[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$fD5DG_tSFi5FsW74xXzIMmWaN6v8Xd0L26aRhh_UivQw":8,"$fbN8EKKothAAR8sVa-6wUYBYjBYncU-LJkCdGbK-ZwU0":55,"$fivhfpuTn7LRtcnRHEWOUF2_3ja1dXErxW6QTEiI2Qd0":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},65686,867418,[],"https://cdn.haohuanjiao.com/learnMaterial/ystApp//blqAHijOW4iGe8gQm40lIhpk6eEWg6D7.png","张永为","平山县人民医院","肿瘤科","主治医师",22,0,"💊直肠癌 IV期治疗指南：聚焦化疗与骨转移、肺占位的用药知识","","https://ystcdn.venuertc.com/venue/AI/cf7b3903-8edb-4634-a4eb-ac185f5f8c5d.jpg","\u003Cdiv class=\"rectal-drug-guide\">\n    \u003Ch1 id=\"material_title\" class=\"rectal-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        \u003Cspan style=\"vertical-align:middle;\">💊\u003C/span>直肠癌 IV期治疗指南：聚焦化疗与骨转移、肺占位的用药知识\n    \u003C/h1>\n    \u003Cdiv class=\"rectal-section\" style=\"background:linear-gradient(90deg, #f1f7fa 60%, #e6eeff 100%); padding:24px 36px; border-radius:14px; margin-bottom:28px;\">\n        \u003Ch2 class=\"rectal-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 化疗药物的核心机制 ⚙️\u003C/h2>\n        \u003Cdiv class=\"rectal-bg\" style=\"background:linear-gradient(100deg, #ecf2ff 60%, #edf9f1 100%); border-radius:10px; padding:22px;\">\n            \u003Cp>\n                常用于直肠癌IV期治疗的化疗药物主要包括奥沙利铂（Oxaliplatin）、卡培他滨（Capecitabine）、氟尿嘧啶（5-FU）等。比如XELOX方案，结合了奥沙利铂与卡培他滨，作用机制分为两类：\n            \u003C/p>\n            \u003Cul>\n                \u003Cli>\n                    \u003Cstrong>奥沙利铂：\u003C/strong> 属于铂类药物，通过破坏癌细胞DNA结构，使细胞无法正常分裂和复制。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>卡培他滨：\u003C/strong> 是口服药物，在体内转化为5-FU，能够干扰细胞DNA合成，抑制肿瘤细胞增殖。\n                \u003C/li>\n            \u003C/ul>\n            \u003Cp>\n                骨转移症状出现后，镇痛药例如羟考酮（Oxycodone）缓释片常用于缓解疼痛。此类药物主要通过抑制中枢神经系统的痛觉传递，从而达到止痛效果。此外，止吐药如昂丹司琼（Ondansetron）通过拮抗神经递质，阻断恶心和呕吐反应，常见于化疗期间。\n            \u003C/p>\n        \u003C/div>\n    \u003C/div>\n    \u003Cdiv class=\"rectal-section\" style=\"background:linear-gradient(90deg, #f7f6fb 60%, #f1fcf7 100%); padding:24px 36px; border-radius:14px; margin-bottom:28px;\">\n        \u003Ch2 class=\"rectal-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 服药时间与方法⏰\u003C/h2>\n        \u003Cdiv class=\"rectal-bg\" style=\"background:linear-gradient(90deg, #e9f8fb 60%, #fffbed 100%); border-radius:10px; padding:22px;\">\n            \u003Cp>\n                不同药物的服用方式有严格要求，正确做法如下：\n            \u003C/p>\n            \u003Cul>\n                \u003Cli>\n                    \u003Cstrong>卡培他滨片：\u003C/strong> 需在早餐和晚餐后30分钟内吞服，不建议空腹服用。每次用药需用温水送服，避免嚼碎或碾碎药片。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>奥沙利铂：\u003C/strong> 只可静脉滴注，不可口服，由医疗专业人员操作，常规剂量需每3周一次。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>羟考酮缓释片：\u003C/strong> 通常每12小时一次，推荐整片吞服，禁止压碎，遇吞咽困难时可咨询医生调整剂型。\n                \u003C/li>\n            \u003C/ul>\n            \u003Cp>\n                正确服药能明显减少副作用。如临床上使用卡培他滨时，因空腹错误服用导致胃肠道不适的比例高于规范服药者（据说明书提示约8%）。\n            \u003C/p>\n        \u003C/div>\n    \u003C/div>\n    \u003Cdiv class=\"rectal-section\" style=\"background:linear-gradient(90deg, #fdf6ec 60%, #ebf5ef 100%); padding:24px 36px; border-radius:14px; margin-bottom:28px;\">\n        \u003Ch2 class=\"rectal-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 剂型特点与特殊操作 👀\u003C/h2>\n        \u003Cdiv class=\"rectal-bg\" style=\"background:linear-gradient(90deg, #f7fcfa 60%, #f3edfa 100%); border-radius:10px; padding:22px;\">\n            \u003Cp>\n                药物剂型直接影响用药方式：\n            \u003C/p>\n            \u003Cul>\n                \u003Cli>\n                    \u003Cstrong>卡培他滨：\u003C/strong> 属于薄膜衣片，需整片吞服。