璩�(g貌u)鐗╂寚鍗�
璩�(g貌u)鐗╀繚闅�
鏀粯鏂瑰紡
閰嶉€佹湇鍕�(w霉)
鍞悗鏈嶅嫏(w霉)
闂�(gu膩n)浜庢垜鍊�
涓冨崄鍛崇弽鐝犱父鐢ㄦ硶鐢ㄩ噺锛氱爺纰庡悗闁嬫按閫佹湇锛岄噸鐥呬汉涓€鏃�1鍏嬶紙1涓革級锛涗竴鑸瘡闅�3-7澶�1鍏嬶紙1涓革級锛屾敞鎰忎簨闋�(xi脿ng)锛氱鐢ㄩ櫝鑸娿€侀吀鎬ч鐗�锛屽皪(du矛)浜庣敤钘ュ姂閲忓拰鐢ㄨ棩娉ㄦ剰浜嬮爡(xi脿ng)锛屽ぇ瀹堕兘鎳�(y墨ng)瑭叉彁鍓嶄簡瑙ｆ竻妤�锛屽苟涓旂敤钘ョ殑鏅�(sh铆)鍊欒鍤�(y谩n)鏍奸伒瀹堥€欎簺灏�(du矛)鐤剧梾鐨勬不鐧傞兘寰堥噸瑕併€� 瑭虫儏
濂у崱瑗垮钩鐗囪捣濮嬪姂閲忓彲浠ョ偤涓€澶�600mg锛�8-10mg/kg/澶╋級锛屽垎鍏╂绲﹁棩锛岀従(xi脿n)鍦ㄩ€欑ó钘ュ搧閫氶亷鐩婅棩搴峰痉妯傚ぇ钘ユ埧灏卞彲浠ヨ卜鍒帮紝鍙﹀涔熸湁鍏朵粬鍑哄敭鍦伴粸(di菐n)銆� 瑭虫儏
鍒╁繀閫氫笉鑹弽鎳�(y墨ng)锛氬湪鏈棩浣滅偤鍠棩娌荤檪鐨勮│椹�(y脿n)涓�锛屼笉鑹弽鎳�(y墨ng)鐨勫牨(b脿o)灏�(d菐o)鍖呮嫭闋棝銆佺柌鍊�銆佺毊鐤�銆佹儭蹇�銆侀牠鏆堛€佸棞鐫″拰澶辩湢锛岃帛钘忥細璨棌浜�30掳C浠ヤ笅锛屼繚鎸佸共鐕�锛屾墍浠ラ€欑ó钘ョ墿浣跨敤閬庡悗涔熸槸鏈夊彲鑳芥渻(hu矛)灏�(d菐o)鑷寸梾浜哄嚭鐝�(xi脿n)涓€浜涗笉鑹弽鎳�(y墨ng)鐨勶紝澶у鐢ㄨ棩闅庢瑕佸娉ㄦ剰涓€涓�銆� 瑭虫儏
寰�(f霉)鏂硅嫰宸存瘮濡ユ捍鍖栭垑鐗囩敤娉曠敤閲忥細鍙ｆ湇锛屾垚浜轰竴娆�1-2鐗�锛屼竴鏃�3娆�锛岀蹇岋細4.瀛曞│鍙婂摵涔虫湡濠﹀コ绂佺敤锛屾偅鑰呮湅鍙嬫噳(y墨ng)瑭叉寜鐓ф纰烘柟娉曟纰虹敤閲忛€�(j矛n)琛岃棩鐗╃殑浣跨敤锛屽皪(du矛)鐢ㄨ棩绂佸繉鐢ㄨ棩娉ㄦ剰浜嬮爡(xi脿ng)閮芥噳(y墨ng)瑭插毚(y谩n)鏍奸伒瀹�锛屽垏瑷樹笉瑕佸挤(qi谩ng)琛屼娇鐢ㄨ嚜宸卞苟涓嶉仼鍚堢殑钘ュ搧銆� 瑭虫儏
