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--> 00:00.733\n这这，\n\n00:00.733 --> 00:03.457\n今天我们来讲一下儿童过敏性鼻炎啊。\n\n00:04.751 --> 00:05.251\n这个。\n\n00:06.183 --> 00:07.382\n儿童过敏性鼻炎呢，\n\n00:07.382 --> 00:10.182\n是一种常见的慢性炎症性疾病。\n\n00:10.432 --> 00:11.633\n在中国，\n\n00:11.633 --> 00:16.183\n0.18岁儿童的过敏性鼻炎患病率约为18.46%。\n\n00:18.089 --> 00:21.339\n就他这个患病率是有南北差异的啊，\n\n00:21.589 --> 00:25.688\n然后总的下来大概是这么个18点四六百分之。\n\n00:26.280 --> 00:26.479\n然后，\n\n00:26.479 --> 00:28.079\n过敏性鼻炎的症状呢，\n\n00:28.079 --> 00:32.080\n它包括这个鼻子痒、打喷嚏、流鼻涕和鼻塞。\n\n00:34.539 --> 00:36.339\n就过敏性鼻炎的危害呢，\n\n00:36.339 --> 00:38.888\n严重影响儿童的生活质量，\n\n00:38.988 --> 00:43.839\n导致疲劳、睡眠差、情绪改变、焦虑和学习障碍，\n\n00:43.938 --> 00:48.738\n并增加哮喘、过敏性结膜炎、鼻窦炎等共患病的风险。\n\n00:52.082 --> 00:53.231\n过敏性鼻鼻炎呢，\n\n00:53.231 --> 01:01.832\n它可以分为季节过敏性鼻炎、常年性过敏性鼻炎、轻度过敏性鼻炎和中重度过敏性鼻炎。\n\n01:03.313 --> 01:06.164\n那么我们来介绍一下鼻用糖皮质激素。\n\n01:09.115 --> 01:10.966\n这个鼻用糖皮质激素。\n\n01:12.569 --> 01:15.268\n是治疗过敏性鼻炎最有效的药物之一。\n\n01:16.091 --> 01:20.140\n是指南推荐儿童过敏性鼻炎的一线用药。\n\n01:21.001 --> 01:22.152\n它的种类有很多。\n\n01:23.165 --> 01:24.065\n比如布地奈德。\n\n01:25.850 --> 01:33.551\n丙酸倍氯米松、糠酸氟替卡松、丙酸氟替卡松、糠酸莫米松、曲安奈德等等。\n\n01:34.543 --> 01:34.918\n其中，\n\n01:34.918 --> 01:40.444\n布地奈德是唯一纳入世界卫生组织儿童基本药物目录的鼻用激素。\n\n01:41.858 --> 01:44.057\n这种鼻用糖皮质激素，\n\n01:44.057 --> 01:45.108\n它的特点是。\n\n01:46.356 --> 01:48.356\n鼻腔局部充分发挥作用，\n\n01:48.356 --> 01:50.481\n容易吸收适度的，\n\n01:50.481 --> 01:52.356\n有亲水性和亲脂性，\n\n01:52.405 --> 01:54.255\n透过粘液层速率快。\n\n01:54.983 --> 01:56.320\n受体亲和力高，\n\n01:56.320 --> 01:58.032\n鼻腔滞留时间长。\n\n01:59.011 --> 02:00.886\n不容易存留体内，\n\n02:00.886 --> 02:01.911\n导致副作用。\n\n02:02.663 --> 02:03.913\n因为它是局部用药。\n\n02:05.383 --> 02:07.032\n它的全身清除比较快，\n\n02:07.383 --> 02:09.082\n代谢产物活性低。\n\n02:10.106 --> 02:11.457\n生物利用度低，\n\n02:11.656 --> 02:12.656\n半衰期短，\n\n02:13.156 --> 02:14.906\n鼻腔外组织分布少。\n\n02:20.429 --> 02:21.029\n再一个是。\n\n02:22.382 --> 02:22.781\n但是呢，\n\n02:22.781 --> 02:27.082\n这个鼻用激素使用目前存在一些不规范的现象，\n\n02:27.531 --> 02:30.481\n比如说用药的时机不正确，\n\n02:30.682 --> 02:32.281\n用药的剂量不正确。