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胃黏膜保护剂的临床应用,牢记这三张图!

2022-07-01 纷飞之翼之住院医师学习笔记 纷飞之翼之住院医师学习笔记

胃粘膜保护剂的临床应用,一文搞定!

胃粘膜损伤见于多种情况,当损伤因子和防御因子失衡时,就可出现。临床治疗除了祛除病因,选择适当的胃粘膜保护剂对症治疗也很重要。今天就和大家分享一下胃黏膜保护剂及其临床应用特点。

1、铋剂

图片

2、常用胃黏膜保护剂

图片

3、其他胃黏膜保护剂

图片

4、胃粘膜保护剂的临床应用

胃粘膜保护剂品种繁多,临床应用过程中,需结合患者特点进行考虑,具体如下:

(1)明确Hp感染者,选用铋剂较为合适,因为其兼具抑制或者杀灭Hp作用。

(2)由胃酸过多引起的胃粘膜损伤,优先使用有抗酸作用或抑制胃蛋白酶活性的药物,比如铝碳酸镁、硫糖铝等,可以发挥抑酸、胃粘膜保护双重药效。

(3)老年人慢性胃炎宜选择如替普瑞酮、铝碳酸镁、瑞巴派特等具有增加黏液分泌、调节黏膜下血流及促进黏膜上皮修复等多重作用的黏膜保护剂。

(4)便秘的患者,不宜使用铝剂、铋剂,因可引起黑便,加重便秘情况;肾功能不全的患者,不宜使用含铝或铋的黏膜保护剂,因肾功能不全,可能会引起体内药物蓄积。

(5)对于酒精或药物引起的胃粘膜损伤,可选择有内源性前列腺素刺激分泌作用药物,如替普瑞酮、瑞巴派特等。

(6)胆汁反流所致的胃黏膜损伤,可选择有吸附胆盐、胆汁酸作用的黏膜保护剂,如铝碳酸镁、硫糖铝和秘剂等。

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1835929, encodeId=3d5f1835929d5, content=<a href='/topic/show?id=cfdc22e893f' target=_blank style='color:#2F92EE;'>#临床应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22789, encryptionId=cfdc22e893f, topicName=临床应用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Fri Oct 14 07:19:06 CST 2022, time=2022-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1931854, encodeId=b69f1931854cb, content=<a href='/topic/show?id=250183421dc' target=_blank style='color:#2F92EE;'>#胃黏膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83421, encryptionId=250183421dc, topicName=胃黏膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=743d308, createdName=baoya, createdTime=Wed Dec 28 17:19:06 CST 2022, time=2022-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1230307, encodeId=ca02123030ec2, content=铋制剂能和其他胃黏膜保护剂联用吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b6c1974111, createdName=huaguang, createdTime=Sun Jul 03 16:42:15 CST 2022, time=2022-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1230306, encodeId=e526123030685, content=思维导图做的挺好,方便记忆, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b6c1974111, createdName=huaguang, createdTime=Sun Jul 03 16:39:37 CST 2022, time=2022-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520108, encodeId=457f152010808, content=<a href='/topic/show?id=6ab11032506f' target=_blank style='color:#2F92EE;'>#黏膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103250, encryptionId=6ab11032506f, topicName=黏膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=057f11309297, createdName=snowpeakxu, createdTime=Sun Jul 03 09:19:06 CST 2022, time=2022-07-03, status=1, ipAttribution=)]
    2022-12-28 baoya
  3. [GetPortalCommentsPageByObjectIdResponse(id=1835929, encodeId=3d5f1835929d5, content=<a href='/topic/show?id=cfdc22e893f' target=_blank style='color:#2F92EE;'>#临床应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22789, encryptionId=cfdc22e893f, topicName=临床应用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Fri Oct 14 07:19:06 CST 2022, time=2022-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1931854, encodeId=b69f1931854cb, content=<a href='/topic/show?id=250183421dc' target=_blank style='color:#2F92EE;'>#胃黏膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83421, encryptionId=250183421dc, topicName=胃黏膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=743d308, createdName=baoya, createdTime=Wed Dec 28 17:19:06 CST 2022, time=2022-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1230307, encodeId=ca02123030ec2, content=铋制剂能和其他胃黏膜保护剂联用吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b6c1974111, createdName=huaguang, createdTime=Sun Jul 03 16:42:15 CST 2022, time=2022-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1230306, encodeId=e526123030685, content=思维导图做的挺好,方便记忆, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b6c1974111, createdName=huaguang, createdTime=Sun Jul 03 16:39:37 CST 2022, time=2022-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520108, encodeId=457f152010808, content=<a href='/topic/show?id=6ab11032506f' target=_blank style='color:#2F92EE;'>#黏膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103250, encryptionId=6ab11032506f, topicName=黏膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=057f11309297, createdName=snowpeakxu, createdTime=Sun Jul 03 09:19:06 CST 2022, time=2022-07-03, status=1, ipAttribution=)]
    2022-07-03 huaguang

