[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$fbmdITpE55coiAkSYe3a85ZGhoNYmfBIu50JVe1ZLVWU":8,"$fvXULJwumJXFcxoO955XzyEAqVqFY6Z4oNl4bSQj1FkI":55,"$fZyCLKV7AJCkhyd3GeHL-CuDc6L2-HjD5IgmhEfJEScw":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},66771,869460,[],"https://cdn.haohuanjiao.com/learnMaterial/ystApp//oxzyB6fWPWB6dtH5WvFkMh8jEI76jIwG.png","田彦华","树兰（杭州）医院","皮肤性病科","主治医师",35,0,"免疫治疗与化疗药物规范用法指南——聚焦肛管恶性黑色素瘤肝转移病例","","https://ystcdn.venuertc.com/venue/AI/b99e7ae3-7de9-48e0-83d9-99c4dabc8b80.jpg","\u003Cdiv class=\"drug-material-container\">\n  \u003Ch2 id=\"material_title\" class=\"drug-material-title\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">免疫治疗与化疗药物规范用法指南——聚焦肛管恶性黑色素瘤肝转移病例\u003C/h2>\n\n  \u003Csection class=\"drug-material-section\">\n    \u003Cdiv class=\"drug-material-subtitle-bg\">\n      \u003Ch2 class=\"drug-material-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 免疫药物和化疗药物的主要成分和类型 🍃\u003C/h2>\n    \u003C/div>\n    \u003Cp class=\"drug-material-text\">\n      在针对恶性黑色素瘤相关治疗中，主要药品包括免疫检查点抑制剂（例如PD-1、CTLA-4相关制剂）和常见化疗药物（如紫杉醇类）。这些药物搭配支持性治疗（如5-HT3受体拮抗剂用于止吐、静脉补液维持电解质平衡）。免疫药物通常为单抗制剂，规格多为静脉注射剂型。化疗药物以注射剂为主，规格参照说明书。\n    \u003C/p>\n  \u003C/section>\n\n  \u003Csection class=\"drug-material-section\">\n    \u003Cdiv class=\"drug-material-subtitle-bg\">\n      \u003Ch2 class=\"drug-material-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 药品的作用机制解读 🌱\u003C/h2>\n    \u003C/div>\n    \u003Cp class=\"drug-material-text\">\n      免疫检查点抑制剂通过阻断肿瘤免疫逃逸关键通路，使机体免疫细胞重新识别并攻击异常细胞。具体来说，PD-1/PD-L1类抑制剂可解除免疫系统受抑状态，增强对异常细胞的清除能力。紫杉醇类化疗药物通过抑制细胞微管合成，阻碍有害细胞的分裂与增殖。5-HT3受体拮抗剂则通过阻断外周和中枢神经系统的相关受体，实现止吐功能，不参与抗肿瘤作用，但有助减轻药物不良反应。\n    \u003C/p>\n  \u003C/section>\n\n  \u003Csection class=\"drug-material-section\">\n    \u003Cdiv class=\"drug-material-subtitle-bg\">\n      \u003Ch2 class=\"drug-material-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 正确服药时间、方法与剂型要求 🕒\u003C/h2>\n    \u003C/div>\n    \u003Cp class=\"drug-material-text\">\n      \u003Cstrong>正确做法：\u003C/strong>免疫制剂和化疗药物均应在有专业医疗监护的情况下，以静脉注射方式给药。化疗药物如紫杉醇需严格按照周期性方案施用。止吐药推荐在化疗前30分钟首次给药，随后按标准间隔补充。静脉补液需与主药经专用通道输入，不与其他药物混合。所有药品剂量以体重或表面积计，由医生根据具体药品说明书、个体指标设定，不得自行调整。\n    \u003C/p>\n    \u003Cul class=\"drug-material-list\">\n      \u003Cli>静脉注射药品需在具备应急处理能力的医疗机构使用。\u003C/li>\n      \u003Cli>口服药品严禁自行增减剂量。\u003C/li>\n      \u003Cli>所有药品均应先核查药物名称与规格，确认与处方相符。\u003C/li>\n    \u003C/ul>\n  \u003C/section>\n\n  \u003Csection class=\"drug-material-section\">\n    \u003Cdiv class=\"drug-material-subtitle-bg\">\n      \u003Ch2 class=\"drug-material-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 药物相互作用及合理联用注意事项 ⚠️\u003C/h2>\n    \u003C/div>\n    \u003Cp class=\"drug-material-text\">\n      \u003Cstrong>需要注意：\u003C/strong>免疫制剂与化疗药物联合使用时，可能发生药物加重骨髓抑制，需监测血常规。止吐类药物（如5-HT3受体拮抗剂）与其他中枢抑制药并用时，有增加胃肠动力障碍和QT延长风险。静脉给药不宜同时加入多种药物，避免物理或化学不兼容。静脉补液时，电解质制剂与主要药物要分开使用，防止沉淀或失效。\n    \u003C/p>\n    \u003Cul class=\"drug-material-list\">\n      \u003Cli>免疫制剂宜避开强免疫抑制药同用，防止疗效下降。\u003C/li>\n      \u003Cli>化疗周期内，止吐药物可酌情与镇痛药联用，但需医生指导。\u003C/li>\n      \u003Cli>如需服用其他药品，应先咨询医师或药师，确认无显著相互作用。\u003C/li>\n    \u003C/ul>\n  \u003C/section>\n\n  \u003Csection class=\"drug-material-section\">\n    \u003Cdiv class=\"drug-material-subtitle-bg\">\n      \u003Ch2 class=\"drug-material-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 特殊人群用药调整方案 👩‍⚕️\u003C/h2>\n    \u003C/div>\n    \u003Cp class=\"drug-material-text\">\n      \u003Cstrong>正确做法：\u003C/strong>对于老年人、肝肾功能减退者，药品剂量和间隔需根据最新药品说明书与医师评估调整。孕妇和哺乳期人群通常不建议使用强烈免疫或化疗类药物。如必须使用，须权衡利弊后在严格监控下进行。慢性内分泌功能障碍者（如甲状腺减退）接受治疗时，应常规检测相关指标，有些药物可能影响激素水平，需酌情调整辅助治疗药品。\n    \u003C/p>\n    \u003Cul class=\"drug-material-list\">\n      \u003Cli>肝功能不全者用药前需评估、减量或延长给药间隔。\u003C/li>\n      \u003Cli>如既往有骨髓抑制或血细胞减少史，需密切监查血象变化。\u003C/li>\n      \u003Cli>儿童及青少年用药方案应由专科医师订制。\u003C/li>\n    \u003C/ul>\n  \u003C/section>\n\n  \u003Csection class=\"drug-material-section\">\n    \u003Cdiv class=\"drug-material-subtitle-bg\">\n      \u003Ch2 class=\"drug-material-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措施 🧾\u003C/h2>\n    \u003C/div>\n    \u003Cp class=\"drug-material-text\">\n      \u003Cstrong>不良反应提示：\u003C/strong>免疫药物可能出现皮疹、乏力、肝酶升高等。紫杉醇类主要导致骨髓抑制（白细胞和血小板减少）、脱发、局部过敏等。止吐药较常见副作用为便秘、头晕，偶有心率异常。临床研究数据显示，紫杉醇类制剂骨髓抑制发生率约达60%\u003Csup>[1]\u003C/sup>，免疫药物引发肝功能异常率达15%-30%。\n    \u003C/p>\n    \u003Cul class=\"drug-material-list\">\n      \u003Cli>出现发热、皮疹或严重乏力，应停止用药并尽快联系医生。\u003C/li>\n      \u003Cli>骨髓抑制时需及时补充粒细胞刺激因子、调整化疗周期。\u003C/li>\n      \u003Cli>止吐药导致便秘时，可适当增加饮水或配合温和泻药（遵医嘱）。\u003C/li>\n      \u003Cli>所有严重不良反应必须由专业医师处理，不可自行停药或加药。\u003C/li>\n    \u003C/ul>\n  \u003C/section>\n\n  \u003Csection class=\"drug-material-section\">\n    \u003Cdiv class=\"drug-material-subtitle-bg\">\n      \u003Ch2 class=\"drug-material-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 储存方法及有效期管理 🧊\u003C/h2>\n    \u003C/div>\n    \u003Cp class=\"drug-material-text\">\n      \u003Cstrong>正确储存：\u003C/strong>静脉注射类药品一般要求冷藏（2-8°C），避光密闭保存，勿放置于冰箱门或冷冻室；化疗药物和免疫药可放于原包装，避免经常开封。口服药品建议干燥、避光存放，避免高温潮湿环境。不建议将药品分装，防止混淆和失效。药品有效期需以包装标识为准，过期药不得继续使用，应依照药店或医院回收渠道处理。\n    \u003C/p>\n    \u003Cul class=\"drug-material-list\">\n      \u003Cli>未开封的药品须存放于医嘱指定环境，不要随意改换包装。\u003C/li>\n      \u003Cli>开封后药品应在说明书规定时间内使用完毕。\u003C/li>\n      \u003Cli>存放药品时需避免儿童和宠物接触。\u003C/li>\n    \u003C/ul>\n  \u003C/section>\n\n  \u003Csection class=\"drug-material-section\">\n    \u003Cdiv class=\"drug-material-subtitle-bg\">\n      \u003Ch2 class=\"drug-material-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 漏服与过量用药处理 🧮\u003C/h2>\n    \u003C/div>\n    \u003Cp class=\"drug-material-text\">\n      \u003Cstrong>漏服处理：\u003C/strong>静脉用药漏服时需与医师沟通，由专业人员决定是否补用。口服止吐药如漏服，建议按下次预定服药时间正常使用，不宜提前加量。过量用药（特别是化疗和免疫类药物）风险极高，可能引发急性器官损伤，须立即就医，由专业人员进行洗胃、对症治疗或应用特定拮抗剂。千万不可自行处理或延迟就诊时间。\n    \u003C/p>\n    \u003Cul class=\"drug-material-list\">\n      \u003Cli>静脉药物漏服或过量不可私自补救。\u003C/li>\n      \u003Cli>如发现服药错误，第一时间报告医务人员。\u003C/li>\n      \u003Cli>若出现异常反应，如意识不清、严重恶心呕吐等，按紧急处理流程及时送医。\u003C/li>\n    \u003C/ul>\n  \u003C/section>\n\n  \u003Csection class=\"drug-material-section\">\n    \u003Cdiv class=\"drug-material-subtitle-bg\">\n      \u003Ch2 class=\"drug-material-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">09 典型用药案例分析 🌟\u003C/h2>\n    \u003C/div>\n    \u003Cdiv class=\"drug-material-case-list\">\n      \u003Cdiv class=\"drug-material-case\">\n        \u003Cspan class=\"drug-material-case-icon\">🔬\u003C/span>\n        \u003Cp>案例1：有位58岁女性在免疫制剂联合化疗期间出现骨髓抑制，经粒细胞刺激剂干预后稳定，调整周期后未再复发。\u003C/p>\n      \u003C/div>\n      \u003Cdiv class=\"drug-material-case\">\n        \u003Cspan class=\"drug-material-case-icon\">💊\u003C/span>\n        \u003Cp>案例2：临床上使用5-HT3受体拮抗剂止吐时，患者出现便秘，饮食调整、增加低剂量泻药后症状缓解。\u003C/p>\n      \u003C/div>\n      \u003Cdiv class=\"drug-material-case\">\n        \u003Cspan class=\"drug-material-case-icon\">🧑‍⚕️\u003C/span>\n        \u003Cp>案例3：一位肝功能不全患者接受化疗剂量减半，血象与肝酶指标保持稳定，未发生严重不良反应。\u003C/p>\n      \u003C/div>\n    \u003C/div>\n  \u003C/section>\n\n  \u003Csection class=\"drug-material-section\">\n    \u003Cdiv class=\"drug-material-subtitle-bg\">\n      \u003Ch2 class=\"drug-material-subtitle\" style=\"color: rgb(44, 62, 80); margin: 1.2em 0px 0.6em; font-weight: 700; border-bottom: 1px solid rgb(238, 238, 238);\">10 临床主要数据与参考 \u003Cspan>📚\u003C/span>\u003C/h2>\n    \u003C/div>\n    \u003Cp class=\"drug-material-text\">\n      临床研究表明，紫杉醇类化疗药物在标准方案下，骨髓抑制发生率高达60%\u003Csup>[1]\u003C/sup>；免疫检查点制剂相关的肝功能异常风险约15%-30%之间\u003Csup>[2]\u003C/sup>。实际应用时，这类药品需结合个体代谢特点配合动态监测。\n    \u003C/p>\n    \u003Cp class=\"drug-material-ref-title\">关键参考文献：\u003C/p>\n    \u003Cul class=\"drug-material-ref-list\">\n      \u003Cli>\n        \u003Cspan>Schmid, P. et al. “Taxanes in Cancer Treatment: Mechanisms of Action, Resistance and Toxicity.” \u003Ci>Anticancer Research\u003C/i>, 2012, 32(8): 2915–2925.\u003C/span>\n      \u003C/li>\n      \u003Cli>\n        \u003Cspan>Postow, M.A., Chesney, J., et al. “Nivolumab and Ipilimumab versus Ipilimumab in Untreated Melanoma.” \u003Ci>New England Journal of Medicine\u003C/i>, 2015, 372:2006-2017.\u003C/span>\u003C/li>\u003C/ul>\u003C/section>\n\u003C/div>\n\n\u003Cstyle>\n.drug-material-container {\n  max-width: 820px;\n  margin: 0 auto;\n  background-color: #f4f9f7;\n  font-family: 'Helvetica Neue', Helvetica, Arial, 'PingFang SC', '微软雅黑', '宋体', sans-serif;\n  border-radius: 18px;\n  box-shadow: 0 5px 28px rgba(100, 120, 140, .10);\n  padding: 48px 32px 38px 32px;\n}\n\n.drug-material-title {\n  font-size: 2.1em;\n  font-weight: 600;\n  text-align: center;\n  color: #26a899;\n  letter-spacing: 2px;\n  padding-bottom: 12px;\n  margin-bottom: 35px;\n}\n\n/* 子标题背景 */\n.drug-material-subtitle-bg {\n  background: linear-gradient(90deg, #e3f7f4 70%, #d3ede7 100%);\n  border-radius: 9px;\n  padding: 23px 0 21px 20px;\n  margin-bottom: 18px;\n  margin-top: 18px;\n}\n\n.drug-material-subtitle {\n  font-size: 1.35em;\n  font-weight: 500;\n  color: #27927c;\n  margin: 0;\n  letter-spacing: 1px;\n  display: flex;\n  align-items: center;\n}\n\n.drug-material-section {\n  margin-bottom: 38px;\n}\n\n/* 正文文本样式 */\n.drug-material-text {\n  font-size: 1.08em;\n  color: #266059;\n  margin-bottom: 22px;\n  line-height: 1.9;\n}\n\n/* 列表样式 */\n.drug-material-list {\n  margin-left: 20px;\n  margin-bottom: 7px;\n  padding-left: 15px;\n  color: #317567;\n  font-size: 1em;\n}\n.drug-material-list li {\n  margin-bottom: 8px;\n  line-height: 1.7;\n  list-style-type: '⦿ ';\n}\n\n/* 案例样式 */\n.drug-material-case-list {\n  margin-top: 13px;\n  margin-bottom: 8px;\n  padding-left: 5px;\n}\n.drug-material-case {\n  background: #e8f7f3;\n  border-radius: 8px;\n  font-size: 1em;\n  color: #345d58;\n  margin-bottom: 12px;\n  padding: 14px 18px 13px 15px;\n  display: flex;\n  align-items: flex-start;\n}\n.drug-material-case-icon {\n  font-size: 1.35em;\n  margin-right: 13px;\n  filter: grayscale(20%);\n}\n\n/* 参考文献样式 */\n.drug-material-ref-title {\n  font-weight: 600;\n  color: #2ca49d;\n  margin-bottom: 10px;\n  font-size: 1.05em;\n}\n.drug-material-ref-list {\n  border-left: 4px solid #59c9bb;\n  padding-left: 16px;\n  margin-left: 4px;\n  color: #356771;\n  font-size: 0.97em;\n}\n.drug-material-ref-list li {\n  margin-bottom: 8px;\n}\n\n@media screen and (max-width: 900px) {\n  .drug-material-container {\n    max-width: 99%;\n    padding: 17px 5% 12px 5%;\n  }\n  .drug-material-title {\n    font-size: 1.25em;\n  }\n}\n\u003C/style>\n","\u003Cdiv class=\"drug-material-container\">\n  \u003Ch2 id=\"material_title\" class=\"drug-material-title\" style=\"c",530,"2025-09-18 16:08:41","肛管恶性黑色素瘤, 免疫治疗, 化疗, 药物使用指南, 不良反应, 药物相互作用, 监测, 特殊人群","本指南提供免疫治疗与化疗药物的使用方法，含主要成分、作用机制及注意事项，适用肛管恶性黑色素瘤患者，助您科学用药，降低不良反应。","2025-09-30 06:30:00",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","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},[],[]]