优思弗药品信息

优思弗药品信息 一、优思弗—— 一、 消化内科:【胆汁淤积性肝病】 1、PBC(原发性胆汁性肝硬化)和PSC(原发性硬化性胆管炎):患者需要终身服药; 优思弗是唯一可以阻断或延缓疾病发展过程的有效药物;注意:碱性磷酸酶的检测，以便于早期发现和诊断病人。 需足量服用，说明书剂量为 13-15mg/kg/d，如果病情较重或生化指 标下降不理想者，可以最大剂量服用到 20-30mg/kg/d。(大剂量文献见附件文件夹) 注意:碱性磷酸酶的检测，以便于早期发现和诊断病人。 2、广义的胆汁淤积性肝:病毒性肝炎伴肝内胆汁淤积，药物性肝病引起的肝内胆 汁淤积，脂肪肝等。 1、病毒性肝炎:12-15 mg/kg/d，4-5 天有效退黄。 2、非酒精性脂肪肝:一般认为脂肪肝不需要进行药物治疗，但是以下三种情况是需要治疗的:a.重度脂肪肝，出现乏力、黄疸等有明显临 床症状的; b.虽无症状但有明显肝损伤，现为转氨酶升高者，可以提醒医生对有经济条件 的试用;c.碱性磷酸酶升高，提示有胆管损伤的，需要治疗。 3、胆汁反流性胃炎:有临床表现的，建议先药物治疗，可以避免疏水性胆汁酸对胃黏膜的损伤。 4、自身免疫性肝炎、重叠综合症 5、干部病房:脂肪肝，胆汁反流性胃炎。同时该科室可以作为一method of basic operation; including CT, and MRI various contrast, and Image-guided biopsy, ultrasound, etc. (11) teaching, scientific research and training in clinical teaching, written within three years with some level of review or book reports of not less than 1. Four, to read reference books, Journal of internal medicine (medical college planning materials) and of the medical imaging (medical college planning materials); the practical science; the Harrison Science (in English), Chinese Journal of internal medicine series. Surgical surgical specialist refers to the rules complete the medical undergraduate or graduate education Foundation, accepted and adopted surgical specialist training, surgical diagnosis, treatment, prevention and follow-up of common diseases, surgical diagnosis and treatment of rare or incurable diseases, acute and critical illness in emergency and rescue have preliminary knowledge and experience. Surgical specialist training for 3 years. A surgical specialist, training goals through training, trainees to achieve surgical specialist level, with more skilled surgical skills, can guide the teaching of 个开发上的捷径，作为 老干部用药常备目录中药物。 一、优思弗—— 二、肝胆外科: 1、溶石——胆固醇性结石:常规的有临床症状的胆固醇性结石 可用。 10-15 mg/kg/d，晚上一次顿服，需 6-24 月。 2、肝胆术后预防逆行性感染: 胆管开口在肠道，肠道内有丰富的细菌菌落，容易向上侵袭造成逆行性感染，术后并发率高，容易引发“医患矛盾”，服用优思弗可以增加胆汁酸的分泌，促进胆汁的流动，起到 “流水不腐，户枢不蠹”的作用。(有文献支持，见附件《熊去氧胆酸对胆肠吻合术后胆道 逆行性感染的预防作用》。孙备，哈尔滨医科大学) 3、胆囊息肉: 治疗原则为:轻度只需要用药治疗即可，重度则需手术。 需要注意的是:胆囊息肉较小，在B超检查中无法分辨是属于哪种类型，这是最令医生 和病人感到遗憾的地方。医生只能根据息肉的形态和发展情况判其是否恶变。而胆囊息肉有 可能引起胆囊癌，若不需要立即做手术则可以服用优思弗观察3个月。如如息肉缩小，则证 明是良性结石，继续用药可以消除;如息肉大小无裱花，则证明有癌变的可能，需尽快手 术。 method of basic operation; including CT, and MRI various contrast, and Image-guided biopsy, ultrasound, etc. (11) teaching, scientific research and training in clinical teaching, written within three years with some level of review or book reports of not less than 1. Four, to read reference books, Journal of internal medicine (medical college planning materials) and of the medical imaging (medical college planning materials); the practical science; the Harrison Science (in English), Chinese Journal of internal medicine series. Surgical surgical specialist refers to the rules complete the medical undergraduate or graduate education Foundation, accepted and adopted surgical specialist training, surgical diagnosis, treatment, prevention and follow-up of common diseases, surgical diagnosis and treatment of rare or incurable diseases, acute and critical illness in emergency and rescue have preliminary knowledge and experience. Surgical specialist training for 3 years. A surgical specialist, training goals through training, trainees to achieve surgical specialist level, with more skilled surgical skills, can guide the teaching of 浙江大学医学院附属第二医院普外科主任曹利平教授，正在进行优思弗治疗胆囊息肉的研究。 4、ERCP(“胆管支架放置术)术后使用: ?溶解\冲刷泥沙样结石 ?预防ERCP术后并发症(如胆源性胰腺炎、逆行性胆道系统感染、胆管细胞损伤等) ? 预防结石复发(市场切入点可先选择结石复发过的患者) ?ERCP术后延长支架通畅时间。(有文献支持:《熊去氧胆酸预防ERCP术后反流性胆管炎临床研究》、《熊去氧胆酸预防胆管结石内镜逆行胰胆管造影术后复发的临床研究》) 注:结石术后二次复发的复发率为30%术后服药预防复发，可避免医患矛盾。推荐疗程12个月。