糖皮质激素在炎症性肠病围手术期的应用
来源:岁月联盟
时间:2017-02-28
6 结论
糖皮质激素是炎症性肠病患者内科治疗的经典药物之一。在IBD围手术期合理使用糖皮质激素可以调节内源糖皮质激素的分泌不足以及糖皮质受体的暂时性功能低下,有效保护肾上腺功能,防止肾上腺危象的发生,并且可以减少术后并发症以及减轻全身炎症反应。但是由于激素负面作用太多,如何在保证治疗的情况下,把激素用量减少至最小、最低剂量,是我们努力的方向。
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