\n\n02:33.119 --> 02:34.444\n用药的选择不正确，\n\n02:34.444 --> 02:35.843\n用药方法不正确，\n\n02:35.843 --> 02:37.518\n用药的疗程不正确。\n\n02:37.669 --> 02:40.169\n比如说有些家长会担心副作用，\n\n02:40.169 --> 02:41.819\n随意停药等等。\n\n02:43.882 --> 02:44.382\n那么。\n\n02:47.113 --> 02:49.613\n儿童鼻用激素怎么样合理用药呢，\n\n02:50.014 --> 02:53.714\n我们是首先推荐是要规范性的使用鼻用激素，\n\n02:53.964 --> 02:56.563\n在什么情况下可以使用鼻用激素呢，\n\n02:56.914 --> 03:02.264\n是第一个是临床上可用于所有类型过敏性鼻炎的治疗。\n\n03:03.309 --> 03:08.858\n第二个是首选用于儿童中重度间歇性或持续性过敏性鼻炎。\n\n03:09.949 --> 03:12.149\n用法、用量和疗程推荐。\n\n03:12.990 --> 03:20.341\n第一个是需要根据过敏性鼻炎的种类、严重程度及不同的阶段进行预防或按需治疗，\n\n03:20.541 --> 03:25.341\n第二个是接受鼻用激素治疗的儿童应使用最低有效剂量，\n\n03:25.341 --> 03:27.541\n并根据患儿具体情况进行调整。\n\n03:28.106 --> 03:30.106\n第三个是季节性过敏性鼻炎患儿，\n\n03:30.106 --> 03:31.507\n建议预防性用药。\n\n03:33.557 --> 03:35.533\n用药的年龄是绝大多数，\n\n03:35.533 --> 03:38.507\n上市的鼻用激素可用于12岁以上儿童，\n\n03:38.757 --> 03:42.358\n那么6岁以上的儿童可用激素为布地奈德。\n\n03:43.207 --> 03:47.057\n4岁以上的儿童可用激素为曲安奈德，\n\n03:47.406 --> 03:50.807\n3岁以上儿童可用激素为糠酸莫米松，\n\n03:51.057 --> 03:55.007\n两岁以上儿童可用激素为糠酸氟替卡松。\n\n03:58.048 --> 04:03.048\n那么这些就是比较安全的这种鼻用激素这种疗程，\n\n04:03.298 --> 04:05.173\n它这个怎么规范使用呢？\n\n04:05.173 --> 04:06.697\n就是分两种情况，\n\n04:07.048 --> 04:09.248\n一种是常年过敏性的鼻炎。\n\n04:09.951 --> 04:11.126\n常年过敏性鼻炎呢，\n\n04:11.126 --> 04:13.552\n它是分为发作期和缓解期。\n\n04:14.462 --> 04:18.111\n发作期的时候大约表现为一个呢，\n\n04:18.111 --> 04:20.361\n是表现为轻度的过敏性鼻炎。\n\n04:21.989 --> 04:23.463\n就是流涕啊，\n\n04:23.463 --> 04:24.289\n鼻塞这种，\n\n04:24.389 --> 04:25.889\n那么鼻用激素呢？\n\n04:25.889 --> 04:27.739\n我们推荐使用大于两周。\n\n04:29.006 --> 04:30.207\n然后再评估疗效。\n\n04:32.397 --> 04:32.796\n发作期，\n\n04:32.796 --> 04:34.546\n另一个就是发作比较重，\n\n04:34.546 --> 04:36.397\n就是中重度过敏性鼻炎，\n\n04:36.796 --> 04:38.897\n要使用降阶梯治疗方案。\n\n04:40.088 --> 04:41.537\n要单独或联合用药，\n\n04:41.537 --> 04:42.287\n大于两周。\n\n04:43.334 --> 04:46.433\n再一个就是中重度的这种过敏性鼻炎呢，\n\n04:46.433 --> 04:48.084\n它要逐渐减量使用，\n\n04:48.433 --> 04:51.433\n剂量的调整疗程要大于两周。