{"id":35047,"date":"2024-05-27T04:01:03","date_gmt":"2024-05-27T04:01:03","guid":{"rendered":"https:\/\/zydq.1006ss.com\/?p=35047"},"modified":"2024-05-27T04:01:03","modified_gmt":"2024-05-27T04:01:03","slug":"%e9%98%b5%e5%8f%91%e6%80%a7%e4%ba%a4%e6%84%9f%e7%a5%9e%e7%bb%8f%e8%bf%87%e5%ba%a6%e5%85%b4%e5%a5%8b%e7%bb%bc%e5%90%88%e5%be%81","status":"publish","type":"post","link":"http:\/\/zydq.1006ss.com\/?p=35047","title":{"rendered":"\u9635\u53d1\u6027\u4ea4\u611f\u795e\u7ecf\u8fc7\u5ea6\u5174\u594b\u7efc\u5408\u5f81"},"content":{"rendered":"<p>\u81ea\u4e3b\u795e\u7ecf\u529f\u80fd\u969c\u788d\u5305\u62ec\u4ea4\u611f\u795e\u7ecf\u3001\u526f\u4ea4\u611f\u795e\u7ecf\u548c\u80c3\u80a0\u9053\u795e\u7ecf\u53d7\u7d2f\uff0c\u8868\u73b0\u4e3a\u5fc3\u8840\u7ba1\u529f\u80fd\u969c\u788d\u3001\u4f53\u6e29\u8c03\u8282\u969c\u788d\u3001\u6392\u6c57\u969c\u788d\u3001\u80c3\u80a0\u9053\u529f\u80fd\u969c\u788d\u3001\u8180\u80f1\u529f\u80fd\u969c\u788d\u7b49\u3002\u672c\u8282\u91cd\u70b9\u4ecb\u7ecd\u81ea\u4e3b\u795e\u7ecf\u529f\u80fd\u969c\u788d\u4e2d\u6700\u4e3a\u5371\u91cd\u7684\u9635\u53d1\u6027\u4ea4\u611f\u795e\u7ecf\u8fc7\u5ea6\u5174\u594b(paroxysmal sympathetic hyperactivity,PSH)\u7efc\u5408\u5f81\u3002<\/p>\n<p>\u5b9a\u4e49\u4e25\u91cd\u83b7\u5f97\u6027\u8111\u635f\u4f24\u5e78\u5b58\u60a3\u8005\uff0c\u53ef\u51fa\u73b0\u540c\u6b65\u3001\u9635\u53d1\u3001\u77ed\u6682\u4ea4\u611f\u795e\u7ecf\u6d3b\u52a8\u589e\u5f3a\u7684\u4e00\u7ec4\u7efc\u5408\u5f81\uff0c\u8868\u73b0\u4e3a\u5fc3\u52a8\u8fc7\u901f\u3001\u8840\u538b\u589e\u9ad8\u3001\u547c\u5438\u52a0\u5feb\u3001\u4f53\u6e29\u589e\u9ad8\u3001\u51fa\u6c57\u589e\u52a0\u548c\u8fd0\u52a8\u59ff\u52bf\u969c\u788d(\u8eaf\u4f53\u8fc7\u4f38\u3001\u808c\u5f20\u529b\u969c\u788d)\u7b49\u3002\u8bca\u65ad\u8981\u70b9\u6839\u636ePSH\u8bc4\u4f30\u91cf\u8868(paroxysmal sympathetic hyperactivity assessment measure,PSH-AM)\u8fdb\u884c\u8bca\u65ad\u3002PSH-AM\u75312\u4e2a\u72ec\u7acb\u7ed3\u6784\u7ec4\u6210\u30021.