(有关复发率的文献支持《保胆取石术后结石复发相关因素及长期随访分析》， 陈理国，解放军254医院。) method of basic operation; including CT, and MRI various contrast, and Image-guided biopsy, ultrasound, etc. (11) teaching, scientific research and training in clinical teaching, written within three years with some level of review or book reports of not less than 1. Four, to read reference books, Journal of internal medicine (medical college planning materials) and of the medical imaging (medical college planning materials); the practical science; the Harrison Science (in English), Chinese Journal of internal medicine series. Surgical surgical specialist refers to the rules complete the medical undergraduate or graduate education Foundation, accepted and adopted surgical specialist training, surgical diagnosis, treatment, prevention and follow-up of common diseases, surgical diagnosis and treatment of rare or incurable diseases, acute and critical illness in emergency and rescue have preliminary knowledge and experience. Surgical specialist training for 3 years. A surgical specialist, training goals through training, trainees to achieve surgical specialist level, with more skilled surgical skills, can guide the teaching of 按科室推广的适应症 消化科:PBC，PSC，结石，胆囊息肉，ERCP，脂肪肝，胆汁反流性胃炎，药物性肝病。 PBC与UC伴发的概率约为60%-70%，如果UC 患者ALP升高提示可能为PBC. 传染科:PBC，脂肪肝，重症肝炎，病毒性肝炎，药物性肝病。 风湿免疫科:PBC患者伴发干燥综合症科大60%-70%，有干燥综合征的患者可以提醒医生注意碱性磷酸酶的检测， 如升高则提示是否考虑为PBC 。(文献支持《优思弗-原发性 胆汁性肝硬化与干燥综合征四例分析》) 血液科、肿瘤科、风湿免疫科、中医科:药物性肝病(文献支持《熊去氧胆酸治疗药物性肝损伤开放对照临床试验》) 普外科、肝胆外科:结石药物治疗，肝胆术后，ERCP。 干部病房:脂肪肝，胆汁反流性胃炎。同时该科室可以作为一个开发上的捷径，作为 老干部用药常备目录中药物。method of basic operation; including CT, and MRI various contrast, and Image-guided biopsy, ultrasound, etc. (11) teaching, scientific research and training in clinical teaching, written within three years with some level of review or book reports of not less than 1. Four, to read reference books, Journal of internal medicine (medical college planning materials) and of the medical imaging (medical college planning materials); the practical science; the Harrison Science (in English), Chinese Journal of internal medicine series. Surgical surgical specialist refers to the rules complete the medical undergraduate or graduate education Foundation, accepted and adopted surgical specialist training, surgical diagnosis, treatment, prevention and follow-up of common diseases, surgical diagnosis and treatment of rare or incurable diseases, acute and critical illness in emergency and rescue have preliminary knowledge and experience. Surgical specialist training for 3 years. A surgical specialist, training goals through training, trainees to achieve surgical specialist level, with more skilled surgical skills, can guide the teaching of method of basic operation; including CT, and MRI various contrast, and Image-guided biopsy, ultrasound, etc. (11) teaching, scientific research and training in clinical teaching, written within three years with some level of review or book reports of not less than 1. Four, to read reference books, Journal of internal medicine (medical college planning materials) and of the medical imaging (medical college planning materials); the practical science; the Harrison Science (in English), Chinese Journal of internal medicine series. Surgical surgical specialist refers to the rules complete the medical undergraduate or graduate education Foundation, accepted and adopted surgical specialist training, surgical diagnosis, treatment, prevention and follow-up of common diseases, surgical diagnosis and treatment of rare or incurable diseases, acute and critical illness in emergency and rescue have preliminary knowledge and experience. Surgical specialist training for 3 years. A surgical specialist, training goals through training, trainees to achieve surgical specialist level, with more skilled surgical skills, can guide the teaching of