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--> 00:02.877\n嗯。\n\n00:04.790 --> 00:05.290\n大家好，\n\n00:05.540 --> 00:05.941\n嗯，\n\n00:05.991 --> 00:14.241\n今天我们科普的一个主要内容是妊娠期呼吸疾病一个管理。\n\n00:18.402 --> 00:20.302\n人些呼呼吸疾病的一个管理，\n\n00:20.702 --> 00:25.452\n那么我们主要从以下几个方面来阐述。\n\n00:32.217 --> 00:34.467\n就是一个是妊娠期的，\n\n00:34.667 --> 00:35.068\n嗯。\n\n00:36.130 --> 00:37.580\n呼吸疾病的概述，\n\n00:37.979 --> 00:38.354\n嗯，\n\n00:38.354 --> 00:41.130\n妊娠期安全用药的一个原则，\n\n00:41.680 --> 00:44.930\n妊娠期常见呼吸疾病及用药指导，\n\n00:45.630 --> 00:48.880\n妊娠期特殊药物的使用注意事项，\n\n00:49.229 --> 00:49.580\n嗯，\n\n00:49.580 --> 00:52.529\n还有妊娠期呼吸疾病管理策略。\n\n00:53.881 --> 00:54.006\n嗯，\n\n00:54.006 --> 00:54.680\nPart one,\n\n00:54.680 --> 00:57.430\n部分就是妊娠期呼吸疾病的概述，\n\n00:57.881 --> 01:00.430\n那么常见的呼吸疾病的类型呢，\n\n01:00.831 --> 01:01.930\n支气管哮喘，\n\n01:03.131 --> 01:04.680\n慢性阻塞性肺疾病。\n\n01:07.504 --> 01:11.855\n那个呼吸道的感染以及这个肺炎。\n\n01:13.727 --> 01:21.127\n支气管哮喘就是表现为反复发作的喘息气急胸闷或者咳嗽等症状，\n\n01:21.277 --> 01:24.178\n常见夜间以及凌晨发作和加重。\n\n01:25.428 --> 01:30.178\n慢性阻塞性肺疾病具有进行性发展的肌肉受限特征，\n\n01:30.377 --> 01:33.277\n包括慢性支气管炎和肺气肿，\n\n01:33.578 --> 01:40.527\n上呼吸道感染就如感冒流感等常见症状包括鼻塞、流涕、咽痛咳嗽等等。\n\n01:40.977 --> 01:43.828\n肺炎就是他可能出现了发热咳嗽。\n\n01:44.010 --> 01:45.459\n呼吸困难等症状，\n\n01:45.809 --> 01:47.910\n严重时他可能危及母婴生命。\n\n01:49.448 --> 01:49.799\n那么，\n\n01:49.799 --> 01:51.749\n妊娠期药物代谢的特点，\n\n01:51.999 --> 01:53.749\n一个药物吸收的增加，\n\n01:53.948 --> 01:55.999\n孕妇胃肠道功能增强，\n\n01:56.299 --> 01:58.149\n药物吸收速度加快，\n\n01:58.799 --> 02:00.499\n还有药物分布的变化。\n\n02:00.598 --> 02:02.899\n由于孕妇体内血容量增加，\n\n02:03.448 --> 02:05.598\n药物分布容积随之增加，\n\n02:05.698 --> 02:07.549\n药物浓度相对降低，\n\n02:07.799 --> 02:09.348\n还药物代谢加速，\n\n02:09.548 --> 02:11.748\n孕妇肝脏代谢功能增强，\n\n02:12.399 --> 02:14.248\n药物代谢的速度加快，\n\n02:14.498 --> 02:16.048\n药物半衰期缩短，\n\n02:16.548 --> 02:19.848\n药物的排泄增加孕妇的肾脏负担。\n\n02:19.908 --> 02:21.557\n加重药物的排泄量，\n\n02:21.557 --> 02:23.908\n增加可能影响药物疗效。