糖皮質(zhì)激素類藥物臨床應(yīng)用指導(dǎo)原則

1、1糖皮質(zhì)激素類藥物臨床應(yīng)用指導(dǎo)原則糖皮質(zhì)激素類藥物臨床應(yīng)用指導(dǎo)原則目錄前言........................................................................................................................................................................7第一章第一章糖皮質(zhì)激素臨床應(yīng)

2、用的基本原則糖皮質(zhì)激素臨床應(yīng)用的基本原則..........................................................................................................8一、糖皮質(zhì)激素治療性應(yīng)用的基本原則............................................................................

3、...............................8（一）嚴(yán)格掌握糖皮質(zhì)激素治療的適應(yīng)證..................................................................................................8（二）合理制訂糖皮質(zhì)激素治療方案.......................................................

4、...................................................8（三）重視疾病的綜合治療........................................................................................................................10（四）監(jiān)測糖皮質(zhì)激素的不良反應(yīng)...................

5、.........................................................................................10（五）注意停藥反應(yīng)和反跳現(xiàn)象................................................................................................................10二

6、、糖皮質(zhì)激素在兒童、妊娠、哺乳期婦女中應(yīng)用的基本原則.................................................................11（一）兒童糖皮質(zhì)激素的應(yīng)用..................................................................................................................

7、..11（二）妊娠期婦女糖皮質(zhì)激素的應(yīng)用........................................................................................................11（三）哺乳期婦女糖皮質(zhì)激素的應(yīng)用..............................................................................

8、..........................11第二章第二章糖皮質(zhì)激素臨床應(yīng)用管理糖皮質(zhì)激素臨床應(yīng)用管理....................................................................................................................1212一、管理........................................

9、.....................................................................................................................12二、落實與督查..............................................................................................

10、...................................................12第三章第三章糖皮質(zhì)激素的適用范圍和用藥注意事項糖皮質(zhì)激素的適用范圍和用藥注意事項............................................................................................1414一、適用范圍.........................

11、............................................................................................................................14二、不良反應(yīng)........................................................................................

12、.............................................................16三、注意事項.....................................................................................................................................................17

13、（一）盡量避免使用糖皮質(zhì)激素的情況....................................................................................................17（二）慎重使用糖皮質(zhì)激素的情況......................................................................................

14、......................17（三）其他注意事項....................................................................................................................................18四、分類及常用藥物（表1～４）......................................

15、............................................................................18第四章第四章糖皮質(zhì)激素在不同疾病中的治療原則糖皮質(zhì)激素在不同疾病中的治療原則................................................................................................2222一、內(nèi)分

16、泌系統(tǒng)疾病.........................................................................................................................................22（一）腎上腺皮質(zhì)功能減退癥...............................................................

17、.....................................................22（二）先天性腎上腺皮質(zhì)增生癥................................................................................................................24（三）腎上腺皮質(zhì)危象...........................

18、.....................................................................................................27（四）Graves眼病..........................................................................................................

19、.............................28（五）糖皮質(zhì)激素在內(nèi)分泌系統(tǒng)疾病診斷中的應(yīng)用................................................................................30二、呼吸系統(tǒng)疾病.............................................................................

20、................................................................31（一）哮喘（成人）....................................................................................................................................31（二）特發(fā)性間質(zhì)性肺炎

21、............................................................................................................................33（三）變態(tài)反應(yīng)性支氣管肺曲菌病...............................................................................

22、.............................36（四）結(jié)節(jié)病................................................................................................................................................37（五）慢性阻塞性肺疾病..........................

23、..................................................................................................38（六）變應(yīng)性鼻炎................................................................................................................

24、........................393九、眼科疾病.....................................................................................................................................................84（一）眼表急性炎癥和干眼........................

25、................................................................................................84急性細(xì)菌性結(jié)膜炎..................................................................................................................

26、.....................................84沙眼急性期...................................................................................................................................................................85包涵體性結(jié)膜炎急性期.

27、..............................................................................................................................................86腺病毒性結(jié)膜炎（急性期）................................................................

28、.......................................................................86流行性出血性結(jié)膜炎..........................................................................................................................................

29、.........87急性變應(yīng)性結(jié)膜炎.......................................................................................................................................................88自身免疫性結(jié)膜炎急性發(fā)作....................................

30、...................................................................................................88細(xì)菌性角膜潰瘍................................................................................................................

31、...........................................89真菌性角膜潰瘍...........................................................................................................................................................90角膜病毒感染.....

32、..........................................................................................................................................................90棘阿米巴角膜炎.........................................................

33、..................................................................................................91蠶食性角膜潰瘍.................................................................................................................

34、..........................................92干眼..............................................................................................................................................................................

35、.93（二）急性淺層鞏膜炎和鞏膜炎................................................................................................................93淺層鞏膜炎....................................................................................

36、...............................................................................93鞏膜炎........................................................................................................................................

37、...................................94（三）葡萄膜炎............................................................................................................................................95（四）視網(wǎng)膜疾病..........................

38、..............................................................................................................97白塞綜合征.......................................................................................................

39、............................................................97Vogt小柳原田病.....................................................................................................................................................

40、.....98視網(wǎng)膜血管炎...............................................................................................................................................................99（五）視神經(jīng)炎.......................................

41、...................................................................................................101（六）外傷性視神經(jīng)病變...........................................................................................................

42、...............101（七）眼科手術(shù)后......................................................................................................................................102角膜移植術(shù)后...................................................

43、..........................................................................................................102青光眼術(shù)后..........................................................................................................

44、.......................................................104白內(nèi)障術(shù)后.............................................................................................................................................................

45、....105視網(wǎng)膜扣帶術(shù)后.........................................................................................................................................................106玻璃體手術(shù)后............................................

46、.................................................................................................................106十、皮膚疾病..................................................................................................

47、.................................................107（一）天皰瘡..............................................................................................................................................107（二）大皰性類天皰瘡.......

48、.......................................................................................................................108（三）藥物性皮炎..........................................................................................

49、............................................109（四）紅皮病..............................................................................................................................................111（五）濕疹與皮炎..............

50、........................................................................................................................111（六）銀屑病...........................................................................................

51、...................................................112十一、重癥患者的加強醫(yī)療...........................................................................................................................114（一）休克.......................

52、...........................................................................................................................114感染性休克.........................................................................................

53、........................................................................114過敏性休克............................................................................................................................................

54、.....................115創(chuàng)傷性休克.................................................................................................................................................................116（二）急性肺損傷和（或）ARDS...........