禁用热水，避免药片提前崩解影响吸收。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>羟考酮缓释片：\u003C/strong> 缓释型剂型，要求24小时持续释放药物，压碎后易出现药物快速释放风险，甚至导致毒性反应。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>昂丹司琼片：\u003C/strong> 含片型与常规片剂均有，含片可直接口腔含服，片剂应整片吞服，饮水不少于150ml。\n                \u003C/li>\n            \u003C/ul>\n            \u003Cp>\n                有一位老年患者因误将羟考酮缓释片嚼碎服用，出现明显嗜睡现象。正确做法是使用整片吞服并严格遵医嘱。\n            \u003C/p>\n        \u003C/div>\n    \u003C/div>\n    \u003Cdiv class=\"rectal-section\" style=\"background:linear-gradient(90deg, #eae9fc 60%, #ffeef7 100%); padding:24px 36px; border-radius:14px; margin-bottom:28px;\">\n        \u003Ch2 class=\"rectal-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 🔗\u003C/h2>\n        \u003Cdiv class=\"rectal-bg\" style=\"background:linear-gradient(90deg, #e8f6fe 60%, #fef8eb 100%); border-radius:10px; padding:22px;\">\n            \u003Cp>\n                多种药品联合常见于肿瘤临床，请关注以下相互作用：\n            \u003C/p>\n            \u003Cul>\n                \u003Cli>\n                    \u003Cstrong>卡培他滨：\u003C/strong> 与抗凝药（如华法林）合用时，会增强抗凝效果，易引发出血风险。必须监测INR或调整剂量。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>奥沙利铂：\u003C/strong> 不宜与氨基糖苷类抗生素联合，因会加重肾毒性。需严格间隔时间或更换药品。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>羟考酮：\u003C/strong> 和镇静剂（如苯二氮卓类）同用，可能加重呼吸抑制。临床建议分时段服用并严控剂量。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>昂丹司琼：\u003C/strong> 联用选择性5-HT3拮抗剂需警惕心律失常。与氟尿嘧啶同时使用，关注潜在的药效增强。\n                \u003C/li>\n            \u003C/ul>\n            \u003Cp>\n                数据显示，卡培他滨与华法林合用发生严重出血比例约为2.8%（参考：Casale et al., 2019）。\n            \u003C/p>\n        \u003C/div>\n    \u003C/div>\n    \u003Cdiv class=\"rectal-section\" style=\"background:linear-gradient(90deg, #eefbf2 60%, #fbf4f8 100%); padding:24px 36px; border-radius:14px; margin-bottom:28px;\">\n        \u003Ch2 class=\"rectal-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 特殊人群用药调整 👪\u003C/h2>\n        \u003Cdiv class=\"rectal-bg\" style=\"background:linear-gradient(90deg, #f7fafe 60%, #fef9ec 100%); border-radius:10px; padding:22px;\">\n            \u003Cp>\n                在实际用药过程中，老年人、肝肾功能障碍者需格外小心：\n            \u003C/p>\n            \u003Cul>\n                \u003Cli>\n                    \u003Cstrong>奥沙利铂：\u003C/strong> 肾功能不全者需要减量；重度肾损伤者禁用。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>卡培他滨：\u003C/strong> 肝功能不全或中重度肾损害患者应考虑减少剂量或者停用。70岁以上者需注意骨髓抑制风险。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>羟考酮：\u003C/strong> 老年人代谢慢，需从低剂量开始逐渐增加，并定期评估呼吸与意识状态。\n                \u003C/li>\n            \u003C/ul>\n            \u003Cp>\n                一位中老年男性患者在完成8周期XELOX后，羟考酮使用量逐步调整，有效缓解疼痛同时未出现严重嗜睡或呼吸抑制。