[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$fUH4vrtysoRMzWRSPEG8rA-p9Sm6rGEw0EfIba_bItJE":8,"$fUm4pkAm405rrH22iK-8zB-u2xKQaGY7BBRSiv6MG0ms":55,"$fBRlpitNEQhWmRinG2jOq9odqIny88WLhd-Zpi1ScpbI":59},{"code":4,"msg":5,"message":6,"data":6,"success":7},401,"认证失败，无法访问系统资源",null,false,{"code":9,"msg":10,"message":6,"data":11,"success":54},200,"操作成功",{"id":12,"specialistId":13,"specialistAssistants":14,"profilePhoto":15,"specialistName":16,"hospital":17,"department":18,"postsTitle":19,"materialTotal":20,"videoTotal":21,"isConcern":7,"title":22,"coverVertical":23,"coverAcross":24,"content":25,"description":26,"views":27,"likes":21,"isThumbsUp":7,"isCollection":7,"collections":21,"createTime":28,"seoTitle":22,"seoKeywords":29,"seoDescription":30,"shelvesTime":31,"version":32,"menus":33,"menuId":35,"type":42,"quality":53,"commentCount":21,"isComment":42},48562,868534,[],"https://cdn.haohuanjiao.com/learnMaterial/ystApp//fHxuhTbfUiFLhx0WHVWkQ60l8omXtfSX.png","李玉琼","平山县人民医院","肿瘤科","副主任医师",11,0,"肝癌IV期患者的糖尿病管理：缓解恶心与不良反应的实用用药指南","","https://ystcdn.venuertc.com/venue/AI/99d289b2-773d-43e6-ab06-0e1d3ffc59e5.jpg","\u003Cdiv id=\"material_title\" class=\"mat-special-title\">\n  肝癌IV期患者的糖尿病管理：缓解恶心与不良反应的实用用药指南\n\u003C/div>\n\n\u003Cdiv class=\"mat-section\">\n  \u003Cdiv class=\"mat-subtitle mat-bg1\">\n    \u003Cspan>🟦 01. 糖尿病用药基础：肝癌IV期常用药物类型与特点\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"mat-content\">\n    在肝癌IV期合并糖尿病的用药管理中，选择合适的降糖药尤为重要。目前常用的降糖药主要包括口服药物（如二甲双胍、格列美脲、阿卡波糖等）和胰岛素注射剂型。每种药物的结构和代谢途径不同，肝功能异常或损伤会影响药物在体内的加工方式。例如，二甲双胍为双胍类口服降糖药，不经肝脏代谢，主要通过肾脏排泄，理论上对肝功能影响较小，而磺脲类则需部分经肝脏代谢，须特别注意安全性。\u003Cbr>\u003Cbr>\n    不同剂型（片剂、缓释片、注射型）对于服药便利性、起效速度和副作用也有明显区别。举例来说，缓释片可减少血糖波动，胰岛素注射更便于快速、灵活调整降糖力度。正确识别每种药品的成分和剂型，是后续安全用药的基础。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"mat-section\">\n  \u003Cdiv class=\"mat-subtitle mat-bg2\">\n    \u003Cspan>🟩 02. 用法用量：正确服药，关键细节不容忽视\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"mat-content\">\n    使用口服降糖药时，需注意药片规格及个体化剂量调整。例如，二甲双胍常见规格有500 mg、850 mg等，起始用量较低，逐步调整以减少胃肠道不适。推荐餐中或餐后服用以减少胃部反应。而格列美脲应空腹或早餐前服用，避免夜间低血糖。\u003Cbr>\u003Cbr>\n    胰岛素制剂按起效时间可分为速效、中效和长效，胰岛素注射需选定腹部、上臂或大腿等部位轮换注射，防止皮肤出现硬结。\u003Cbr>\u003Cbr>\n    \u003Cstrong>正确做法：\u003C/strong>\u003Cbr>\n    — 固定时间、固定剂量服药，避免漏服、超剂量。\u003Cbr>\n    — 服药时用200 ml左右的温水送服，不宜咀嚼控释剂型药片。\u003Cbr>\n    — 胰岛素注射前检查药液澄清度，避免剧烈摇晃。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"mat-section\">\n  \u003Cdiv class=\"mat-subtitle mat-bg3\">\n    \u003Cspan>🟨 03. 不良反应识别：常见问题与处理技巧\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"mat-content\">\n    在降糖药与支持药物同时使用时，恶心及消化道不适较为常见。降糖药中，二甲双胍最多见的副作用是腹泻和恶心。数据显示，该不良反应发生率可达5%-20%（McCreight LJ, et al., 2016）。如出现明显不适，可考虑餐后服用或更换为缓释剂型。\u003Cbr>\u003Cbr>\n    格列美脲和其他磺脲类有低血糖风险，表现为出汗、心慌、头晕等。胰岛素注射副作用则集中于低血糖和注射部位局部反应。\u003Cbr>\u003Cbr>\n    \u003Cstrong>正确做法：\u003C/strong>\u003Cbr>\n    — 服药过程中出现恶心、呕吐等症状时，须主动报告给医生。\u003Cbr>\n    — 若出现低血糖，可含服方糖200 mg或进食含糖食物及时缓解。\u003Cbr>\n    — 若呕吐严重时，可暂停药物并及时就医，不宜自行加减药。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"mat-section\">\n  \u003Cdiv class=\"mat-subtitle mat-bg4\">\n    \u003Cspan>🟧 04. 特殊用药人群：老年、肝肾功能异常与注意事项\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"mat-content\">\n    老年、肝功能损害或肾功能下降的患者，用药更要谨慎。二甲双胍虽较为安全，但肾功能受损或严重肝病者禁用。格列美脲等磺脲类药物则存在加重低血糖的风险。此外，GLP-1 受体激动剂近期应用较多，虽对肝脏友好，但可能引起胃肠道反应。\u003Cbr>\u003Cbr>\n    \u003Cstrong>使用技巧：\u003C/strong>\u003Cbr>\n    — 老年患者需低剂量起步，逐步递增，避免低血糖。\u003Cbr>\n    — 严重肾功能不佳时，需定期复查肾功能指标。\u003Cbr>\n    — 肝功能明显异常时，建议咨询药师或医生调整降糖方案。\u003Cbr>\u003Cbr>\n    \u003Cspan class=\"mat-highlight\">特别提醒：胰岛素调整需根据血糖监测结果，在专业人员指导下进行，避免擅自更改。\u003C/span>\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"mat-section\">\n  \u003Cdiv class=\"mat-subtitle mat-bg5\">\n    \u003Cspan>🟫 05. 药物相互作用与配伍禁忌\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"mat-content\">\n    降糖药与其他药品可能产生多种相互作用。二甲双胍与碘造影剂合用可增加乳酸中毒风险，需在检查前停用。格列美脲如与非甾体类抗炎药、部分抗生素合用，会增强降糖作用，易出现低血糖。滴眼药、部分降压药、激素类等也可能影响血糖水平。\u003Cbr>\u003Cbr>\n    \u003Cstrong>正确做法：\u003C/strong>\u003Cbr>\n    — 用药期间如需合并用药，应主动告知医生所有正在服用的药品。\u003Cbr>\n    — 调整药物组合时须间隔2小时以上，尽量错开服用时段。\u003Cbr>\n    — 新增药物时密切关注血糖变化及不良反应。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"mat-section\">\n  \u003Cdiv class=\"mat-subtitle mat-bg6\">\n    \u003Cspan>🟥 06. 储存条件与药品安全管理\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"mat-content\">\n    正确存放药品是维护药效的重要环节。口服降糖药需密封置于干燥、避光、室温（15-25℃）环境，不可放在潮湿浴室或阳光直射处。胰岛素开启后建议放入2-8℃冰箱冷藏，避免冷冻。不得与其他药品混放。\u003Cbr>\u003Cbr>\n    \u003Cstrong>操作要点：\u003C/strong>\u003Cbr>\n    — 未开启胰岛素可常温存放，开启后4周内用完。\u003Cbr>\n    — 定期检查药品保质期，过期药品需及时废弃。\u003Cbr>\n    — 固体药物如发现变色、潮解、异味，应立即停止使用。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"mat-section\">\n  \u003Cdiv class=\"mat-subtitle mat-bg7\">\n    \u003Cspan>🟨 07. 漏服与超剂量的处理方法\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"mat-content\">\n    药品偶发漏服是常事，但错误处理会影响血糖稳定。一般而言，若发现漏服，应在半小时内补服，若接近下次服药时间，则跳过本次，不可双倍剂量补服。超量服用可能造成低血糖、乳酸中毒等风险。\n    \u003Cbr>\u003Cbr>\n    \u003Cstrong>正确做法：\u003C/strong>\u003Cbr>\n    — 血糖下降明显时，应立即进食含糖食物。\u003Cbr>\n    — 超剂量服药后应及时联系医生，根据情况调整处理方案。\u003Cbr>\n    — 常备血糖仪和快速升糖食品，便于应急。\u003Cbr>\n    \u003Cspan class=\"mat-highlight\">如24小时内出现剧烈恶心、乏力或神智异常，应立即前往医院处理。\u003C/span>\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"mat-section\">\n  \u003Cdiv class=\"mat-subtitle mat-bg8\">\n    \u003Cspan>🟩 08. 实际用药案例与实用经验\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"mat-content\">\n    \u003Cul class=\"mat-uli\">\n      \u003Cli>有位患者服用二甲双胍出现胃部不适，调整为餐中服用后恶心感明显减轻。\u003C/li>\n      \u003Cli>临床上见胰岛素及时轮换注射部位，有效避免了皮肤硬结的发生。\u003C/li>\n      \u003Cli>一位老年患者使用格列美脲时逐渐加量，有效降低低血糖风险。\u003C/li>\n    \u003C/ul>\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"mat-section mat-summary\">\n  \u003Cdiv class=\"mat-subtitle mat-bg9\">\n    \u003Cspan>🟦 09. 总结与关键提示\u003C/span>\n  \u003C/div>\n  \u003Cdiv class=\"mat-content\">\n    总体来说，糖尿病药物在肝癌IV期患者的管理中，要关注剂型选择、服药细节、恶心等副作用、有无器官损害、不良反应的及时处理。最关键的是：\u003Cbr>\n    \u003Cstrong>1. 规范用药流程、及时监测血糖。\u003C/strong>\u003Cbr>\n    \u003Cstrong>2. 发现恶心或不可耐受情况时，不要擅自调整用药，应第一时间联系专科医生。\u003C/strong>\u003Cbr>\n    合理选药、了解禁忌和配伍、保持良好储存习惯与应急能力，能有效提升用药安全和生活质量。如有疑惑，可以随时求助专业药师。\n  \u003C/div>\n\u003C/div>\n\n\u003Cdiv class=\"mat-biblio-title\">主要参考文献\u003C/div>\n\u003Cul class=\"mat-biblio\">\n  \u003Cli>\n    McCreight LJ, Bailey CJ, Pearson ER. Metformin and the gastrointestinal tract. \u003Cem>Diabetologia\u003C/em>. 2016;59(3):426-435.\n  \u003C/li>\n  \u003Cli>\n    American Diabetes Association. Standards of Medical Care in Diabetes—2023. \u003Cem>Diabetes Care\u003C/em>; 2023;46(Suppl. 1):S1-S291.\n  \u003C/li>\n  \u003Cli>\n    Maruthur NM, Tseng E, Hutfless S, et al. Diabetes Medications as Monotherapy or Metformin-Based Combination Therapy for Type 2 Diabetes: A Systematic Review and Meta-analysis. \u003Cem>Annals of Internal Medicine\u003C/em>. 2016;164(11):740-751.\n  \u003C/li>\n\u003C/ul>\n\n\n\u003Cstyle>\n/* 独立样式命名，防止全局污染 */\n.mat-special-title {\n  font-size: 28px;\n  font-weight: 700;\n  color: #184776;\n  margin-bottom: 32px;\n  padding: 22px 30px 18px 36px;\n  border-left: 8px solid #5cb9ef;\n  background: linear-gradient(90deg, #e0f0fb 84%, transparent 100%);\n  border-radius: 12px 0 0 12px;\n  letter-spacing: 1.8px;\n}\n.mat-section {\n  margin-bottom: 36px;\n}\n.mat-subtitle {\n  font-size: 22px;\n  font-weight: 600;\n  margin-bottom: 18px;\n  padding: 16px 24px;\n  border-radius: 8px;\n  letter-spacing: 1.2px;\n  /* 子标题区分背景样式 */\n}\n.mat-bg1 { background: linear-gradient(120deg, #eef9fc 80%, #d4eaf2 100%); }\n.mat-bg2 { background: linear-gradient(120deg, #f6fbe8 80%, #e2f5c2 100%); }\n.mat-bg3 { background: linear-gradient(120deg, #fff9e5 80%, #fae9b3 100%); }\n.mat-bg4 { background: linear-gradient(120deg, #fbedec 85%, #fad9d3 100%); }\n.mat-bg5 { background: linear-gradient(120deg, #f5f5f5 85%, #dbe4e0 100%); }\n.mat-bg6 { background: linear-gradient(120deg, #edefff 80%, #cfd9ef 100%); }\n.mat-bg7 { background: linear-gradient(120deg, #fdfbe3 80%, #edeab0 100%); }\n.mat-bg8 { background: linear-gradient(120deg, #e9f8ef 80%, #cde8d7 100%); }\n.mat-bg9 { background: linear-gradient(120deg, #e9f4fb 85%, #c0e7fa 100%); }\n.mat-content {\n  font-size: 17px;\n  color: #26323b;\n  padding: 0 24px 0 32px;\n  line-height: 2;\n  margin-bottom: 8px;\n}\n.mat-content strong {\n  color: #174385;\n  background: #ecf5ff;\n  padding: 1px 6px;\n  border-radius: 4px;\n  font-weight: 700;\n}\n.mat-highlight {\n  color: #b02a37;\n  background: #ffeaea;\n  font-weight: 600;\n  padding: 3px 8px;\n  border-radius: 4px;\n  font-size: 16px;\n  margin-left: 10px;\n}\n.mat-uli {\n  list-style: disc inside;\n  margin-left: 14px;\n  margin-bottom: 0;\n  padding-left: 0;\n  color: #183f41;\n}\n.mat-uli li {\n  padding: 2px 0 2px 4px;\n  font-size: 16px;\n}\n.mat-summary {\n  border-left: 6px solid #2586c6;\n  background: linear-gradient(130deg, #f5fbff 98%, transparent 100%);\n  border-radius: 12px 0 0 12px;\n  margin-top: 32px;\n}\n.mat-biblio-title {\n  font-size: 18px;\n  font-weight: 700;\n  color: #16527e;\n  margin-bottom: 10px;\n  margin-left: 2px;\n}\n.mat-biblio {\n  background: #f8fcfd;\n  padding: 18px 32px 18px 28px;\n  color: #233d49;\n  border-radius: 8px;\n  font-size: 15px;\n  margin-bottom: 50px;\n  margin-top: 0;\n}\n.mat-biblio li {\n  margin-bottom: 4px;\n  line-height: 1.7;\n  list-style-type: decimal;\n}\n@media screen and (max-width: 700px) {\n  .mat-special-title {\n    font-size: 21px;\n    padding: 16px 14px 12px 11px;\n    border-radius: 6px 0 0 6px;\n  }\n  .mat-section {\n    margin-bottom: 24px;\n  }\n  .mat-subtitle {\n    font-size: 17px;\n    margin-bottom: 10px;\n    padding: 10px 13px;\n    border-radius: 6px;\n  }\n  .mat-content {\n    font-size: 14px;\n    padding: 0 8px 0 10px;\n  }\n  .mat-uli li {\n    font-size: 14px;\n  }\n  .mat-biblio-title {\n    font-size: 15px;\n  }\n  .mat-biblio {\n    font-size: 12px;\n    padding: 10px 4px 10px 8px;\n  }\n}\n\u003C/style>\n\n","\u003Cdiv id=\"material_title\" class=\"mat-special-title\">\n  肝癌IV期患者的糖尿病管理：缓解恶心与不良反应的实用用药指南\n\u003C/div>\n\n\u003Cdiv cl",559,"2025-07-12 10:03:35","肝癌, 糖尿病管理, 降糖药, 二甲双胍, 格列美脲, 不良反应, 患者用药, 用药安全","本指南为肝癌IV期糖尿病患者提供有效的降糖药管理方案，关注药物类型、服药细节及不良反应处理，确保安全用药与生活质量提升。","2025-07-12 19:32:00",2,[34],{"menuId":35,"menuName":36,"parentId":21,"orderNum":32,"path":37,"component":38,"isFrame":39,"isCache":40,"menuType":41,"visible":42,"status":21,"createDept":6,"remark":23,"createTime":43,"children":44,"columnImage":45,"columnLogo":46,"uncheckedLogo":6,"checkedLogo":6,"isHot":42,"isHome":21,"forceLogin":21,"color":47,"seoTitle":48,"seoKeywords":49,"seoDescription":50,"contentNum":6,"promotionalPoster":51,"menuFrame":7,"innerLink":7,"parentView":7,"routeName":52,"routerPath":37,"componentInfo":38},"1986713082609147906","健康科普","article","/article.html","1","0","T",1,"2025-11-07 16:31:25",[],"https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:08:49/d4291d16-ed1c-48dd-84c8-ec1f85980b75.png","https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:08:52/6fe64094-9416-442c-a66d-032fb292666a.png","#c8e6ca","健康科普助力健康中国2030:共享健康知识新理念","健康科普, 健康中国, 科普知识, 健康家庭, 性健康, 营养健康, 运动健康, 科普宣传","探索健康科普在健康中国行动中的重要角色,了解最新的健康科普创新大赛、动漫及短视频,传播健康知识,助力全民健康。","https://ystcdn.venuertc.com/venue/undefined/2026-01-24-18:08:56/bd33f471-6c54-4d1b-a364-b06973dbc144.png","Article","慢性病,癌症肿瘤",true,{"code":9,"msg":10,"message":6,"data":56,"success":54},{"pageNo":42,"pageSize":57,"result":58,"totalSize":21},10,[],{"code":9,"msg":10,"message":6,"data":60,"success":54},{"authors":61,"appraiseDimensionScoresVos":62},[],[]]