\n\n02:24.358 --> 02:24.682\n嗯，\n\n02:24.682 --> 02:25.408\nPart two,\n\n02:25.557 --> 02:27.557\n妊娠期安全用药原则，\n\n02:28.057 --> 02:29.658\n遵循医嘱的重要性，\n\n02:30.408 --> 02:31.557\n一咨询医生，\n\n02:31.908 --> 02:38.057\n妊娠期妇女在使用任何药物前都应咨询医生或者药师获取专业的指导。\n\n02:38.358 --> 02:38.757\n嗯，\n\n02:38.858 --> 02:39.432\n第二点，\n\n02:39.432 --> 02:40.507\n严格遵医嘱，\n\n02:41.007 --> 02:44.557\n按照医生开具的剂量和用药方式使用药物，\n\n02:44.757 --> 02:45.858\n不随意更改。\n\n02:46.257 --> 02:46.996\n第三点，\n\n02:46.996 --> 02:47.858\n定期产检，\n\n02:47.957 --> 02:49.807\n他能够及时发现药物。\n\n02:49.916 --> 02:51.716\n可能对胎儿产生的不良影响，\n\n02:52.466 --> 02:54.565\n避免自行购买和服用药物，\n\n02:55.716 --> 02:57.115\n即便是非处方药，\n\n02:57.315 --> 02:59.916\n它也有可能对胎儿造成不良影响，\n\n03:00.016 --> 03:01.966\n因此是不能够随意使用的。\n\n03:02.466 --> 03:02.865\n还有，\n\n03:02.865 --> 03:04.266\n网络信息是不可靠的，\n\n03:04.315 --> 03:08.416\n你避免要根据网络上的信息自行购买和服用药物，\n\n03:08.416 --> 03:10.016\n以免产生严重后果。\n\n03:10.365 --> 03:11.815\n药物的相互作用，\n\n03:11.865 --> 03:15.065\n多种药物同时使用可能产生相互作用，\n\n03:15.065 --> 03:18.416\n增加风险和了解药物对胎儿的影响。\n\n03:19.001 --> 03:19.951\n药物分级，\n\n03:20.102 --> 03:22.451\n了解药物对胎儿的危害等级，\n\n03:22.552 --> 03:26.102\n尽量避免使用高风险药物制剂。\n\n03:26.102 --> 03:26.701\n敏感期，\n\n03:27.102 --> 03:28.352\n在妊娠的早期，\n\n03:28.352 --> 03:29.751\n尤其是前3个月，\n\n03:30.201 --> 03:31.751\n尽量避免使用药物，\n\n03:31.751 --> 03:34.302\n这是胎儿器官发育的重要时期。\n\n03:34.751 --> 03:35.151\n还有，\n\n03:35.151 --> 03:39.102\n长期或大量使用药物可能对对小胎儿造成累积性的伤害，\n\n03:39.201 --> 03:40.302\n应该特别注意。\n\n03:45.955 --> 03:49.654\n思部分妊娠期常见呼吸疾病及用药指导，\n\n03:50.205 --> 03:51.505\n那么哮喘的诊断，\n\n03:51.705 --> 03:53.104\n预防与治疗方法，\n\n03:53.255 --> 03:54.955\n诊断就是根据症状，\n\n03:54.955 --> 03:58.354\n体征和肺功能检查等确定哮喘的诊断，\n\n03:58.505 --> 04:00.505\n必要时要进行过敏原检测。\n\n04:00.804 --> 04:01.830\n预防措施呢，\n\n04:01.830 --> 04:03.154\n避免接触过敏源，\n\n04:03.354 --> 04:05.054\n保持室内空气清新，\n\n04:05.054 --> 04:07.005\n避免烟雾和空气污染等。\n\n04:07.255 --> 04:08.154\n治疗方法，\n\n04:08.304 --> 04:12.054\n使用吸入性糖皮质激素和支气管扩张制剂，\n\n04:12.404 --> 04:15.654\n严重时需要口服或者静脉使用糖皮质激素。