\n\n04:53.296 --> 04:54.946\n在一个常年过敏性鼻炎，\n\n04:54.946 --> 04:55.997\n它的缓解期。\n\n04:57.192 --> 04:59.692\n我们就是要推荐按需治疗。\n\n05:00.570 --> 05:01.869\n就推荐剂量，\n\n05:01.970 --> 05:04.119\n使用一周后剂量调整。\n\n05:05.648 --> 05:06.722\n在缓解期的时候，\n\n05:06.722 --> 05:10.773\n小于12岁儿童无无临床医生指导下，\n\n05:10.773 --> 05:13.648\n不应每年连续使用大于两个月。\n\n05:17.192 --> 05:20.917\n因为它这个激素长期对儿童使用的话，\n\n05:20.917 --> 05:22.592\n可能会抑制它的生长。\n\n05:24.575 --> 05:28.376\n还会导致骨质疏松等一系列的这种激素性的问题。\n\n05:29.175 --> 05:29.550\n好，\n\n05:29.550 --> 05:32.776\n再一个应用用的是季节性过敏性鼻炎。\n\n05:34.768 --> 05:36.317\n这个季节性过敏性鼻炎，\n\n05:36.518 --> 05:38.618\n我们强调要预防使用，\n\n05:38.917 --> 05:40.618\n就是等这个，\n\n05:40.667 --> 05:42.317\n比如说秋冬换季前，\n\n05:42.317 --> 05:46.518\n在发作前的两到四周就要预防性应用了。\n\n05:47.197 --> 05:48.597\n那么应用。\n\n05:49.787 --> 05:50.537\n比这种。\n\n05:53.058 --> 05:53.259\n鼻，\n\n05:53.759 --> 05:54.808\n鼻用激素。\n\n05:56.042 --> 05:58.143\n可以有效的减轻。\n\n05:59.164 --> 06:00.463\n季节过敏性鼻炎。\n\n06:01.583 --> 06:04.583\n甚至避免季节性过敏鼻炎的发作。\n\n06:06.480 --> 06:06.605\n好，\n\n06:06.605 --> 06:10.080\n然后下面再讲一下这种鼻用激素的使用方法啊。\n\n06:11.122 --> 06:12.247\n使用前准备啊，\n\n06:12.247 --> 06:13.421\n首先要摇匀，\n\n06:14.171 --> 06:16.421\n摇匀然后再取瓶盖。\n\n06:18.397 --> 06:21.122\n第一次使用的时候有一个初始化动作啊，\n\n06:21.122 --> 06:22.446\n第一次使用的时候。\n\n06:23.174 --> 06:23.375\n嗯，\n\n06:23.524 --> 06:24.075\n还有。\n\n06:25.260 --> 06:26.910\n大于一周未使用时。\n\n06:28.407 --> 06:29.907\n第一次使用的时候要摇匀。\n\n06:30.546 --> 06:32.397\n然后要保持直立，\n\n06:32.747 --> 06:34.497\n瓶子直立塞到鼻孔里。\n\n06:35.399 --> 06:36.149\n清洁鼻孔后，\n\n06:36.149 --> 06:37.149\n然后按压。\n\n06:39.321 --> 06:39.596\n那呀，\n\n06:39.596 --> 06:40.071\n然后。\n\n06:41.183 --> 06:43.733\n再一个是大于一周未使用时。\n\n06:45.748 --> 06:48.348\n要注意这个清洁喷嘴后使用。\n\n06:50.989 --> 06:52.839\n然后要连续按压数次，\n\n06:52.839 --> 06:54.540\n直至看到细腻的喷雾。\n\n06:59.135 --> 07:03.334\n然后再讲一下这个喷药姿势的儿童喷药姿势的指导啊，\n\n07:03.334 --> 07:04.834\n首先要清洗双手。\n\n07:06.970 --> 07:07.170\n嗯，\n\n07:07.519 --> 07:10.220\n在第二步要擦鼻涕。