[{"data":1,"prerenderedAt":63},["ShallowReactive",2],{"q-nurse-111-1-medical-surgical-036":3},{"subject":4,"subjectSlug":5,"subjectFullName":4,"question":6,"related":32,"lastmod":62},"內外科護理學","medical-surgical",{"id":7,"webId":8,"year":9,"session":10,"subject":4,"number":11,"stem":12,"options":13,"answer":18,"answerNote":19,"images":20,"explanation":21,"explanationDeep":22,"topics":23,"freq":10},"nurse-111-1-內外科護理學-036","nurse-111-1-medical-surgical-036",111,1,36,"林先生接受骨髓移植後 2 週出現黃疸、腹水、體重增加，下列何者為最可能發生之合併症？",{"A":14,"B":15,"C":16,"D":17},"感染","間質性肺炎","肝靜脈阻塞疾病","慢性移植物對抗宿主疾病","C",null,[],"本題考點為骨髓移植後短期內出現黃疸、腹水、體重增加三聯徵的合併症判讀。此臨床表現符合肝靜脈阻塞疾病（veno-occlusive disease, VOD／又稱 SOS），成因是高劑量化療放療損傷肝小靜脈內皮，造成肝竇阻塞、門脈高壓，典型於移植後數週內出現體重上升、疼痛性肝腫大、腹水與黃疸，故選 C。感染（A）以發燒為主、間質性肺炎（B）表現呼吸症狀、慢性移植物對抗宿主疾病（D）多在移植 100 天後且以皮膚黏膜為主，皆與此三聯徵不符。","VOD 的診斷常用 Baltimore 或 modified Seattle criteria：移植後早期出現高膽紅素、體重增加或腹水、肝腫大或右上腹痛。機轉為前處置藥物（如 busulfan、cyclophosphamide）造成肝竇內皮傷害與微血栓，導致肝內血流阻塞。與 GVHD 區分要訣：VOD＝早期＋體液滯留三聯徵；急性 GVHD＝皮膚紅疹、腹瀉、膽汁鬱積型黃疸。掌握「移植 2 週＋體重腹水黃疸」即可鎖定 VOD。",[24,26,28,30],{"term":25,"count":10},"骨髓移植合併症",{"term":27,"count":10},"肝靜脈阻塞疾病 VOD",{"term":29,"count":10},"肝竇內皮損傷",{"term":31,"count":10},"腹水與黃疸三聯徵",[33,37,42,47,52,58],{"webId":34,"stem":35,"number":36,"year":9,"session":10},"nurse-111-1-medical-surgical-037","有關白血病病人接受異體骨髓移植後出現合併症之敘述，下列何者錯誤？",37,{"webId":38,"stem":39,"number":40,"year":9,"session":41},"nurse-111-2-medical-surgical-053","有關肺水腫（pulmonary edema）的敘述，下列何者正確？",53,2,{"webId":43,"stem":44,"number":45,"year":46,"session":10},"nurse-112-1-medical-surgical-067","有關造成糖尿病病人血糖過低之促因，下列何者正確？",67,112,{"webId":48,"stem":49,"number":50,"year":51,"session":41},"nurse-113-2-medical-surgical-005","20 歲男性，清晨騎乘重機外出不小心與大卡車擦撞滑倒顳側先著地，送醫時 GCS E4V5M6，為安全起見留院觀察，2 小時後病人突然喪失意識，診斷為硬膜上出血，下列敘述何者錯誤？",5,113,{"webId":53,"stem":54,"number":55,"year":56,"session":57},"nurse-114-3-medical-surgical-009","有關肝癌，下列敘述何者最不適當？",9,114,3,{"webId":59,"stem":60,"number":40,"year":61,"session":10},"nurse-106-1-medical-surgical-053","下列何者是肺氣腫造成氧氣供應減少的主要原因？",106,"2026-09-04",1788510734555]