\n\n04:16.186 --> 04:21.235\n支气管炎的预防措施与家庭护理预防措施就加强锻炼，\n\n04:21.235 --> 04:22.385\n增强免疫力，\n\n04:22.436 --> 04:24.686\n避免吸烟和被动吸烟等等，\n\n04:24.835 --> 04:27.561\n家庭护理就保持室内空气湿润，\n\n04:27.561 --> 04:28.235\n多喝水，\n\n04:28.385 --> 04:29.436\n定期通风等，\n\n04:29.436 --> 04:31.385\n症状加重时需及时就医。\n\n04:31.786 --> 04:34.911\n肺炎早期识别注意出现发热，\n\n04:34.911 --> 04:35.485\n咳嗽，\n\n04:35.635 --> 04:38.085\n呼吸困难等症状需要及时就医，\n\n04:38.286 --> 04:41.885\n还要根据病原体选择合适的抗生素治疗，\n\n04:41.936 --> 04:43.085\n同时支持治疗，\n\n04:43.085 --> 04:43.411\n如痒，\n\n04:43.411 --> 04:43.985\n痒等等。\n\n04:44.335 --> 04:45.686\n过敏性鼻炎的日常。\n\n04:45.731 --> 04:46.682\n护理药物选择，\n\n04:46.932 --> 04:47.807\n日常护理，\n\n04:47.807 --> 04:49.131\n避免接触过敏源，\n\n04:49.481 --> 04:50.657\n保持鼻腔清洁，\n\n04:50.657 --> 04:52.282\n使用空气净化器等等。\n\n04:52.532 --> 04:54.932\n药物选择优先选择局部用药，\n\n04:55.032 --> 04:56.032\n如鼻喷剂，\n\n04:56.082 --> 04:58.282\n避免口服药物对胎儿的影响，\n\n04:58.631 --> 04:59.356\nPart four,\n\n04:59.356 --> 05:02.881\n部分就是妊娠期特殊药物使用注意事项。\n\n05:03.182 --> 05:05.631\n抗生素类药物使用指南第一，\n\n05:05.631 --> 05:07.082\n青霉素类比较安全，\n\n05:07.231 --> 05:08.782\n但仍需遵医嘱，\n\n05:08.832 --> 05:10.131\n注意过敏反应。\n\n05:10.731 --> 05:11.356\n第二点，\n\n05:11.356 --> 05:13.832\n头孢菌素类相对比较安全，\n\n05:13.832 --> 05:15.682\n但需注意与母乳喂养的。\n\n05:15.760 --> 05:16.459\n兼容性，\n\n05:16.609 --> 05:17.309\n第三点，\n\n05:17.309 --> 05:18.359\n氨基糖苷类，\n\n05:18.359 --> 05:19.510\n它有耳毒性，\n\n05:19.510 --> 05:20.709\n应该避免使用。\n\n05:21.010 --> 05:21.760\n第四点，\n\n05:21.760 --> 05:22.609\n磺胺类，\n\n05:22.709 --> 05:25.584\n它抑制新生儿黄疸和溶血性贫血，\n\n05:25.584 --> 05:29.510\n应避免使用解热镇痛类药物的安全性评估，\n\n05:29.660 --> 05:32.459\n阿司匹林它可能增加胎儿出血风险。\n\n05:32.660 --> 05:34.410\n妊娠晚期应该避免使用。\n\n05:35.410 --> 05:35.859\n第二，\n\n05:35.859 --> 05:38.160\n对乙酰氨基酚是相对比较安全的，\n\n05:38.260 --> 05:43.010\n但是应该注意这个剂量的控制。\n\n05:43.559 --> 05:43.959\n嗯，\n\n05:44.260 --> 05:44.984\n一般的话，\n\n05:44.984 --> 05:45.559\n它是间。\n\n05:45.776 --> 05:47.325\n间隔四到6小时用药，\n\n05:47.376 --> 05:50.876\n二二到四二十四小时内不超过四四次。