having a fever recently, but her cough had gradually worsened, progressing from a dry cough to one productive of light yellow sputum. She worked as an elementary school administrative staff member. She had not traveled abroad within the past month. Apart from her child having had a common cold during the previous two weeks, there was no significant contact history or history of cluster exposure.
At her initial outpatient visit, she was diagnosed with community-acquired pneumonia and was prescribed empiric therapy with amoxicillin/clavulanate and a short-acting bronchodilator. Three days later, she returned to the clinic with worsening cough, accompanied by chest pain and shortness of breath; therefore, hospitalization was recommended.
After admission, physical examination revealed mild wheezing on auscultation, while chest radiography showed no obvious consolidation. In addition to the original amoxicillin/clavulanate therapy, a macrolide antibiotic was added, and inhaled bronchodilator therapy was initiated.
The following day, she reported symptomatic improvement. Follow-up serologic testing confirmed Mycoplasma infection. She was advised to complete the full course of macrolide therapy, and a bronchial provocation test was arranged to evaluate the possibility of asthma.
On the third hospital day, because her condition had improved markedly, she was discharged after providing an adequate sputum specimen, with follow-up arranged in the outpatient clinic.

黴漿菌感染常表現為咽炎、支氣管炎或喘息。一成的感染者可能發生肺炎。它的發病常是漸進的，發生在幾天內，或者更突然。雖然黴漿菌肺炎可能以喉嚨痛開始，但最常見的症狀是咳嗽。咳嗽通常是乾咳，部分患者仍會伴隨痰液。

Mycoplasma pneumoniae infection commonly presents as pharyngitis, bronchitis, or wheezing. Approximately 10% of infected individuals may develop pneumonia. The onset of illness is typically gradual, evolving over several days, although a more abrupt presentation may occasionally occur. Although Mycoplasma pneumoniae pneumonia may initially manifest with a sore throat, cough is the most common presenting symptom. The cough is typically nonproductive, although some patients may have associated sputum production.

理學檢查時，八成的患者有喘息或濕囉音。然而，更多患者的肺炎藉由X光片進行診斷。最常見的是支氣管周圍肺炎、支氣管標記增厚和間質浸潤。臨床上二成的患者有胸腔積液。
On physical examination, approximately 80% of patients exhibit wheezing or crackles on auscultation. Nevertheless, pneumonia is more commonly diagnosed radiographically. The most frequent radiographic findings include peribronchial pneumonia, bronchial wall thickening, and interstitial infiltrates. Pleural effusion is clinically observed in approximately 20% of patients.

臨床表現常無法區分黴漿菌肺炎與其他類型的社區性肺炎。當社區性肺炎對青黴素或頭孢類抗生素無效時，應考慮黴漿菌感染的可能性。儘管黴漿菌肺炎通常是自限性，但適當的抗菌治療可顯著縮短持續時間。一些患者在急性肺炎治癒後，可能伴隨長期反覆喘息。慢性感染可能與氣喘有關，需要積極追蹤複查。

The clinical manifestations of Mycoplasma pneumoniae pneumonia are often indistinguishable from those of other types of community-acquired pneumonia. M. pneumoniae infection should be considered when patients with community-acquired pneumonia fail to respond to penicillins or cephalosporins. Although M. pneumoniae pneumonia is generally a self-limiting disease, appropriate antimicrobial therapy can significantly shorten the duration of illness. Some patients may experience persistent or recurrent wheezing even after resolution of the acute pneumonia. Chronic infection has been implicated in the pathogenesis of asthma; therefore, close follow-up and further evaluation are warranted.

兒童手足口病(Hand,foot and mouth disease)

最近，上海的天氣越來越熱，但門診的患者卻有增無減。一位四歲大的小男孩前來就診，看起來精神不太好。媽媽說他間歇姓發燒，而且胃口不佳。仔細詢問後，小男孩說自已吃不下是因為喉嚨不舒服。請他張開嘴，看到咽部有數個水泡，並且有二個潰瘍。請他伸出雙手，看見掌面有突起紅色丘疹，有些為水泡狀。再請他伸出雙腳，果然又見類似病灶。結果，媽媽馬上說，其實臀部也有。很明顯的，這又是腸病毒造成的另一種疾病─手足口病(Hand-foot-and-mouth disease)。