闁嬫郸铇敤娉曠敤閲忥細锛�2锛夌郸钘ユ柟娉曞拰鍔戦噺锛氭垚浜猴紙>18姝诧級鍜岄潚灏戝勾锛�12-17姝诧級楂旈噸鈮�50kg璧峰娌荤檪鍔戦噺鐐烘瘡娆�500mg锛屾瘡鏃�2娆�锛岄棞(gu膩n)浜庣敤钘ユ儏娉�锛屽湪瑾�(shu艒)鏄庢浉涓婂叾瀵�(sh铆)閮芥湁鍏烽珨浠嬬垂鐨�锛屽ぇ瀹剁敤钘ヤ箣鍓嶆噳(y墨ng)瑭蹭粩绱�(x矛)鏌ョ湅涓€涓�锛屽鏋滄湁涓嶆噦鐨勫湴鏂癸紝瑕佷富鍕�(d貌ng)璜�(q菒ng)鏁欏皥妤�(y猫)浜哄＋銆� 瑭虫儏
寰楃悊澶氱洰鍓嶅湪鐩婅棩搴峰痉妯傚ぇ钘ユ埧灏辨湁璩ｇ殑锛屽ぇ瀹跺彲浠ュ幓瑭茶棩鎴胯臣(g貌u)璨疯棩鍝侊紝姝よ棩鐗╃敤浜�4姝叉垨4姝蹭互涓嬪厭绔�锛屽垵濮嬪姂閲忓湪20-60mg/澶�锛岀劧鍚庨殧鏃ュ鍔�20-60mg锛屽闀�(zh菐ng)瑕佸公鍔╁瀛愬毚(y谩n)鏍煎皣鐢ㄩ噺鎺у埗濂�锛屼笉瑕侀毃渚胯(di脿o)鏁淬€� 瑭虫儏
涓欐垔閰搁垑绶╅噵鐗囧厭绔ユ湇鐢ㄦ湰钘ュ搧鏅�(sh铆)锛屽父瑕�(gu墨)鍔戦噺鐐烘瘡鏃�30mg/kg锛岃偛榻″│濂抽櫎闈炴槑纰洪渶瑕侊紙鍗冲湪鍏朵粬娌荤檪鐒�(w煤)鏁堟垨涓嶈兘鑰愬彈鐨勬儏娉佷笅锛�锛屾湰钘ュ搧涓嶅疁鍦ㄨ偛榻″│濂充腑浣跨敤锛屾垜鍊戞噳(y墨ng)瑭插湪灏堟キ(y猫)閱�(y墨)鐢熸寚灏�(d菐o)涓嬪幓閬告搰娌荤檪鐧茬檱鐨勮棩鐗�锛屽苟涓斾篃瑕佹敞鎰忔纰虹殑鎿嶄綔鐩搁棞(gu膩n)娉ㄦ剰浜嬮爡(xi脿ng)瑕佽獚(r猫n)鐪熼伒瀹�銆� 瑭虫儏
鎷夎帿涓夊棯鐗囩敤娉曠敤閲忥細?ji菐n)鍡″构濮旂厽?2姝蹭互涓婃偅鑰呮湰钘ュ柈钘ユ不鐧傜殑鍒濆鍔戦噺鏄�25mg锛屾瘡鏃ヤ竴娆�锛岄€ｆ湇2鍛�锛涢毃鍚庣敤50mg锛屾瘡鏃�1娆�锛岄€ｆ湇鍏╁懆锛屾垜鍊戝彲浠ラ€氶亷鐩婅棩搴峰痉妯傚ぇ钘ユ埧鍘昏臣(g貌u)璨疯┎钘ュ搧锛屾垨鑰呬篃鍙互鍘诲叾浠栬棩搴�锛岄啱(y墨)闄㈠湪璨疯棩鐨勬檪(sh铆)鍊欒瑾�(r猫n)鐪熸煡鐪嬬敓鐢�(ch菐n)鏃ユ湡锛屼篃瑕佷粩绱�(x矛)鐪嬩竴涓嬬敓鐢�(ch菐n)寤犲銆� 瑭虫儏