\n\n07:11.587 --> 07:13.486\n把鼻腔清洁，\n\n07:13.786 --> 07:14.861\n鼻涕擦干净，\n\n07:14.861 --> 07:16.886\n创造一个干净的鼻腔。\n\n07:18.256 --> 07:18.705\n第三步，\n\n07:18.705 --> 07:20.980\n要把鼻用激素摇均匀。\n\n07:20.980 --> 07:24.881\n摇均匀喷药前先应将药液摇匀，\n\n07:24.881 --> 07:27.006\n确保喷出有效的喷雾。\n\n07:28.239 --> 07:29.489\n第四步是要垂直，\n\n07:29.789 --> 07:31.588\n头部微微向前倾斜，\n\n07:31.889 --> 07:35.389\n保持平与地面的垂直深度，\n\n07:35.739 --> 07:41.139\n将喷嘴要插入鼻孔中0.5.1.0cm处。\n\n07:43.028 --> 07:45.178\n再一个它这个方向要朝外侧，\n\n07:45.178 --> 07:48.428\n将喷嘴要朝向外眼角的方向喷。\n\n07:51.954 --> 07:55.354\n配合动作是喷药时的时候要配合轻轻的吸气，\n\n07:55.753 --> 07:57.854\n不要立即去擦这个鼻涕。\n\n08:00.343 --> 08:01.343\n这个连续喷药，\n\n08:01.343 --> 08:02.593\n注意时间间隔。\n\n08:02.794 --> 08:05.044\n如果每个鼻孔需要两喷，\n\n08:05.194 --> 08:08.044\n那么间隔2.3秒后再喷下一喷。\n\n08:10.088 --> 08:11.937\n喷完之后要清洁喷嘴，\n\n08:11.937 --> 08:14.912\n用清洁的布或纸巾擦净喷嘴，\n\n08:14.912 --> 08:16.388\n然后盖上防尘帽。\n\n08:18.875 --> 08:20.524\n好有一个注意事项啊。\n\n08:24.092 --> 08:26.041\n就是8岁以下的儿童呢，\n\n08:26.191 --> 08:29.291\n尽量在监护人的帮助下使用鼻用激素。\n\n08:30.472 --> 08:31.472\n就是有一些小朋友，\n\n08:31.472 --> 08:32.122\n他可能会。\n\n08:33.937 --> 08:34.888\n觉得这个很好玩，\n\n08:34.888 --> 08:37.588\n然后就喷的量有点大，\n\n08:38.038 --> 08:41.987\n所以我们要监护人爸爸妈妈要在旁边看一下啊。\n\n08:41.987 --> 08:44.288\n监护人要记录这个喷鼻的次数，\n\n08:44.487 --> 08:47.588\n不要超过鼻用激素最大喷的鼻次数。\n\n08:48.724 --> 08:51.575\n然后再一个是要定期清洁这个喷嘴。\n\n08:52.778 --> 08:55.578\n保证这个喷药量的准确。\n\n08:59.411 --> 09:03.161\n那么再讲一下这个儿童鼻用激素的安全性啊。\n\n09:05.689 --> 09:06.189\n可能有。\n\n09:07.341 --> 09:07.666\n哪些？\n\n09:07.666 --> 09:10.091\n它可能有哪些不良反应？\n\n09:11.695 --> 09:12.796\n一个是鼻部症状。\n\n09:13.973 --> 09:17.223\n不良反应多为轻度或中度的局部反应。\n\n09:18.215 --> 09:21.565\n鼻干燥、鼻烧灼感、鼻痒、鼻出血等。\n\n09:23.703 --> 09:23.903\n嗯，\n\n09:24.004 --> 09:27.304\n较罕见的严重并发症为鼻中隔穿孔。\n\n09:28.596 --> 09:31.096\n他这个其实这个用的时候这个。\n\n09:32.302 --> 09:34.177\n最常见的这种小朋友，\n\n09:34.177 --> 09:36.752\n这个鼻梁反应就是他会一喷的时候，\n\n09:36.752 --> 09:39.703\n他会觉得这个地这个有点刺激，\n\n09:39.853 --> 09:41.953\n所以要注意这个喷嘴，\n\n09:41.953 --> 09:43.002\n它要朝向外。