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西药综合 学习笔记 倒计时161天

  • 2026-05-23 16:10:12
西药综合 学习笔记 倒计时161天

西药综合 学习笔记 倒计时161天

第十一章 消化系统常见疾病
第二节 消化性溃疡

一、抑酸药物


类型 重要特点
抑酸药物
① 首选PPI
② H₂RA 抑酸效果逊于PPI
③ 钾离子竞争性酸阻滞剂（P-CAB）：起效更快、抑酸效果更持久、服药不受进餐影响

 

二、根除Hp的四联疗法

- 方案：PPI + 铋剂 + 2种抗生素（阿莫西林首选）
​
- 疗程：14天

 

三、黏膜保护剂

1. 米索前列醇：具有致畸性，孕妇禁用；剂量依赖性，与食物同服可减轻
​
2. 吉法酯、替普瑞酮：餐后服用
​
3. 铋剂：不良反应有口中氨味、灰黑便等，餐前1h或睡前服用
​
4. 硫糖铝：餐前1h或睡前服用

 

四、非甾体抗炎药（NSAIDs）导致溃疡的防治

1. 尽可能停用NSAIDs，或换用选择性COX-2抑制剂如塞来昔布
​
2. 积极抑酸治疗，首选PPI；疗效不佳时加用米索前列醇

 

五、抗血小板药导致溃疡的防治

- 阿司匹林所致消化道溃疡：选择阿司匹林 + PPI联合治疗
谢谢你‌

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      1. CONNECT:[ UseTime:0.000875s ] mysql:host=127.0.0.1;port=3306;dbname=no_67808;charset=utf8mb4
      2. SHOW FULL COLUMNS FROM `fenlei` [ RunTime:0.001443s ]
      3. SELECT * FROM `fenlei` WHERE `fid` = 0 [ RunTime:0.000633s ]
      4. SELECT * FROM `fenlei` WHERE `fid` = 63 [ RunTime:0.002592s ]
      5. SHOW FULL COLUMNS FROM `set` [ RunTime:0.001333s ]
      6. SELECT * FROM `set` [ RunTime:0.000522s ]
      7. SHOW FULL COLUMNS FROM `article` [ RunTime:0.001449s ]
      8. SELECT * FROM `article` WHERE `id` = 490337 LIMIT 1 [ RunTime:0.000959s ]
      9. UPDATE `article` SET `lasttime` = 1779573817 WHERE `id` = 490337 [ RunTime:0.015557s ]
      10. SELECT * FROM `fenlei` WHERE `id` = 65 LIMIT 1 [ RunTime:0.000752s ]
      11. SELECT * FROM `article` WHERE `id` < 490337 ORDER BY `id` DESC LIMIT 1 [ RunTime:0.001412s ]
      12. SELECT * FROM `article` WHERE `id` > 490337 ORDER BY `id` ASC LIMIT 1 [ RunTime:0.000901s ]
      13. SELECT * FROM `article` WHERE `id` < 490337 ORDER BY `id` DESC LIMIT 10 [ RunTime:0.001750s ]
      14. SELECT * FROM `article` WHERE `id` < 490337 ORDER BY `id` DESC LIMIT 10,10 [ RunTime:0.004002s ]
      15. SELECT * FROM `article` WHERE `id` < 490337 ORDER BY `id` DESC LIMIT 20,10 [ RunTime:0.011661s ]
      0.230791s