手足口病主要是由柯薩奇病毒和腸病毒71型引起。它有時伴隨發燒，常見咽部發炎，並且有水泡見於舌頭、頰粘膜、後咽部和軟腭，有時會有潰瘍，周圍伴隨紅斑。紅色丘疹、水泡可能見於手、腳、臀部和腹股溝。通常手比腳更為常見。一般而言，水泡消失約要一週。兒童罹患此病時，常因口腔潰瘍無法進食，病程持續7至10天。

腸病毒重症好發於三歲以下兒童，與腸病毒71型有關，發病五天內須特別留意，包含以下特徵：
一、嗜睡、意識不清、活力不佳、手腳無力
二、肌躍型抽搐（無故驚嚇或突然間全身肌肉收縮）
三、持續嘔吐
四、呼吸急促或心跳加快

腸道病毒感染無明確有效抗病毒藥物，支持性治療為主要方式。補充水分可以避免因食慾不佳所導致嚴重脫水。若罹患腸病毒重症，需住院治療，有些可施予免疫球蛋白注射。預防方面務必勤洗手，防止環境中的傳播。

兒童疱疹性咽峽炎(Herpangina)

今天遇到一位三歲小男孩，因間斷高燒39.5'C二天被帶來門診。沒有明顯的咳嗽或流鼻水，發燒前略有腹痛，但已緩解，沒有嘔吐或腹瀉，胃口不佳，不太想吃東西。他感覺喉嚨痛，特別是嚥口水或吞喝熱湯時，感覺不舒服。我請他張開嘴巴，結果看到軟顎上有三至四個囊泡，後咽部有潰瘍，齒齦無任何病灶。如我心中所想，又是一個疱疹性咽峽炎的病患。他不是第一位案例，因為沒多久前，他所在幼兒園已有二位小朋友因此停課在家休養。

從五月下旬以來，上海的兒科門診有越來越多得到疱疹性咽峽炎的小朋友。這種疾病肇因於腸病毒感染。腸病毒屬於小RNA病毒，至今已發現100多種。腸道為其侵犯的第一站，然侯在此大量複製，而擴散到其他部位。所以，患者腸胃道症狀多不明顯。

皰疹性咽峽炎主要由柯薩奇病毒引起。特徵為突然發熱，喉嚨痛，吞嚥困難和咽後部病變。溫度可以從正常到41'C。較大的兒童可能出現頭痛或腰酸，四分之一患者會出現嘔吐和腹痛。囊泡和潰瘍(1-2mm)可以在扁桃體、軟齶、懸雍垂和後咽壁發現。通常3天內會擴大至3-4mm，並且被紅斑環圍繞。平均有5個病灶，範圍從1至15個。大多數病例很輕微，沒有併發症。然而有些與腦膜炎有關。發燒一般持續1至4天，並於3至7天內緩解。

因缺乏經過證實的腸道病毒感染之抗病毒藥物，支持性治療是最主要的方法。補充水分可以避免因食慾不佳而嚴重脫水。預防上務必勤洗手，以防止環境中的傳染。

兒童急性蕁麻疹(Acute urticaria)

今天上午看診時，遇見一位小朋友起全身紅疹。紅色中帶有蒼白色，周圍伴隨紅暈，形狀不規則，有大有小。他覺得非常癢，想要一直抓，但紅疹卻越來越多。這是典型的蕁麻疹病灶。再仔細一問，媽媽說過往就有多次發生紀錄，似乎每次在學校午餐吃到魚時，都會發生這樣的情形。這次也不例外。

I saw a child with a red rash all over his body this morning. It was red with a pale tinge, surrounded by a red halo, and was irregular in shape, ranging from large to small. He felt very itchy and kept scratching, but the rash was getting worse. This was a typical urticaria. Upon further inquiry, his mother said that there had been a number of previous occurrences. It seemed to happen every time while his eating fish as the lunch at school. This time was no exception.

蕁麻疹是皮膚黏膜因血管通透性暫時增加，而發生的侷限性水腫。病因有時不容易找得到。常見原因有：
一、食物(如海鮮、奶、蛋)
二、感染(如病毒、細菌、真菌)
三、藥物(如Amoxicillin)
四、呼吸道吸入(如花粉、粉塵)
五、皮膚接觸(如昆蟲叮咬)
六、物理因素(如冷、熱、壓力)

Urticaria is a limited edema of the mucous membranes of the skin due to a temporary increase in vascular permeability. The cause is not always easy to find. Common causes include

1. Food (e.g. seafood, milk, eggs).

2. Infections (e.g. viruses, bacteria, fungi).

3. Drugs (e.g. Amoxicillin)

4. Respiratory inhalation (e.g. pollen, dust)

5. Skin contact (e.g. insect bites)

6. Physical factors (e.g. cold, heat, pressure).

急性蕁麻疹出現快，一般24小時內會消失。

Acute urticaria appears quickly and usually disappears within 24 hours.