\n\n09:45.161 --> 09:45.361\n嗯，\n\n09:45.861 --> 09:49.760\n再一个是这个鼻用激素对眼眼睛的影响啊。\n\n09:50.596 --> 09:55.346\n现在研究没有发现这个鼻用激素会增加儿童眼部疾病的风险啊。\n\n09:56.093 --> 09:56.356\n但是，\n\n09:56.356 --> 10:02.093\n对于这些有眼压升高啊、青光眼或者是这白内障病史的这种患儿，\n\n10:02.442 --> 10:03.393\n必须使用。\n\n10:03.492 --> 10:06.793\n使用时还是要密切监测相关的风险。\n\n10:09.145 --> 10:10.169\n然后对生长发育，\n\n10:10.169 --> 10:13.044\n就是鼻用激素对生长发育的时候，\n\n10:13.044 --> 10:14.445\n它的治疗剂量低，\n\n10:14.445 --> 10:17.294\n并且局部给要给儿童的生长发育。\n\n10:18.065 --> 10:19.866\n总体上无显著影响，\n\n10:20.366 --> 10:25.166\n但是治疗过程中仍需定期监测儿童身高等生长发育指标。\n\n10:27.812 --> 10:31.463\n那么鼻用激素使用过程中有一些注意事项啊？\n\n10:32.833 --> 10:35.684\n一个是要选择合适的鼻用激素。\n\n10:37.205 --> 10:37.455\n嗯，\n\n10:37.455 --> 10:40.229\n根据儿童的具体情况和医生的建议，\n\n10:40.229 --> 10:41.679\n选择合适的鼻用激素，\n\n10:41.679 --> 10:44.054\n并注意鼻用激素的辅料差异。\n\n10:44.937 --> 10:47.937\n对制剂、辅料存在过敏的患儿，\n\n10:47.937 --> 10:50.036\n注意鼻用激素品种的选择。\n\n10:52.434 --> 10:54.534\n第二个是规范使用鼻喷。\n\n10:55.463 --> 10:55.913\n寄宿。\n\n10:57.593 --> 10:59.992\n掌握正确的鼻腔喷药方法，\n\n10:59.992 --> 11:01.942\n避免朝向鼻中隔喷药。\n\n11:01.992 --> 11:02.418\n然后，\n\n11:02.418 --> 11:03.718\n像鼻中隔喷药的话，\n\n11:03.718 --> 11:07.343\n它它会感觉一个很刺激的一种冲击啊，\n\n11:07.343 --> 11:09.543\n所以小朋友有可能就会很抗拒。\n\n11:11.370 --> 11:11.620\n嗯。\n\n11:13.731 --> 11:16.182\n然后再一个就是上鼻中隔喷药，\n\n11:16.182 --> 11:17.831\n会引起这种鼻出血，\n\n11:17.831 --> 11:19.981\n或者是鼻中隔穿孔这种。\n\n11:20.723 --> 11:21.723\n这种发生的。\n\n11:22.661 --> 11:23.062\n风险，\n\n11:23.512 --> 11:24.661\n所以一定要这个，\n\n11:24.661 --> 11:26.312\n避免向鼻中隔喷药。\n\n11:27.054 --> 11:30.804\n第三个是定期监测身身高等生长发育指标。\n\n11:30.804 --> 11:36.005\n长期使用鼻用激素的宝宝需要定期监测身高等生长发育指标，\n\n11:36.304 --> 11:38.455\n确保药物的安全性。\n\n11:39.903 --> 11:43.254\n那么还有鼻用激素和其他药物连用的话。\n\n11:45.818 --> 11:47.468\n一个常见的连用术语。\n\n11:48.479 --> 11:49.880\n糖皮质激素联用。\n\n11:50.541 --> 11:51.892\n就是对于这种。\n\n11:53.434 --> 11:54.208\n过敏性鼻炎，\n\n11:54.208 --> 11:55.984\n而且伴有哮喘的这种。\n\n11:57.263 --> 11:57.812\n小朋友。\n\n11:58.565 --> 12:02.215\n我们需要采用这种鼻用及吸入糖皮质激素。\n\n12:03.434 --> 12:04.585\n联合治疗方案。