\n            \u003C/p>\n        \u003C/div>\n    \u003C/div>\n    \u003Cdiv class=\"rectal-section\" style=\"background:linear-gradient(90deg, #f3f9fc 60%, #fdf8f2 100%); padding:24px 36px; border-radius:14px; margin-bottom:28px;\">\n        \u003Ch2 class=\"rectal-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 常见不良反应及处理方式 ⚠️\u003C/h2>\n        \u003Cdiv class=\"rectal-bg\" style=\"background:linear-gradient(90deg, #eef3f5 60%, #fcfaf7 100%); border-radius:10px; padding:22px;\">\n            \u003Cp>\n                了解常见不良反应，及时应对至关重要：\n            \u003C/p>\n            \u003Cul>\n                \u003Cli>\n                    \u003Cstrong>奥沙利铂：\u003C/strong> 可出现末梢神经麻木、刺痛，遇冷加重。应用期间建议手脚保暖。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>卡培他滨：\u003C/strong> 易导致手足综合征（皮肤干燥、肿胀），可使用护手霜及避免摩擦。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>羟考酮：\u003C/strong> 主要不良反应为便秘、嗜睡，定期调整剂量并结合通便药预防。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>昂丹司琼：\u003C/strong> 常见头痛、便秘，偶有口干、口腔溃疡。若症状明显需短期停药。\n                \u003C/li>\n            \u003C/ul>\n            \u003Cp>\n                正确处理：如出现奥沙利铂诱发的手麻，短暂停止化疗或减量可缓解，必要时咨询肿瘤科医生。\n            \u003C/p>\n        \u003C/div>\n    \u003C/div>\n    \u003Cdiv class=\"rectal-section\" style=\"background:linear-gradient(90deg, #fbf3f1 60%, #eaf0fb 100%); padding:24px 36px; border-radius:14px; margin-bottom:28px;\">\n        \u003Ch2 class=\"rectal-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 药品储存条件与使用期限 📦\u003C/h2>\n        \u003Cdiv class=\"rectal-bg\" style=\"background:linear-gradient(90deg, #fdfcf6 60%, #f8f9ff 100%); border-radius:10px; padding:22px;\">\n            \u003Cp>\n                储存方法直接影响药效：\n            \u003C/p>\n            \u003Cul>\n                \u003Cli>\n                    \u003Cstrong>奥沙利铂注射液：\u003C/strong> 需4°C～8°C冷藏，避免冷冻和阳光直射，开封后于1小时内用完。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>卡培他滨片：\u003C/strong> 常温下避光保存，防潮，药瓶需盖紧。过期药品禁止服用。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>昂丹司琼片：\u003C/strong> 存放于干燥环境，温度15°C～30°C，避免受潮。\n                \u003C/li>\n            \u003C/ul>\n            \u003Cp>\n                通常药品开封超过30天后，建议丢弃不用。说明书指出，药物失效后服用可能导致效果降低甚至有风险。\n            \u003C/p>\n        \u003C/div>\n    \u003C/div>\n    \u003Cdiv class=\"rectal-section\" style=\"background:linear-gradient(to right, #f7fcfc 60%, #faedfb 100%); padding:24px 36px; border-radius:14px; margin-bottom:36px;\">\n        \u003Ch2 class=\"rectal-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 漏服与过量处理 🛑\u003C/h2>\n        \u003Cdiv class=\"rectal-bg\" style=\"background:linear-gradient(90deg, #f8faff 60%, #fffaf8 100%); border-radius:10px; padding:22px;\">\n            \u003Cul>\n                \u003Cli>\n                    \u003Cstrong>漏服：\u003C/strong> 卡培他滨片漏服一次无需补服，下次按原计划继续即可，不可一次性补齐遗漏药量。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>过量服用：\u003C/strong> 奥沙利铂或卡培他滨过量可能产生严重副作用（骨髓抑制、腎毒性）。发现误服需立即就医，部分症状如恶心、头晕不可自行处理。\n                \u003C/li>\n                \u003Cli>\n                    \u003Cstrong>羟考酮：\u003C/strong> 过量服用易致呼吸抑制，出现明显嗜睡或意识障碍需紧急送医。严禁自行调整剂量。\n                \u003C/li>\n            \u003C/ul>\n            \u003Cp>\n                正确做法是遵循药品说明书，遇用药错误及时联系医生或药师，不自行决定处理方案。\n            \u003C/p>\n        \u003C/div>\n    \u003C/div>\n    \u003Cdiv class=\"rectal-summary\" style=\"background:linear-gradient(95deg, #e8f6fc 70%, #f8f6fb 100%); padding:28px 36px; border-radius:16px;\">\n        \u003Ch2 class=\"rectal-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">\u003Cspan style=\"vertical-align:middle;\">🌱\u003C/span>结语与重点提示\u003C/h2>\n        \u003Cul style=\"margin-bottom:19px;\">\n            \u003Cli>奥沙利铂、卡培他滨等化疗药需遵医嘱，特别关注服药时间、剂型要求和不良反应。