若反覆發作六週以上，就要考慮慢性蕁麻疹。慢性蕁麻疹通常和食物無關，但與我們的自體免疫系統異常有關。

If it recur for more than six weeks, chronic urticaria is considered. Chronic urticaria is not usually related to food but the abnormality in our autoimmune system.

急性蕁麻疹患者常自覺癢感，接著在癢感部位出現大小不等的圓形、橢圓形或不規則病灶。可以各自獨立，或又擴大融合成片。手摸起來有突出的感覺，顏色偏紅，或呈現蒼白色。常見數分鐘至數小時後消失，然而有時一個區塊消失，另一個區塊又出現。嚴重者有過敏性休克症狀，可能聲音沙啞或呼吸困難。

Patients with acute urticaria often experience itchy sensation, followed by round, oval or irregular lesions of varying sizes on the itchy areas. They may be separate or enlarged to form patches. They might be prominent while touching and be reddish or pale in color. They usually disappear after a few minutes to a few hours. However, one area sometimes disappears, and the other appears. In severe cases, there are signs of anaphylaxis, which may be characterized by hoarse voice or short of breathing.

急性蕁麻疹治療以抗組織胺為首選。一般而言，第二代抗組織胺較無嗜睡感，適合已開始上學的兒童。嚴重者可以針劑藥物注射，類固醇可以考慮短期使用。

Antihistamines are the first choice for the treatment of acute urticaria. Generally speaking, the second generation Antihistamines are less drowsy and are suitable for children who have started school. For severe cases, injections can be given and steroids can be considered for short-term use.

預防方面，若找得到原因，就需要盡量在日常生活中避開。

For prevention, if you can find the cause, you need to avoid it as much as possible in your daily life.

兒童急性細支氣管炎(Acute bronchiolitis)

急性細支氣管炎常見於二歲以下的小朋友，由病毒感染造成。最常見者為呼吸道融合病毒，其他包括副流行性感冒病毒、流行性感冒病毒、腺病毒或黴漿菌等。

在開始三至五天，會以上呼吸道症狀，如咳嗽或流鼻水為表現。接著會有發燒，呼吸急促，甚至有多痰及「咻咻」的喘聲。咳嗽和呼吸困難發作後48-72小時內，出現呼吸危險的風險最高，但因此而致命的比例小於1%。症狀持續約二星期，有十分之一的小朋友可能會達到三星期。得過此病未來得到氣喘的機會上升。

治療上需要補充水分，若住院者，可給予氧氣帳。其他藥物的使用，在最新實證醫學上並無證據支持。預防總是勝於治療。均衡的營養、良好的衛生、勤洗手、避免公共場所暴露都可以減少得到急性細支氣管炎的機會。

劉威宏醫師 Dr. Wei-Hung Liu

語言 (Language) (ภาษา)

國語、台語、英文(English)、泰文(ไทย)

專長

慢性濕疹、蕁麻疹、酒糟、灰指甲

糖尿病、高血壓、高血脂

老化與疾病、社區傳染病防治

學歷

安徽醫科大學皮膚病研究所

長庚大學醫學系

經歷

台灣台北市立大學身心障礙者轉銜及休閒教育碩士學位學程兼任教師

上海禾新醫院國際部健檢科副主任暨代理主任
上海禾新醫院主治醫師

上海復旦大學附屬中山醫院全科住院醫師指導教師

台灣聯新國際醫院畢業後一般醫學訓練(PGY)教師

台灣聯新國際醫院實習醫學生臨床導師

台灣聯新國際醫院家庭醫學科主治醫師

台灣桃園國際機場醫療中心特約主治醫師

台灣聯新國際醫院家庭醫學科總醫師

台灣台北市立萬芳醫院內科住院醫師

台灣長庚紀念醫院神經內科住院醫師
台灣台大醫院內科部實習醫師

新加坡國家皮膚中心(NSC)進修

專業學會會員

美國家庭醫師學會(AAFP)會員

美國老年醫學會(AGS)會員

台灣老年學暨老年醫學會會員

台灣家庭醫學醫學會會員

中華民國航空醫學會會員

著作

常見良性皮膚腫瘤, 劉威宏, 家庭醫學與基層醫療 32:5, 2017, 頁136-140

台北-至祥診所、富國至祥診所(2019-2026)

上海-禾新醫院(2018-2019)