\n\n05:50.876 --> 05:51.776\n吲哚美辛呢，\n\n05:51.776 --> 05:54.200\n它可能导致胎儿的动脉导管狭窄，\n\n05:54.200 --> 05:58.851\n应避免使用抗过敏药物的选择以及副作用监测啊，\n\n05:58.851 --> 05:59.700\n氯雷他定呢，\n\n05:59.700 --> 06:00.651\n相对安全，\n\n06:00.651 --> 06:02.526\n但需注意心肌等副作用。\n\n06:02.825 --> 06:03.825\n西替利嗪呢，\n\n06:03.825 --> 06:04.526\n相对安全，\n\n06:04.526 --> 06:06.376\n但需注意嗜睡等副作用。\n\n06:06.526 --> 06:08.300\n苯海拉明是可能致剂的，\n\n06:08.300 --> 06:11.075\n应该避免使用糖皮质激素类的药物。\n\n06:11.075 --> 06:12.251\n使用时机和剂量，\n\n06:12.251 --> 06:13.126\n使用时机呢，\n\n06:13.226 --> 06:14.851\n请在病情需要时使用，\n\n06:14.851 --> 06:15.726\n避免长期使用。\n\n06:15.779 --> 06:16.954\n用使用剂量呢，\n\n06:16.954 --> 06:17.630\n遵循医嘱，\n\n06:17.630 --> 06:18.880\n避免过量使用。\n\n06:18.980 --> 06:19.679\n注意事项，\n\n06:19.679 --> 06:22.380\n可能增加妊娠、糖尿病、高血压等风险，\n\n06:22.480 --> 06:23.929\n需要密切监测。\n\n06:25.665 --> 06:28.816\nPart的five部分就妊娠期呼吸疾病管理策略，\n\n06:29.915 --> 06:32.941\n保持良好的生活习惯和饮食习惯啊，\n\n06:32.941 --> 06:34.915\n孕妇应该完全戒烟，\n\n06:35.115 --> 06:37.066\n并且避免吸入二手烟，\n\n06:37.316 --> 06:38.966\n同时限制酒精摄入，\n\n06:38.966 --> 06:40.665\n以保护胎儿和自身健康。\n\n06:40.865 --> 06:41.216\n还有，\n\n06:41.216 --> 06:43.415\n孕妇应注意饮食营养均衡，\n\n06:43.466 --> 06:44.915\n多吃富含蛋白质，\n\n06:44.915 --> 06:46.765\n维生素和矿物质的食物，\n\n06:47.015 --> 06:47.665\n如鱼，\n\n06:47.665 --> 06:47.990\n肉，\n\n06:47.990 --> 06:48.278\n蛋，\n\n06:48.278 --> 06:48.566\n奶，\n\n06:48.566 --> 06:49.915\n蔬菜和水果等等。\n\n06:49.966 --> 06:50.365\n还有，\n\n06:50.365 --> 06:52.165\n孕妇保持充足的睡眠，\n\n06:52.365 --> 06:54.716\n应该保证每天有足够的睡眠时间，\n\n06:54.816 --> 06:56.015\n并究保持。\n\n06:56.108 --> 06:59.907\n左侧卧位有助于胎儿血液循环和自身呼吸的顺畅，\n\n07:00.407 --> 07:00.808\n嗯。\n\n07:04.033 --> 07:04.359\n那么，\n\n07:04.359 --> 07:05.617\n定时的一个检查，\n\n07:05.617 --> 07:07.734\n及时发现并处理异常情况，\n\n07:07.884 --> 07:08.933\n按时产检。\n\n07:09.134 --> 07:12.683\n孕妇应该按照医生的建议的时间表进行产检，\n\n07:12.834 --> 07:15.584\n及时发现并处理任何异常情况。\n\n07:15.884 --> 07:16.283\n嗯，\n\n07:16.283 --> 07:17.533\n关注呼吸症状，\n\n07:17.533 --> 07:20.033\n孕妇应该注意自身呼吸症状的变化，\n\n07:20.084 --> 07:22.484\n如呼吸困难、咳嗽、胸痛等等，\n\n07:22.484 --> 07:23.334\n及时就医，\n\n07:23.484 --> 07:24.808\n还要遵循医生指导。