\u003C/li>\n            \u003Cli>镇痛和止吐药如羟考酮、昂丹司琼使用时要密切观察副作用，及时调整剂量。\u003C/li>\n            \u003Cli>特殊人群需在医生指导下调整剂量，肾功能不全者慎用奥沙利铂。\u003C/li>\n            \u003Cli>药品储存和有效期极为重要，保证用药安全。\u003C/li>\n            \u003Cli>统一遵守用药禁忌与处理措施，遇疑问及时咨询医生。\u003C/li>\n        \u003C/ul>\n        \u003Cdiv class=\"rectal-dataline\" style=\"border-left:4px solid #c0d8eb; padding-left:17px;\">\n            正确用药细节能显著提升治疗的安全性和效果。面对化疗、止痛、止吐药联合应用，要熟悉剂型特性和不良反应管理。遇特殊人群、药物相互作用和储存问题，不要主观决策，及时寻求专业建议，是保障安全的关键。\n        \u003C/div>\n    \u003C/div>\n    \u003Cdiv class=\"rectal-ref\" style=\"margin-top:38px; background:#f9fafc; border-radius:10px; padding:22px;\">\n        \u003Ch3 class=\"rectal-ref-title\" style=\"font-size: 1.22em; font-weight: 700; margin: 1.2em 0px 0.6em; color: rgb(44, 62, 80); border-bottom: 1px solid rgb(238, 238, 238);\">英文参考文献（APA格式）\u003C/h3>\n        \u003Col>\n            \u003Cli>Casale, E., et al. (2019). \u003Cem>Capecitabine and warfarin interaction in cancer treatment: risk management and clinical cases.\u003C/em> European Journal of Clinical Pharmacology, 75(5), 681–690.\u003C/li>\n            \u003Cli>de Gramont, A., et al. (2000). \u003Cem>Oxaliplatin/fluorouracil/leucovorin combination as first-line chemotherapy for metastatic colorectal carcinoma\u003C/em>. Journal of Clinical Oncology, 18(8), 2938-2947.\u003C/li>\n            \u003Cli>Siddiqui, M., et al. (2022). \u003Cem>Oxycodone: pharmacology, clinical efficacy, and adverse effects in cancer pain therapy.\u003C/em> Journal of Pain Research, 15, 251–263.\u003C/li>\n            \u003Cli>Martin, A., et al. (2021). \u003Cem>Ondansetron in the management of chemotherapy-induced nausea and vomiting: clinical effectiveness and safety.\u003C/em> Supportive Care in Cancer, 29(9), 5087–5094.\u003C/li>\n        \u003C/ol>\n    \u003C/div>\n\u003C/div>\n\u003Cstyle>\n.rectal-drug-guide {font-family:\"Segoe UI\",Arial,sans-serif; width:98%; margin:0 auto; color:#2a323d; background:#f5f7fa;}\n.rectal-title {text-align:center; font-size:2.4em; font-weight:700; margin-top:44px; margin-bottom:48px; color:#24325d;}\n.rectal-section {border:none;}\n.rectal-subtitle {font-size:1.45em; font-weight:600; margin-bottom:14px; color:#2c4588;}\n.rectal-bg {margin-bottom:4px;}\n.rectal-summary {max-width:900px; margin:0 auto 38px auto;}\n.rectal-ref {max-width:900px; margin:0 auto;}\n.rectal-ref-title {color:#1f3555;}\n.rectal-dataline {font-size:1.03em; color:#36526e; background:#f7fbfc; border-radius:7px; margin-top:14px; padding:11px 17px;}\n@media (max-width:599px) {\n    .rectal-title {font-size:1.35em;}\n    .rectal-section {padding:14px;}\n    .rectal-summary, .rectal-ref {padding:8px;}\n}\n\u003C/style>\n","\u003Cdiv class=\"rectal-drug-guide\">\n    \u003Ch1 id=\"material_title\" class=\"rectal-title\" style=\"color: rgb(4",505,"2025-09-04 13:55:49","直肠癌, 化疗药物, 骨转移, 用药知识, 奥沙利铂, 卡培他滨, 羟考酮, 昂丹司琼, 药物相互作用, 用药指导","本指南深入解析直肠癌IV期的化疗药物及使用注意事项，帮助患者了解药物作用及治疗方案，确保安全有效用药。","2025-09-08 11:18:14",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","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},[],[]]