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Jingdong book

国家基本药物临床应用指南(化学药品和生物制品)(2012年版)

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国家基本药物临床应用指南(化学药品和生物制品)(2012年版)

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《国家基本药物临床应用指南(化学药品和生物制品)(2012年版)》详尽介绍了目前基层医疗机构和二级以上医院日常诊疗工作中的常见病和多发病,每类疾病都从概述、诊断要点、药物治疗与注意事项四部分内容作以阐述。在疾病诊断明确的前提下,讲解具有处方权的医生如何使用基本药物,规范医生的用药行为,对于临床实践具有重要的指导意义。

Catalogue

第一章 急诊及危重症
第二章 感染性疾病
第三章 呼吸系统疾病
第四章 消化系统疾病
第五章 心血管系统疾病
第六章 血液系统疾病
第七章 内分泌和代谢性疾病
第八章 神经系统疾病
第九章 精神障碍
第十章 风湿免疫性疾病
第十一章 急性中毒
第十二章 皮肤科疾病
第十三章 泌尿系统与肾脏疾病
第十四章 骨科疾病
第十五章 妇产科疾病与计划生育
第十六章 耳鼻咽喉科疾病
第十七章 眼科疾病
第十八章 口腔疾病
第十九章 肿瘤疾病
后记
Book Abstract

第三十一节 疟疾
【概述】疟疾(malaria)是由疟原虫经蚊虫传播的寄生虫病,寄生于人体的疟原虫有四种:间日疟原虫、恶性疟原虫、三日疟原虫和卵形疟原虫,我国以前两种为常见。疟疾在夏秋季发病较多,热带及亚热带地区一年四季都可以发病,并且容易流行。疟疾广泛流行于世界各地,据世界卫生组织统计,目前仍有92个国家和地区处于高度和中度流行,每年发病人数为1.5亿,死于疟疾者逾200万人。我国广西、云南、海南、广东等仍有流行,此外随着对外交流增加,我国其他地区也有输入性疟疾,需加以重视。
【诊断要点】
1.流行病学史夏秋季节,居住在疟疾流行区居民或从非流行区进人流行区居住、工作、旅行者。
2.典型临床表现以周期性畏寒、寒战、高热、大汗、热退的临床表现为特点,由于感染的疟原虫不同,发作周期有所差异,一般间Et疟每两天发作一次,三日疟每三天发作一次,恶性疟发作缺乏规律;在疟疾发作初期,周期性也不明显;患者反复发作后可出现进行性贫血,体检可以发现脾大;严重疟疾患者可以出现高热、昏迷、抽搐、腹痛、腹泻等表现。
3.实验室检查外周血白细胞正常或减少,贫血情况与发作次数与感染的原虫种类有关。
4.疟原虫检查外周厚血膜涂片检出疟原虫比例较高,发作任何时问均可检查。
【药物治疗】
1.抗疟治疗问日疟对氯喹大多敏感,由于存在迟发型子孢子,需要用伯氨喹进行抗复发治疗,因此标准治疗间日疟的方法为氯喹3日(首剂300mg后,6~8小时再次300rag口服,第2、3日各口服300mg)+伯氨喹14日(每日15rag,口服)治疗。
对抗药性低的地区,可用氯喹三天治疗恶性疟疾,无需伯氨喹;但大多数流行区恶性疟原虫对氯喹耐药明显,一般首选青蒿素类药物治疗恶性疟疾:青蒿琥酯/蒿甲醚lOOmg,每日1次,第一天口服200mg;双氢青蒿素80mg,每日1次,第1天口服160mg。
重型疟疾一般采用注射青蒿素类药物,快速杀灭原虫,缓解症状。青蒿琥酯静脉或肌内注射60mg,每日1次,首剂加倍,6小时后再注射60mg;蒿甲醚。
……

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