    铋制剂能和其他胃黏膜保护剂联用吗?

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1835929, encodeId=3d5f1835929d5, content=<a href='/topic/show?id=cfdc22e893f' target=_blank style='color:#2F92EE;'>#临床应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22789, encryptionId=cfdc22e893f, topicName=临床应用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Fri Oct 14 07:19:06 CST 2022, time=2022-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1931854, encodeId=b69f1931854cb, content=<a href='/topic/show?id=250183421dc' target=_blank style='color:#2F92EE;'>#胃黏膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83421, encryptionId=250183421dc, topicName=胃黏膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=743d308, createdName=baoya, createdTime=Wed Dec 28 17:19:06 CST 2022, time=2022-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1230307, encodeId=ca02123030ec2, content=铋制剂能和其他胃黏膜保护剂联用吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b6c1974111, createdName=huaguang, createdTime=Sun Jul 03 16:42:15 CST 2022, time=2022-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1230306, encodeId=e526123030685, content=思维导图做的挺好,方便记忆, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b6c1974111, createdName=huaguang, createdTime=Sun Jul 03 16:39:37 CST 2022, time=2022-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520108, encodeId=457f152010808, content=<a href='/topic/show?id=6ab11032506f' target=_blank style='color:#2F92EE;'>#黏膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103250, encryptionId=6ab11032506f, topicName=黏膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=057f11309297, createdName=snowpeakxu, createdTime=Sun Jul 03 09:19:06 CST 2022, time=2022-07-03, status=1, ipAttribution=)]
    2022-07-03 huaguang

    思维导图做的挺好,方便记忆

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1835929, encodeId=3d5f1835929d5, content=<a href='/topic/show?id=cfdc22e893f' target=_blank style='color:#2F92EE;'>#临床应用#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22789, encryptionId=cfdc22e893f, topicName=临床应用)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=fc8528, createdName=clmlylxy, createdTime=Fri Oct 14 07:19:06 CST 2022, time=2022-10-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1931854, encodeId=b69f1931854cb, content=<a href='/topic/show?id=250183421dc' target=_blank style='color:#2F92EE;'>#胃黏膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=83421, encryptionId=250183421dc, topicName=胃黏膜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=743d308, createdName=baoya, createdTime=Wed Dec 28 17:19:06 CST 2022, time=2022-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1230307, encodeId=ca02123030ec2, content=铋制剂能和其他胃黏膜保护剂联用吗?, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b6c1974111, createdName=huaguang, createdTime=Sun Jul 03 16:42:15 CST 2022, time=2022-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1230306, encodeId=e526123030685, content=思维导图做的挺好,方便记忆, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1b6c1974111, createdName=huaguang, createdTime=Sun Jul 03 16:39:37 CST 2022, time=2022-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1520108, encodeId=457f152010808, content=<a href='/topic/show?id=6ab11032506f' target=_blank style='color:#2F92EE;'>#黏膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103250, encryptionId=6ab11032506f, topicName=黏膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=057f11309297, createdName=snowpeakxu, createdTime=Sun Jul 03 09:19:06 CST 2022, time=2022-07-03, status=1, ipAttribution=)]
    2022-07-03 snowpeakxu
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