\n\n07:24.808 --> 07:26.984\n如果孕妇出现呼吸疾病症状，\n\n07:27.084 --> 07:29.259\n应该遵循医生的指导进行治疗，\n\n07:29.259 --> 07:31.484\n包括药物治疗和必要的检查，\n\n07:32.384 --> 07:32.783\n嗯。\n\n07:33.795 --> 07:36.145\n那就是我们今天分享的科普的内容，\n\n07:36.246 --> 07:39.346\n那么我将会再详细的补充一些内容。\n\n07:39.496 --> 07:40.846\n比如说像孕妇呢，\n\n07:40.846 --> 07:42.795\n她出现的流流感病毒感染，\n\n07:42.895 --> 07:46.770\n那么我们首选的药物就是奥司他韦75mg，\n\n07:46.770 --> 07:47.545\n每日两次，\n\n07:47.746 --> 07:48.696\n疗程5天。\n\n07:48.996 --> 07:51.895\n那么重症病例可以加倍的可以加倍剂量，\n\n07:51.895 --> 07:54.346\n那么可以疗程延长。\n\n07:54.346 --> 07:55.545\n但是注意事项啊，\n\n07:55.545 --> 07:57.596\n这次使用后它无需终止妊娠，\n\n07:57.846 --> 07:58.145\n嗯，\n\n07:58.145 --> 07:59.496\n但是妊娠的中晚期呢，\n\n07:59.496 --> 08:01.196\n需要进行胎儿的超声检查，\n\n08:01.496 --> 08:04.045\n发病的48小时之内开始。\n\n08:04.131 --> 08:05.532\n用药效果是最佳的，\n\n08:05.731 --> 08:07.807\n那么超过48小时的重症患者，\n\n08:07.807 --> 08:09.131\n他仍可以受益的。\n\n08:09.432 --> 08:11.082\n对于支原体肺炎的话，\n\n08:11.082 --> 08:12.631\n首选就是大环内酯类，\n\n08:12.631 --> 08:15.881\n比如阿奇霉素、红霉素等等的注意事项。\n\n08:15.881 --> 08:19.631\n但是克拉霉素是不能作为推荐使用的。\n\n08:20.131 --> 08:20.532\n嗯，\n\n08:20.682 --> 08:22.381\n那么比如说咳嗽症状，\n\n08:22.381 --> 08:24.631\n那么干咳可以选用右美沙芬，\n\n08:24.832 --> 08:27.082\n妊娠期的前三个月是禁用的。\n\n08:27.231 --> 08:31.532\n那么有痰可以选择对乙酰半胱氨酸、氨溴索等等。\n\n08:31.532 --> 08:34.081\n但是妊娠的前三个月也是。\n\n08:34.127 --> 08:38.728\n慎用的鼻塞流涕首选的是生理盐水冲洗鼻腔，\n\n08:38.877 --> 08:42.677\n症状严重的时候可以短时间使用一个减充血剂。\n\n08:43.278 --> 08:46.528\n对哮喘的急性发作吸入的糖皮质激素，\n\n08:46.528 --> 08:49.002\n那么布地奈德它是为B类药物，\n\n08:49.002 --> 08:49.978\n安全性较高，\n\n08:49.978 --> 08:50.927\n可作为首选。\n\n08:51.177 --> 08:52.778\n贝塔二受体激动剂，\n\n08:52.877 --> 08:57.578\n像沙丁胺醇特布他林等短效药物安全性较好，\n\n08:57.778 --> 08:59.940\n长效药物如福莫特罗，\n\n08:59.940 --> 09:02.328\n沙美特罗需要权衡利弊后使用，\n\n09:02.877 --> 09:03.278\n嗯，\n\n09:03.377 --> 09:04.078\n青霉素。\n\n09:04.140 --> 09:04.914\n类是抗菌药物，\n\n09:04.914 --> 09:07.489\n青霉素类头孢菌素是比较安全的，\n\n09:07.590 --> 09:09.989\n比如阿莫西林、头孢氨苄等等。