\n\n12:06.684 --> 12:09.234\n第二个是是与生理盐水连用。\n\n12:10.447 --> 12:11.297\n及使用顺序，\n\n12:11.297 --> 12:13.697\n当两者连用联合使用的时候，\n\n12:13.697 --> 12:17.497\n使用鼻用激素前可以使用生理盐水洗鼻。\n\n12:17.848 --> 12:21.697\n洗鼻后10.15分钟后再使用鼻用激素。\n\n12:22.700 --> 12:24.151\n那你如果先使用激素，\n\n12:24.151 --> 12:25.500\n再使用生理盐水，\n\n12:25.500 --> 12:27.801\n就把那个激素都冲掉了。\n\n12:29.653 --> 12:29.802\n好，\n\n12:29.802 --> 12:32.103\n第三个就是与鼻用减轻，\n\n12:32.153 --> 12:33.903\n鼻用减轻。\n\n12:35.078 --> 12:38.127\n减鼻用减充血剂联合使用。\n\n12:39.039 --> 12:40.088\n鼻塞严重的时候，\n\n12:40.088 --> 12:42.039\n可以用那个联合用。\n\n12:42.978 --> 12:44.302\n鼻用减充血剂，\n\n12:44.302 --> 12:45.528\n如氟马滴鼻液。\n\n12:46.950 --> 12:49.676\n那么在使用减充血剂10分钟后，\n\n12:49.676 --> 12:51.000\n再使用鼻用激素。\n\n12:52.156 --> 12:54.806\n那个再一个像福麻滴鼻液，\n\n12:54.806 --> 12:59.205\n它的持续使用时间需要小于等于七天如。\n\n13:00.731 --> 13:03.081\n然后以避免其并发症。\n\n13:06.283 --> 13:06.484\n好的，\n\n13:06.484 --> 13:07.083\n有一些，\n\n13:07.434 --> 13:10.734\n还有一些关于鼻用激素的疑问啊。\n\n13:11.783 --> 13:12.007\n比如说，\n\n13:12.007 --> 13:16.632\n有些有些家长就问这个使用鼻用激素会不会影响孩子长高？\n\n13:16.982 --> 13:17.507\n那么，\n\n13:17.507 --> 13:19.182\n现在我们的研究发现，\n\n13:19.182 --> 13:21.432\n总体上是没有显著影响的啊。\n\n13:21.632 --> 13:22.882\n鼻用激素呢，\n\n13:22.882 --> 13:24.033\n它治疗剂量低，\n\n13:24.033 --> 13:25.833\n并且是局部给药。\n\n13:26.486 --> 13:29.887\n仅30%在鼻部通过毛细血管直接吸收。\n\n13:30.286 --> 13:32.336\n儿童对激素的敏感性呢，\n\n13:32.336 --> 13:33.336\n它低于成人，\n\n13:33.486 --> 13:37.536\n对进入体内激素代谢速度较成人快40%。\n\n13:38.708 --> 13:42.408\n这个研究发现大部分在国内上市的这种鼻用激素啊。\n\n13:43.901 --> 13:47.351\n没有发现其对儿童生长发有显著影响啊。\n\n13:48.982 --> 13:49.107\n嗯，\n\n13:49.107 --> 13:53.882\n但是仍建议治疗过程中定期监测儿童身高等生长发育指标。\n\n13:55.330 --> 13:55.679\n再一个，\n\n13:55.679 --> 13:56.580\n有的家长问，\n\n13:56.580 --> 13:59.429\n这个鼻喷激素一天中什么时间喷最好啊？\n\n13:59.929 --> 14:00.755\n鼻用激素，\n\n14:00.755 --> 14:02.429\n它如果是每日一次，\n\n14:02.429 --> 14:03.880\n推荐是早晨使用，\n\n14:03.979 --> 14:05.229\n如果每日两次，\n\n14:05.280 --> 14:08.330\n推荐早晚固定使用时间是各用一次。\n\n14:09.054 --> 14:11.955\n合并哮喘的患儿可在睡前食用。