查詢結果分析
來源資料
相關文獻
- An Evidence-based Review on the Use of Corticosteroids in Peri-operative and Critical Care
- 皮質類固醇在外科手術前後及重症醫學上的實証應用
- 加護病房重症照護的臨床藥事服務
- Organ System Failures Predict Prognosis in Critically Ill Patients with Acute Renal Failure Requiring Dialysis
- 呼吸照護專業在美國
- 臺灣麻醉醫師與重症照護
- Percutaneous Dilatational Tracheostomy Versus Open Tracheostomy--A Prospective, Randomized, Controlled Trial
- Benefits of Personal Digital Assistance in Decreasing Prescribing Errors: Preliminary Experience from a Tertiary Care Hospital
- 心臟手術後病童之立即加強照護
- 提升神經外科重症病人營養評估完整率之改善專案
頁籤選單縮合
題 名 | An Evidence-based Review on the Use of Corticosteroids in Peri-operative and Critical Care=皮質類固醇在外科手術前後及重症醫學上的實證應用 |
---|---|
作 者 | 韓吟宜; 孫維仁; | 書刊名 | 麻醉學雜誌 |
卷 期 | 40:2 2002.06[民91.06] |
頁 次 | 頁71-79 |
分類號 | 416.5 |
關鍵詞 | 腎臟皮質激素; 手術前後照護; 重症照護; Adrenal cortex hormones; Perioperative care; Critical care; |
語 文 | 英文(English) |
中文摘要 | 皮質類固醇的藥理作用複雜且廣泛,在臨床上的使用情形很多。我們針對麻醉科醫師在外科手術前後及重症醫學領域上,可能會遇到的皮質類固醇適應症作一完整的文獻回顧,並依所收集到的證據支持度,將其適應症整理如下列建議。有強烈證據支持的絕對適應症包括:腎上腺功能不足、哮喘、過敏反應、急性脊髓受傷、腦瘤併腦壓升高。一般來說效果不錯,而建議使用的情況包括:手術後止吐、某些特定的呼吸衰竭 (如急性呼吸窘迫症候群、脂肪栓塞、慢性阻塞性肺病 )、腦膿瘍併腦壓升高、甲狀腺風暴和難控制的低體溫症。 大劑量的皮質類固醇,在敗血性休克的治療上可能有助益,但仍需進一步的驗證。而在心臟停止、腦部外傷和梗塞所伴隨的腦壓升高、拔除氣管內管後的呼吸道水腫及吸入性肺炎,則不建議給予,因為效果不彰,甚至會進一步惡化病情。使用皮質類固醇的絕對禁忌有:全身性的黴菌感染、病患對皮質類固醇過敏、原因不明的血小板缺乏性紫斑症患者施行肌肉注射給藥,以及近期接受活病毒疫苗的患者。 |
英文摘要 | With complex and extensive pharmacological effects, corticosteroids are widely used in many clinical situations. A survey conducted to define the role of corticosteroids in various settings of peri-operative and critical care gave strong evidence to support that the use of corticosteroid is absolutely indicated in patients with adrenal insufficiency, asthma, anaphylaxis, acute spinal cord injury, and increased ICP resulting from brain tumors. As the benefits of corticosteroids are much in evidence, their uses are recommended to extend to postoperative antiemesis, acute respiratory failure (sunch as ARDS, COPD, and fat embolism), increased ICP associated with brain abscess, thyroid storm, and refractory hypothermia. Beneficial effect could be expected in septic shock with high-dose corticosteroids. Despite extensive reports on their versatile usefulness, evidence-based review did not recommend the use of corticosteroids in increased ICP associated with traumatic head injury and cerebral infarct, cardiac arrest, post-extubation airway edema, and aspiration pneumonia due to poor effectiveness let alone further worsening of the conditions. Great caution must be taken in clinical situatios where administration of corticosteroids is considered contraindicated such as systemic fungal infection, hypersensitivity to the durg, intramuscular injection in idiopathic thrombocytopenia purpura, vaccination with live virus. |
本系統中英文摘要資訊取自各篇刊載內容。