\n\n09:10.090 --> 09:13.664\n大环内酯类阿奇霉素、红霉素为B类的药物，\n\n09:13.664 --> 09:15.039\n安全性也良好的，\n\n09:15.039 --> 09:16.065\n需要避免使用。\n\n09:16.065 --> 09:19.265\n比如说像左氧氟沙星这种喹诺酮类药物，\n\n09:19.265 --> 09:20.239\n或者四环素，\n\n09:20.239 --> 09:23.789\n比如说多西环素是可以影响胎儿发育的这些药物。\n\n09:24.356 --> 09:24.656\n对。\n\n09:26.356 --> 09:26.531\n那么，\n\n09:26.531 --> 09:27.632\n关于接种疫苗呢？\n\n09:27.632 --> 09:32.106\n孕妇她可以在妊娠的任何阶段接种三价或四甲的灭活流感疫苗。\n\n09:32.156 --> 09:34.706\n应该避免使用减毒活疫苗，\n\n09:34.956 --> 09:35.356\n嗯。\n\n09:42.564 --> 09:47.013\n所以它这个妊娠期呼吸道感染的病原体的范围啦，\n\n09:47.013 --> 09:49.164\n发病率与非妊娠患者相似。\n\n09:49.364 --> 09:50.963\n但是由于这个，\n\n09:50.963 --> 09:54.013\n孕期的呼吸道局部的防御能力它是降低的，\n\n09:54.064 --> 09:57.314\n以及清除呼吸道分泌物的能力也是下降的，\n\n09:57.414 --> 09:59.614\n加上处于一个免疫抑制的状态，\n\n09:59.814 --> 10:02.414\n所以说它更容易使感染加重，\n\n10:02.564 --> 10:04.814\n增加了不良妊娠结局的风险，\n\n10:05.064 --> 10:06.414\n必须重视诊治。\n\n10:06.713 --> 10:07.064\n嗯，\n\n10:07.064 --> 10:12.164\n尽管这个妊娠期呼吸系统感染的治疗原则与非孕期大致相同。\n\n10:12.263 --> 10:12.664\n但。\n\n10:12.728 --> 10:13.403\n是，\n\n10:13.403 --> 10:14.453\n必须，\n\n10:14.453 --> 10:18.677\n更加关注药物对母体和胎儿两方面的潜在影响。\n\n10:22.351 --> 10:22.601\n是。\n\n10:24.229 --> 10:24.429\n嗯，\n\n10:24.729 --> 10:28.479\n比如像这个青霉素类的药物当中的阿莫西林克拉维酸钾，\n\n10:28.528 --> 10:34.229\n它可能是与新生儿坏死性小小肠结肠炎的发病率增加相关性。\n\n10:34.278 --> 10:34.679\n嗯，\n\n10:34.679 --> 10:36.104\n应该有明确指征的时候，\n\n10:36.104 --> 10:37.379\n需要谨慎的使用。\n\n10:41.440 --> 10:41.565\n嗯，\n\n10:41.565 --> 10:43.739\n变速像克拉霉素为什么不能使用？\n\n10:43.739 --> 10:45.565\n那么就是眼动物研究它，\n\n10:45.565 --> 10:47.489\n发现它有致畸的反应，\n\n10:47.640 --> 10:48.739\n比如说恶裂啦，\n\n10:48.739 --> 10:49.789\n心血管畸形啊，\n\n10:49.789 --> 10:51.640\n以及胎儿生长受限等等。\n\n10:53.065 --> 10:54.166\n所以避免使用的。\n\n10:56.190 --> 10:57.414\n四环素类的也是，\n\n10:57.414 --> 11:00.239\n它是因为有对母亲有这个肝毒性的影响，\n\n11:00.289 --> 11:04.489\n可以透过胎盘导致药物在胎儿的骨与牙齿中蓄积，\n\n11:04.690 --> 11:07.414\n特别是中晚期妊娠的宫内暴露，\n\n11:07.414 --> 11:11.989\n导致乳牙永久性的变色和进入胎儿的肠管状骨，\n\n11:11.989 --> 11:13.690\n引起短暂性的生长抑制，\n\n11:13.690 --> 11:14.940\n所以也是避免使用的。\n\n11:18.041 --> 11:19.291\n我说像喹诺酮类的，\n\n11:19.291 --> 11:23.591\n因为它与发育中的胎胎儿出现软骨和骨毒性有关，\n\n11:23.692 --> 11:25.992\n所以说应该也是避免使用的。\n\n11:28.184 --> 11:28.385\n嗯。\n\n11:29.762 --> 11:30.062\n那么，\n\n11:30.062 --> 11:31.387\n急性的上呼吸道感染，\n\n11:31.387 --> 11:33.411\n它的治疗原则就是休息啦，\n\n11:33.411 --> 11:34.336\n多饮水呀，\n\n11:34.336 --> 11:36.211\n对症处理等等措施为主。\n\n11:36.461 --> 11:39.611\n它无需积极的抗病毒治疗和使用抗菌药物。\n\n11:39.961 --> 11:41.611\n那么就是，\n\n11:41.611 --> 11:44.736\n如果说需要适当的使用抗菌药物的话，\n\n11:44.736 --> 11:46.762\n那么就是选用口服的青霉素，\n\n11:46.861 --> 11:50.762\n就是第一第一代或第二代的头孢菌素或者大环内酯类等等。\n\n11:51.211 --> 11:52.187\n那么，\n\n11:52.187 --> 11:53.937\n急性气气管支气管炎，\n\n11:53.937 --> 11:55.312\n它通常是病毒感染，\n\n11:55.562 --> 11:58.236\n那么合并细菌感染可以选用阿莫西林。\n\n11:58.236 --> 11:59.562\n阿莫西林克拉维酸钾。\n\n12:00.239 --> 12:00.489\n嗯，\n\n12:00.539 --> 12:02.340\n如果不能耐受或者过敏，\n\n12:02.340 --> 12:04.265\n那考考虑支原体感染，\n\n12:04.265 --> 12:06.228\n那么应该选用大环内酯类。\n\n12:06.228 --> 12:11.090\n多数患者他就是口服口服服药即可。\n\n12:11.289 --> 12:11.614\n嗯，\n\n12:11.614 --> 12:13.114\n症状重的可以肌注啊，\n\n12:13.114 --> 12:14.739\n或者静脉静滴给药。\n\n12:15.552 --> 12:17.151\n还有社区获得性肺炎，\n\n12:17.502 --> 12:21.127\n社区获得性肺炎它主要是一个肺炎链球菌啦，\n\n12:21.127 --> 12:22.952\n肺炎支原体为主的，\n\n12:22.952 --> 12:26.802\n其中包括了金葡菌、流感嗜血杆菌、肺炎衣原体等等。\n\n12:27.202 --> 12:27.651\n那么，\n\n12:27.651 --> 12:29.877\n在寄存基础疾病的患者当中，\n\n12:29.877 --> 12:33.702\n还常见肺炎克雷伯杆菌、大肠杆菌等等。\n\n12:34.101 --> 12:34.502\n嗯，\n\n12:34.901 --> 12:37.851\n社区获得性肺炎的经验性抗感染治疗，\n\n12:37.851 --> 12:40.377\n一般是以贝塔的内酰胺类抗菌药物为主，\n\n12:40.377 --> 12:41.952\n或者联合大环内酯类。\n\n12:49.323 --> 12:49.573\n哎。\n\n12:55.802 --> 12:56.577\n在用药过程中，\n\n12:56.577 --> 12:58.401\n有几点需要大家特别注意，\n\n12:58.552 --> 13:00.702\n还有就是有一些是复方制剂，\n\n13:00.901 --> 13:04.901\n这些复方制剂当中是否有孕妈妈不能使用的药物成分，\n\n13:05.052 --> 13:07.502\n比如可待因、樟脑等，\n\n13:07.601 --> 13:09.452\n如果有他就不建议使用啦。