绁炵稉(j墨ng)濡ユ▊骞筹細閫氬父鎴愪汉姣忔棩1娆￠€氶亷鐨笅銆佽倢鑲夋垨鑰呴潨鑴堝収(n猫i)娉ㄥ皠3.6鍊�(g猫)绁炵稉(j墨ng)濡ユ▊骞冲柈浣嶏紙1鏀級锛涚蹇岋細灏�(du矛)鏈姂鏈夐亷鏁忓弽鎳�(y墨ng)鏃㈠線鍙茬殑鎮ｈ€呯鐢紝鍚勪綅鐢ㄨ棩鐨勬檪(sh铆)鍊欎竴瀹氳灏囩敤娉曠敤閲忎簡瑙ｆ竻妤�锛岃鎸夎(gu墨)瀹氭搷浣�锛岃€屼笖灏�(du矛)鐢ㄨ棩绂佸繉涔熸噳(y墨ng)瑭茶獚(r猫n)鐪熼伒瀹堟敞鎰忎笉瑕佸挤(qi谩ng)琛屼娇鐢ㄨ嚜宸变笉閬╁悎鐨勮棩鍝�銆� 瑭虫儏
鐧茬檱搴疯啝鍥婃垚浠斤細澶╅夯銆佺煶鑿栬挷銆佷汉宸ョ墰榛�銆佸兊锠�銆佽喗鍗楁槦銆佷汉鍙�銆侀仩(yu菐n)蹇�銆佸叏铦�銆佺惀鐝€銆佸啺鐗囩瓑15鍛�銆備笉鑹弽鎳�(y墨ng)锛氬皻涓嶆槑纰�銆傜洝绠′笉鍚屾偅鑰呯殑娌荤檪鏂规鍙兘鏈夋墍涓嶅悓锛屼絾灏�(du矛)浜庡悓涓€鍊�(g猫)鎮ｈ€咃紝鐢变簬姣忔鐧�(f膩)浣滅殑鐧ョ媭鐩镐技锛屽洜姝ら啱(y墨)鐢熷湪閬告搰娌荤檪钘ョ墿鍜屾柟娉曟檪(sh铆)锛屽線寰€鏈�(hu矛)鍌惧悜浜庨伕鎿囬偅浜涘湪閬庡幓娌荤檪涓偅鑰呰€愬彈鎬ц壇濂界殑鏂规锛屾偅鑰呮噳(y墨ng)鍋氬ソ閱�(y墨)鐢熺殑瀹夋帓鐢ㄨ棩宸ヤ綔銆� 瑭虫儏
鐢茬：閰搁浄娌欏悏铇墖娉ㄦ剰浜嬮爡(xi脿ng)锛氶浄娌欏悏铇噳(y墨ng)閬垮厤鑸囨盁瑗挎眬鎴栨盁浼忔矙鏄庡悎鐢紙鍙冭[钘ョ墿鐩镐簰浣滅敤]锛�锛屽仠鐢ㄦ盁瑗挎眬鑸囬枊濮嬫湇鐢ㄩ浄娌欏悏铇噳(y墨ng)鑷冲皯闁撻殧5鍛�锛屽仠鐢ㄩ浄娌欏悏铇垏闁嬪姘熻タ姹€鎴栨盁浼忔矙鏄庢噳(y墨ng)鑷冲皯闁撻殧14澶�锛屽ぇ瀹跺彲浠ュ湪浣跨敤钘ョ墿鐨勬檪(sh铆)鍊欏厛鏌ョ湅涓€涓嬭(shu艒)鏄庢浉鍏�(n猫i)瀹癸紝涓嶈珫鏄敞鎰忎簨闋�(xi脿ng)閭勬槸鐢ㄨ棩绂佸繉锛岀敤钘ヤ笉鑹弽鎳�(y墨ng)閮芥噳(y墨ng)瑭蹭粩绱�(x矛)浜嗚В娓呮銆� 瑭虫儏
澶氬反绲茶偧鐗囬仼鐢ㄤ簬甯曢噾妫梾锛岀櫏鐙€鎬у笗閲戞．缍滃悎鐧ワ紙鑵︾値鍚�銆佸嫊(d貌ng)鑴堢‖鍖栨€ф垨涓瘨鎬э級锛屼絾涓嶅寘鎷棩鐗╁紩璧风殑甯曢噾妫稖鍚堢櫏?锛涢鍛风换顛峰爲璋濇樊闂鐩熷宫?锛屽彲浠ユ瘡娆℃湇鐢� 1/2 鐗囷紝涓€澶╁悆3娆�锛屽悗绾�(x霉)闇€瑕佹瘡鍛ㄧ殑鏃ユ湇閲忓鍔� 1/2 鐗囷紝鐩磋嚦閬�(d谩)鍒伴仼鍚堣┎鎮ｈ€呯殑娌荤檪閲忕偤姝�锛涘鏋滄槸缍寔娌荤檪锛岄偅涔堣棩鐗╂棩鐢ㄩ噺鑷冲皯鎳�(y墨ng)鍒嗘垚 3 娆℃湇鐢�锛屽钩鍧囩董鎸侀噺鏄瘡澶� 3 娆�锛屾瘡娆′竴鐗�銆� 瑭虫儏