\n\n14:12.765 --> 14:16.015\n早晨用药与内源性激素分泌时间相对一致，\n\n14:16.015 --> 14:18.065\n对自身激素分泌抑制轻。\n\n14:19.018 --> 14:20.669\n哮喘经常夜间发病，\n\n14:20.818 --> 14:23.419\n因夜间体内自身激素水平最低，\n\n14:23.718 --> 14:27.693\n这时喷入或吸入激素对预防哮喘发作有积极作用，\n\n14:27.693 --> 14:30.919\n故建议合并哮喘患儿睡前食用。\n\n14:31.781 --> 14:32.781\n还有的家长问，\n\n14:32.781 --> 14:36.031\n这个鼻喷激素最多连续用多长时间啊？\n\n14:37.546 --> 14:40.846\n就是我们建议就是小于12岁的儿童。\n\n14:42.203 --> 14:42.403\n嗯，\n\n14:42.403 --> 14:45.453\n在问询医生的未咨询医师的情况下，\n\n14:45.453 --> 14:47.304\n建议每天使用鼻用激素，\n\n14:47.304 --> 14:49.754\n连续使用不要超过每年，\n\n14:49.804 --> 14:51.054\n不要超过两个月。\n\n14:52.914 --> 14:55.164\n要接受这个儿童，\n\n14:55.164 --> 14:56.864\n应该使用最低有效剂量，\n\n14:56.914 --> 14:59.713\n并根据小朋友的具体情况进行调整。\n\n15:01.129 --> 15:03.129\n就是还有一个最后一个问题是，\n\n15:03.129 --> 15:08.028\n宝宝只有春天花粉季过敏应该如何使用鼻喷激素啊？\n\n15:08.379 --> 15:11.379\n这种是属于季节性过敏性鼻炎啊。\n\n15:11.379 --> 15:17.379\n建议在春天过敏季节到来之前提前两到四周进行预防性使用。\n\n15:17.952 --> 15:19.552\n可起到有效减轻症状，\n\n15:19.552 --> 15:22.052\n甚至可以避免临床症状的发作啊，\n\n15:22.052 --> 15:22.601\n好的。\n\n15:23.286 --> 15:23.486\n嗯，\n\n15:23.835 --> 15:24.911\n就讲到这里啊，\n\n15:24.911 --> 15:25.486\n谢谢大家。\n\n","v0d47cg10004d7552aaljht067gr199g",929,640,"2026-01-29 00:01:12","儿童鼻喷激素用药指南：安全使用与注意事项  ","儿童鼻喷激素,鼻喷激素用药,过敏性鼻炎治疗,儿童鼻炎喷雾,激素喷雾副作用  ","本文详细解析儿童鼻喷激素的适用症状、正确使用方法及潜在副作用，帮助家长科学应对过敏性鼻炎，确保用药安全有效。","2026-06-11 15:12:58",[35],{"menuId":36,"menuName":37,"parentId":20,"orderNum":21,"path":38,"component":39,"isFrame":40,"isCache":41,"menuType":42,"visible":24,"status":20,"createDept":6,"remark":15,"createTime":43,"children":44,"columnImage":45,"columnLogo":46,"uncheckedLogo":6,"checkedLogo":6,"isHot":20,"isHome":20,"forceLogin":20,"color":6,"seoTitle":47,"seoKeywords":48,"seoDescription":49,"contentNum":6,"promotionalPoster":50,"menuFrame":7,"innerLink":7,"parentView":7,"routeName":51,"routerPath":38,"componentInfo":39},"1986622624134549505","科普视频","video","/video.html","1","0","T","2025-11-07 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