\n\n13:09.502 --> 13:10.052\n另外，\n\n13:10.052 --> 13:14.351\n不同种类的一个复方感冒药有可能含有相同或者相似的成分，\n\n13:14.552 --> 13:16.577\n也是不推荐同时使用，\n\n13:16.577 --> 13:21.651\n或者与其他含有退热、镇咳、抗过敏成分的药物联合使用。\n\n13:24.742 --> 13:25.793\n还有妊娠的前三个月，\n\n13:25.793 --> 13:27.343\n一般很多药物都是禁用的。\n\n13:28.973 --> 13:29.174\n对。\n\n13:31.434 --> 13:35.784\n如果孕妈妈主要症状表现为剧烈的干咳或者少痰，\n\n13:36.135 --> 13:40.484\n那么按按常规剂量服用止咳药物右美沙芬是相对安全的选择。\n\n13:40.784 --> 13:41.885\n那么需要注意的是，\n\n13:41.885 --> 13:43.234\n头3个月是禁用的。\n\n13:43.385 --> 13:46.534\n如果孕妈妈表现为咳嗽并且伴有大量的痰液，\n\n13:46.684 --> 13:51.609\n建议优先选择可用于雾化吸入的乙酰半胱氨酸氨溴索的吸入剂，\n\n13:51.609 --> 13:52.585\n行缓解症状。\n\n13:52.885 --> 13:53.835\n口服药物呢，\n\n13:53.835 --> 13:54.559\n也也选择，\n\n13:54.559 --> 14:01.534\n也包括乙酰半胱氨酸、氨溴索溴己新、右美沙芬、愈创甘油米糖浆目。\n\n14:01.627 --> 14:04.278\n目前市面上有很多以上这些药物的口服剂型，\n\n14:04.328 --> 14:06.627\n大家可以根据实际情况进行选择。\n\n14:06.927 --> 14:08.377\n但在这里也需要注意，\n\n14:08.377 --> 14:11.153\n妊娠的前三个月禁用右美沙芬，\n\n14:11.153 --> 14:13.377\n愈创甘油醚糖浆。\n\n14:14.932 --> 14:17.107\n还有一些孕妈妈可能会出现鼻塞，\n\n14:17.107 --> 14:17.708\n打喷嚏，\n\n14:17.708 --> 14:18.632\n流鼻涕的症状，\n\n14:18.882 --> 14:21.982\n那么建议首选生理盐水冲洗鼻腔。\n\n14:22.232 --> 14:26.208\n如果症状很严重或者本身合并有过敏性鼻炎，\n\n14:26.208 --> 14:28.507\n可以选择口服氯雷他定治疗，\n\n14:28.507 --> 14:31.533\n氯雷他定相对来说还是比较安全的。\n\n14:33.697 --> 14:33.797\n嗯，\n\n14:33.797 --> 14:35.398\n那么就是，\n\n14:35.398 --> 14:37.348\n所以说这些，\n\n14:37.447 --> 14:41.898\n那个希望孕妈妈以及孕妈妈的家人在选择药物的时候，\n\n14:41.898 --> 14:44.197\n一定要看清楚药品的说明书，\n\n14:44.197 --> 14:45.348\n仔细甄别，\n\n14:45.697 --> 14:50.898\n要在医生的指导下合理的使用各种药物。\n\n14:51.047 --> 14:51.447\n嗯，\n\n14:51.547 --> 14:56.497\n那么就是以保护就是自身和胎儿的安全。\n\n14:56.497 --> 14:59.297\n我们今天的科普到此结束，\n\n14:59.297 --> 15:00.598\n谢谢大家。\n\n","v0347cg10004d60qba2ljht3f50ue040",905,916,"2026-01-24 20:48:04"," 妊娠期呼吸疾病管理指南 - 症状、治疗与预防措施  \n"," 妊娠期呼吸疾病,孕妇呼吸道感染,孕期感冒治疗,妊娠期哮喘管理,孕妇肺炎预防,孕期呼吸困难  \n"," 本文提供妊娠期呼吸疾病的全面管理指南，包括常见呼吸道感染、哮喘和肺炎的预防与治疗方法，帮助孕妇安全应对呼吸系统问题，保障母婴健康。了解孕期用药注意事项和症状识别技巧。","2026-02-25 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