鐢茬：閰搁浄娌欏悏铇墖涓嶈壇鍙嶆噳(y墨ng)锛氫笂甯傚悗锛屽湪闆锋矙鍚夎槶鑸囨姉鎶戦儊钘ョ墿/SNRI鑱�(li谩n)鍚堟噳(y墨ng)鐢ㄧ殑鎮ｈ€呬腑锛屾浘鏈夊咕渚嬭娓呯礌缍滃悎寰佺殑鍫�(b脿o)鍛�锛岃〃鐝�(xi脿n)鏈夎垐濂�銆佹剰璀�(sh铆)妯＄硦銆佸兊纭�銆佺櫦(f膩)鐔�銆佽倢鐥欐敚锛屾垜鍊戞噳(y墨ng)瑭插湪灏堟キ(y猫)浜哄＋鎸囧皫(d菐o)涓嬮€�(j矛n)琛岃棩鐗╃殑浣跨敤锛岀敤钘ラ殠娈佃鍤�(y谩n)鏍兼寜鐓ц姹傚仛濂芥敞鎰忎簨闋�(xi脿ng)锛屽鏋滄湁涓嶆噦鐨勫湴鏂硅涓诲嫊(d貌ng)鍚�?q奴)顥滻(y猫)浜哄＋鍜ㄨ銆� 瑭虫儏
鐧茬檱鐨勫垵鏈熸不鐧備互鍙婄董鎸佹不鐧傜殑瀹夋帓骞朵笉鐩稿悓锛岄€欎富瑕佸彇姹轰簬钘ョ墿鐨勪綔鐢ㄤ互鍙婃偅鑰呯殑瀵�(sh铆)闅涚梾鎯呴渶姹傘€傚埄蹇呴€氭瘡闅�1-2鍛ㄥ鍔犲姂閲�锛屾渶澶у鍔犻噺鐐�50-100 mg锛岀洿鑷抽仈(d谩)鍒版渶浣崇檪鏁堬紝閫氬父閬�(d谩)鍒版渶浣崇檪鏁堢殑缍寔鍔戦噺鐐�100-200 mg/鏃�锛屾瘡鏃ヤ竴娆℃垨鍒嗗叐娆＄郸钘ャ€� 瑭虫儏
闁嬫郸铇紙宸︿箼鎷夎タ鍧﹀彛鏈嶆憾娑诧級鍋滆棩锛氭牴鎿�(j霉)鐣�(d膩ng)鍓嶇殑鑷ㄥ簥瀵�(sh铆)韪�,濡傞渶鍋滄鏈嶇敤鏈搧,寤鸿閫愭几鍋滆棩銆�(渚嬪:鎴愪汉鍜岄珨閲�50 kg鎴栦互涓婄殑闈掑皯骞达細姣忛殧2鍒�4鍛�,姣忔娓涘皯500 mg,姣忔棩2娆★級銆傚鏋滃湪鍋滆棩閬庣▼涓嚭鐝�(xi脿n)浠讳綍涓嶉仼鎴栫暟甯告儏娉�锛屽鐧茬檱鐧�(f膩)浣滅殑寰佸厗鎴栫櫏鐙€鍔犻噸锛屾偅鑰呮噳(y墨ng)绔嬪嵆灏遍啱(y墨)骞跺憡鐭ラ啱(y墨)鐢熸鍦ㄩ€�(j矛n)琛岀殑鍋滆棩瑷�(j矛)鍔�銆� 瑭虫儏
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瀹夊叏鏀惧績 闅辩閰嶉€�
