[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$fn2MieM2RSHWIiuJa1URQK8IMM54GnLR6i75rcyQbunI":8,"$fp6Zj7UCkJ75X-gfdOPUq4Q52rOfzJqDyFSTbPBw59ts":55,"$fOgpCvIo6Lqt5iAfD54-o5P0_41JyTvjg_ffkFViT3hM":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},49811,867323,[],"https://ystcdn.venuertc.com/learnMaterial/ystApp//VjxO4NeO7R7u8VxE20BMmMakCRoDYTJ8.png","徐家亮","瓦房店市中心医院","肿瘤科","主任医师",99,0,"原发性肝癌晚期乙型肝炎用药实用指南 🌿","","https://ystcdn.venuertc.com/venue/AI/d47de5fc-8225-46fe-ac40-f9a3cbd2468c.jpg","\u003Cdiv class=\"medicine-guide-container\">\n  \u003Ch1 id=\"material_title\" class=\"medicine-guide-title\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">\n    原发性肝癌晚期乙型肝炎用药实用指南 🌿\n  \u003C/h1>\n\n  \u003Cdiv class=\"medicine-guide-section medicine-guide-intro\" style=\"background: linear-gradient(90deg,#f7fafc 60%,#f0f5f4 100%);\">\n    \u003Ch2 class=\"medicine-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">开场白：乙肝肝癌治疗中的药物使用要点\u003C/h2>\n    \u003Cp>说起针对晚期原发性肝癌和慢性乙型肝炎的药物治疗，不少人首先关心的就是疗效和安全。其实，现代药物种类繁多，包括口服和注射两大类，比如靶向小分子药、免疫检查点抑制剂、核苷（酸）类似物、各种注射用抗病毒药等等。每种药物的服用方法、相互作用以及不良反应处理细节都不同。本篇将带你逐条梳理7个关键用药细节，助你用得放心。\u003C/p>\n  \u003C/div>\n\n  \u003C!-- 药品类别与主要成分 -->\n  \u003Csection class=\"medicine-guide-section medicine-guide-bg1\">\n    \u003Ch2 class=\"medicine-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">01. 药物类别与成分 🧬\u003C/h2>\n    \u003Cdiv class=\"medicine-guide-content\">\n      \u003Cul>\n        \u003Cli>\n          \u003Cstrong>靶向治疗药物：\u003C/strong>常见如索拉非尼（Sorafenib）、仑伐替尼（Lenvatinib）。这些多为口服小分子，作用于癌细胞分子通路，抑制肿瘤生长（Wilhelm et al., 2004）。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>免疫治疗药物：\u003C/strong>代表如PD-1抑制剂派姆单抗（Pembrolizumab）、纳武利尤单抗（Nivolumab），多为静脉注射，用于激活免疫系统对抗异常细胞（El-Khoueiry et al., 2017）。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>抗乙肝病毒药物：\u003C/strong>口服常用恩替卡韦（Entecavir）、替诺福韦（Tenofovir）。属于核苷酸类似物，可直接抑制病毒复制。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>不同药物的规格剂型对应不同用法，务必参照产品说明书或由医生指导。\u003C/p>\n    \u003C/div>\n  \u003C/section>\n\n  \u003C!-- 服用时间与方法 -->\n  \u003Csection class=\"medicine-guide-section medicine-guide-bg2\">\n    \u003Ch2 class=\"medicine-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">02. 服用时间和方法 ⏰\u003C/h2>\n    \u003Cdiv class=\"medicine-guide-content\">\n      \u003Cul>\n        \u003Cli>\n          绝大多数口服抗乙型肝炎药物（如恩替卡韦）应在空腹（餐前2小时或餐后2小时）服用，提高吸收率（Chang et al., 2006）。\n        \u003C/li>\n        \u003Cli>\n          索拉非尼、仑伐替尼通常每日2次，具体是否与餐同服要严格按说明书或医嘱。\n        \u003C/li>\n        \u003Cli>\n          静注免疫药物多由专业医护操作，家属和患者不自行注射。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>正确做法：服药时间按医生指示，配水量充足（约150-200ml），不要咀嚼或掰开肠溶片类药物。遇特殊剂型（如缓释、控释片）不可随意改变剂型。\u003C/p>\n    \u003C/div>\n  \u003C/section>\n\n  \u003C!-- 剂型特点与用药技巧 -->\n  \u003Csection class=\"medicine-guide-section medicine-guide-bg3\">\n    \u003Ch2 class=\"medicine-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">03. 剂型选择与用药技巧 💊\u003C/h2>\n    \u003Cdiv class=\"medicine-guide-content\">\n      \u003Cul>\n        \u003Cli>\n          \u003Cstrong>片剂/胶囊：\u003C/strong>完整吞服，勿嚼碎、压碎。如遇吞咽困难，联系医师换用其他制剂。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>注射剂：\u003C/strong>严格医院操作。患者与家属仅需关注注射部位是否有红肿、硬结或过敏反应。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>缓释或控释制剂：\u003C/strong>此类药物释放速度平稳，切勿擅自拆分，否则可能导致药效异常波动或不良反应发生。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>正确做法：遇到服药障碍时，及时向医生或药师咨询剂型更换方案。\u003C/p>\n    \u003C/div>\n  \u003C/section>\n\n  \u003C!-- 药物相互作用细节 -->\n  \u003Csection class=\"medicine-guide-section medicine-guide-bg1\">\n    \u003Ch2 class=\"medicine-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">04. 药物相互作用须知 ⚠️\u003C/h2>\n    \u003Cdiv class=\"medicine-guide-content\">\n      \u003Cul>\n        \u003Cli>\n          \u003Cstrong>索拉非尼：\u003C/strong>与华法林、利福平、酮康唑等药物同服时要警惕血药浓度变化，否则可能增强毒副作用（Wilhelm et al., 2004）。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>恩替卡韦、替诺福韦：\u003C/strong>与其他肾毒性药物合用时要加强肾功能监测，防止肾脏损伤。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>免疫抑制剂：\u003C/strong>避免与活疫苗同时使用，防止免疫抑制后感染风险上升（El-Khoueiry et al., 2017）。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>需要注意：如正在服用新药或保健品，应主动告知医生所有药物品种，防止意外相互作用。\u003C/p>\n    \u003C/div>\n  \u003C/section>\n\n  \u003C!-- 特殊人群的用药调整 -->\n  \u003Csection class=\"medicine-guide-section medicine-guide-bg2\">\n    \u003Ch2 class=\"medicine-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">05. 特殊人群的剂量调整 👪\u003C/h2>\n    \u003Cdiv class=\"medicine-guide-content\">\n      \u003Cul>\n        \u003Cli>\n          \u003Cstrong>老年人：\u003C/strong>往往肝肾功能减退，部分小分子靶向药需个体化调整剂量。每次增减剂量时，应先与主治医生沟通。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>孕妇/哺乳期：\u003C/strong>恩替卡韦、替诺福韦在特殊时期用药须经严格评估风险，切忌自行停药或加量；许多靶向及免疫药目前怀孕期间禁用\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>肝肾功能不全者：\u003C/strong>必须密切监测生化指标，部分药品（如索拉非尼）需降低起始剂量或延长用药间隔。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>正确做法：任何剂量调整必须在医生指导下进行，严禁私自增减剂量。\u003C/p>\n      \u003Cdiv class=\"medicine-guide-case\">\n        \u003Cstrong>用药案例：\u003C/strong>\n        \u003Cspan>临床曾有一位老年男性，服用索拉非尼期间因未及时调整剂量，出现轻度手足皮炎，后依医嘱减量后症状改善。\u003C/span>\n      \u003C/div>\n    \u003C/div>\n  \u003C/section>\n\n  \u003C!-- 常见不良反应与处理 -->\n  \u003Csection class=\"medicine-guide-section medicine-guide-bg3\">\n    \u003Ch2 class=\"medicine-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">06. 常见不良反应与应对 🌡️\u003C/h2>\n    \u003Cdiv class=\"medicine-guide-content\">\n      \u003Cul>\n        \u003Cli>\n          \u003Cstrong>靶向药物：\u003C/strong>消化道反应（如腹泻、恶心）、手足综合征和高血压最常见。出现严重反应时应立即就医。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>抗乙型肝炎药物：\u003C/strong>个别可见头痛、恶心、轻度肝酶升高。持续不缓解时要及时复查肝功能。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>免疫药物：\u003C/strong>小部分人可能出现免疫相关不良事件（如皮疹、肝炎），务必遵循医护人员监测计划。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>正确做法：按时复查，保留所有不适的具体记录，便于医生调整方案。所有严重不良反应需第一时间联系医疗团队。\u003C/p>\n      \u003Cdiv class=\"medicine-guide-case\">\n        \u003Cstrong>用药案例：\u003C/strong>\n        \u003Cspan>有位中年男性在联合免疫和靶向治疗期间，发生了轻度胃肠不适，经过短时调整饮食与药物剂量后恢复正常。\u003C/span>\n      \u003C/div>\n      \u003Cp>数据表明，靶向药物类不良反应发生成约20-30%（Wilhelm et al., 2004）\u003C/p>\n    \u003C/div>\n  \u003C/section>\n\n  \u003C!-- 储存方式与有效期 -->\n  \u003Csection class=\"medicine-guide-section medicine-guide-bg1\">\n    \u003Ch2 class=\"medicine-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">07. 药品储存与保存期限 📦\u003C/h2>\n    \u003Cdiv class=\"medicine-guide-content\">\n      \u003Cul>\n        \u003Cli>\n          \u003Cstrong>避光保存：\u003C/strong>大部分口服制剂需密封避光，室温条件下（15-25°C）存放。不可放在潮湿浴室、暴晒环境。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>注射剂：\u003C/strong>未开启需冷藏（2-8°C），已开启的药液按说明书最迟在24小时内用完。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>过期药物：\u003C/strong>严禁自行服用。应统一交回医疗机构或药房安全处理。切勿丢入生活垃圾或马桶。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>正确做法：定期清理药箱，保存药品原包装和说明书，方便随时核查起始日期和服用方法。\u003C/p>\n    \u003C/div>\n  \u003C/section>\n\n  \u003C!-- 漏服与过量处理 -->\n  \u003Csection class=\"medicine-guide-section medicine-guide-bg2\">\n    \u003Ch2 class=\"medicine-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">08. 漏服与过量如何应对❓\u003C/h2>\n    \u003Cdiv class=\"medicine-guide-content\">\n      \u003Cul>\n        \u003Cli>\n          \u003Cstrong>漏服：\u003C/strong>发现后如离下次服药还有6小时以上，立即补服；如时间接近下次，则跳过，不可双倍剂量。\n        \u003C/li>\n        \u003Cli>\n          \u003Cstrong>过量用药：\u003C/strong>切勿等待观察。若发生误服过量，应立即携带药品包装前往急诊就医。\n        \u003C/li>\n      \u003C/ul>\n      \u003Cp>特别提醒：部分口服抗乙肝或靶向药过量可能出现肝、肾损害甚至更严重不良后果，切勿掉以轻心。\u003C/p>\n      \u003Cdiv class=\"medicine-guide-case\">\n        \u003Cstrong>用药案例：\u003C/strong>\n        \u003Cspan>有患者曾因连续两次漏服恩替卡韦后擅自加倍补服，结果出现头晕等不适症状，后经医生指导改正，并恢复正常。\u003C/span>\n      \u003C/div>\n    \u003C/div>\n  \u003C/section>\n\n  \u003C!-- 小结与重点提示 -->\n  \u003Csection class=\"medicine-guide-section medicine-guide-summary\" style=\"background:linear-gradient(90deg,#fbfbfc 70%,#e8f4f5 100%);\">\n    \u003Ch2 class=\"medicine-guide-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">👀 结语：把握2大安全要点\u003C/h2>\n    \u003Col class=\"medicine-guide-content medicine-guide-list\">\n      \u003Cli>\n        \u003Cstrong>任何药物剂量的更改、停用或添加新药必须经医生批准，切忌自作主张。\u003C/strong>\n      \u003C/li>\n      \u003Cli>\n        \u003Cstrong>遇到不适、误服、异常症状，请及时携带药品包装就医，不应自行处理。\u003C/strong>\n      \u003C/li>\n    \u003C/ol>\n    \u003Cp>合理用药、细节为先，是对自己最大的保护。遇到用药疑惑时，主动与医生、药师沟通才是最稳妥。\u003C/p>\n  \u003C/section>\n\u003C/div>\n\n\u003C!-- 样式部分  -->\n\u003Cstyle>\n/* 样式唯一前缀 medicine-guide- 避免外部干扰 */\n.medicine-guide-container {\n  max-width: 850px;\n  margin: 32px auto;\n  font-family: \"PingFang SC\", \"Helvetica Neue\", Arial, sans-serif;\n  color: #24292f;\n  line-height: 1.8em;\n  background: #f6f9fb;\n  border-radius: 14px;\n  box-shadow: 0 2px 16px 0 rgba(41,57,80,.07);\n  padding: 28px 36px 36px 36px;\n}\n.medicine-guide-title {\n  text-align: center;\n  font-weight: bold;\n  font-size: 2.2em;\n  background: linear-gradient(90deg, #fcfcfc 60%, #e3edee 100%);\n  padding: 30px 0 16px 0;\n  border-radius: 14px 14px 0 0;\n  margin-bottom: 16px;\n  letter-spacing: 1.5px;\n  color: #193648;\n}\n.medicine-guide-subtitle {\n  font-size: 1.45em;\n  font-weight: 600;\n  letter-spacing: .6px;\n  background: #eef4f8;\n  border-left: 5px solid #63b6b8;\n  padding: 10px 0 10px 14px;\n  border-radius: 7px;\n  margin-bottom: 14px;\n  margin-top: 22px;\n}\n.medicine-guide-section {\n  padding: 28px 22px 24px 22px;\n  border-radius: 9px;\n  margin-bottom: 24px;\n  box-shadow: 0 2px 8px 0 rgba(41,57,80,.03);\n  background-size: 100% auto;\n}\n/* 三种淡背景轮换 */\n.medicine-guide-bg1 {\n  background: linear-gradient(90deg,#e8f2fa 60%,#eef8f4 100%);\n}\n.medicine-guide-bg2 {\n  background: linear-gradient(90deg,#fafcfa 80%,#dbeef4 100%);\n}\n.medicine-guide-bg3 {\n  background: linear-gradient(90deg,#f9fafc 80%,#fbeeed 100%);\n}\n.medicine-guide-content {\n  font-size: 1.07em;\n  margin-left: 10px;\n  margin-right: 10px;\n}\n.medicine-guide-case {\n  background: #fcfcf7;\n  border-left: 5px solid #fab76b;\n  margin: 21px 0 6px 0;\n  padding: 11px 13px 11px 17px;\n  border-radius: 4px;\n  font-size: 1em;\n  color: #6c5c3a;\n}\n.medicine-guide-list li {\n  margin-bottom: 12px;\n}\n.medicine-guide-summary {\n  box-shadow: 0 4px 26px 0 rgba(18,40,78,.09);\n  border: 2px dashed #89c3c2;\n}\n@media (max-width: 640px) {\n  .medicine-guide-container {\n    max-width: 100%;\n    padding: 11px 3px;\n  }\n  .medicine-guide-subtitle {\n    font-size: 1.09em;\n    padding: 8px 0 8px 8px;\n  }\n  .medicine-guide-section {\n    padding: 16px 6px 13px 6px;\n  }\n}\n\n/* 小细节优化 */\n.medicine-guide-content ul {\n  padding-left: 16px;\n  padding-bottom: 3px;\n}\n.medicine-guide-content li {\n  margin-bottom: 7px;\n}\n\n/* 引用文献样式 */\n.medicine-guide-references {\n  background: #f6f7fa;\n  border-left: 4px solid #a1c4ce;\n  margin: 40px 0 10px 0;\n  padding: 18px 16px 12px 16px;\n  border-radius: 7px;\n  font-size: 1em;\n  color: #404a5d;\n}\n.medicine-guide-references-title {\n  font-size: 1.04em;\n  font-weight: 600;\n  color: #193648;\n  margin-bottom: 4px;\n}\n\u003C/style>\n\n\u003Cdiv class=\"medicine-guide-references\">\n  \u003Cdiv class=\"medicine-guide-references-title\">参考文献\u003C/div>\n  \u003Col>\n    \u003Cli>Wilhelm, S. M., Carter, C., Tang, L., Wilkie, D., McNabola, A., Rong, H., ... & Lynch, M. (2004). BAY 43-9006 exhibits broad spectrum oral antitumor activity and targets the RAF/MEK/ERK pathway and receptor tyrosine kinases involved in tumor progression and angiogenesis. \u003Cem>Cancer Research\u003C/em>, 64(19), 7099-7109. https://doi.org/10.1158/0008-5472.CAN-04-1443\u003C/li>\n    \u003Cli>El-Khoueiry, A. B., Sangro, B., Yau, T., Crocenzi, T. S., Kudo, M., Hsu, C., ... & Melero, I. (2017). Nivolumab in patients with advanced hepatocellular carcinoma (CheckMate 040): an open-label, non-comparative, phase 1/2 dose escalation and expansion trial. \u003Cem>Lancet\u003C/em>, 389(10088), 2492-2502. https://doi.org/10.1016/S0140-6736(17)31046-2\u003C/li>\n    \u003Cli>Chang, T. T., Gish, R. G., de Man, R., Gadano, A., Sollano, J., Chao, Y. C., ... & Carosi, G. (2006). A comparison of entecavir and lamivudine for HBeAg-positive chronic hepatitis B. \u003Cem>The New England Journal of Medicine\u003C/em>, 354(10), 1001-1010. https://doi.org/10.1056/NEJMoa051285\u003C/li>\n  \u003C/ol>\n\u003C/div>\n\n","\u003Cdiv class=\"medicine-guide-container\">\n  \u003Ch1 id=\"material_title\" class=\"medicine-guide-title\" style=",529,"2025-07-17 11:20:34","原发性肝癌, 乙型肝炎, 用药指南, 靶向治疗, 免疫治疗, 抗病毒药物, 常见不良反应, 药物相互作用","本指南详细介绍晚期原发性肝癌和乙型肝炎的用药要点，确保患者在使用靶向药、免疫药及抗病毒药物时，能安全有效地进行治疗。","2025-07-18 09:36:00",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,传染病,癌症肿瘤,重大疾病",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},[],[]]