\u4e34\u5e8a\u7279\u5f81\u8bc4\u5206(clinical feature scale,CFS)\u7528\u4e8e\u5206\u6790\u662f\u5426\u5b58\u5728\u80be\u4e0a\u817a\u7d20\u80fd\u548c\u8fd0\u52a8\u6d3b\u52a8\u8fc7\u5ea6\uff0c\u4ee5\u53ca\u4e25\u91cd\u7a0b\u5ea6(\u8868-1)\u3002<\/p>\n<p>\u8868-1 &nbsp;\u9635\u53d1\u6027\u4ea4\u611f\u795e\u7ecf\u8fc7\u5ea6\u5174\u594b\u8bc4\u4f30\u91cf\u8868(PSH-AM)<\/p>\n<\/p>\n<p>B:\u8bca\u65ad\u53ef\u80fd\u6027\u8bc4\u4f30\u5de5\u5177(DLT):\u6bcf\u98791\u5206\u6025\u6027\u9885\u8111\u75be\u75c5\u4e4b\u540e\u4e34\u5e8a\u8868\u73b0\u540c\u6b65\u51fa\u73b0\u4e34\u5e8a\u8868\u73b0\u5448\u53d1\u4f5c\u6027\u6b63\u5e38\u975e\u75bc\u75db\u523a\u6fc0\u8fc7\u5ea6\u53cd\u5e94\u53d1\u4f5c\u671f\u65e0\u526f\u4ea4\u611f\u795e\u7ecf\u5174\u594b\u8868\u73b0\u8fde\u7eed\u53d1\u4f5c\uff1e3\u65e5\u8111\u635f\u4f242\u5468\u540e\u4ecd\u6709\u53d1\u4f5c\u6bcf\u65e5\u53d1\u4f5c&gt;2\u6b21\u65e0\u5176\u4ed6\u75c5\u56e0\u53ef\u4ee5\u89e3\u91ca\u6309\u5176\u4ed6\u75be\u75c5\u6cbb\u7597\u65e0\u6548\u5df2\u7ecf\u4f7f\u7528\u6291\u5236\u4ea4\u611f\u795e\u7ecf\u5174\u594b\u836f\u7269<\/p>\n<p>C:\u8bc4\u5206\u5206\u6790<\/p>\n<\/p>\n<p>2.\u8bca\u65ad\u53ef\u80fd\u6027\u8bc4\u4f30\u5de5\u5177(diagnosis likelihood tool,DLT)\u7528\u4e8ePSH\u8bca\u65ad\u7684\u53ef\u80fd\u6027\u5206\u6790\u3002\u76d1\u6d4b\u4e0e\u6cbb\u7597<\/p>\n<p>1.\u4e3b\u8981\u76d1\u6d4b\u6307\u6807&nbsp; &nbsp; &nbsp;\u5e38\u89c4\u76d1\u6d4b\u4f53\u6e29\u3001\u547c\u5438\u3001\u5fc3\u7387\u3001\u8840\u538b\u3001\u51fa\u6c57\u3001\u59ff\u52bf\u5f02\u5e38\u7b49\uff0c\u95f4\u65ad\u4e88\u4ee5PSH-AM\u8bc4\u5206\u3002<\/p>\n<p>2.\u6cbb\u7597\u65b9\u6cd5PSH\u6cbb\u7597\u539f\u5219\u5305\u62ec\uff1a\u2460\u907f\u514d\u5f15\u8d77\u53d1\u4f5c\u7684\u5404\u79cd\u8bf1\u56e0\uff1b\u2461\u51cf\u8f7b\u4ea4\u611f\u795e\u7ecf\u8fc7\u5ea6\u5174\u594b\uff1b\u2462\u901a\u8fc7\u652f\u6301\u6027\u6cbb\u7597\u51cf\u8f7bPSH\u5bf9\u5668\u5b98\u7cfb\u7edf\u529f\u80fd\u5f71\u54cd\u3002\u7531\u4e8e\u836f\u7269\u9884\u9632\u5bf9\u7ec8\u6b62PSH\u53d1\u4f5c\u7684\u6548\u679c\u5e76\u4e0d\u786e\u5207\uff0c\u56e0\u6b64\u901a\u5e38\u91c7\u7528\u591a\u79cd\u836f\u7269\u7ec4\u5408\u7684\u6cbb\u7597\u65b9\u6848\uff0c\u4ee5\u53d1\u6325\u76f8\u4e92\u8865\u5145\u7684\u4f5c\u7528\u3002<\/p>\n<p>(1)\u907f\u514d\u8bf1\u56e0\uff1aPSH\u60a3\u8005\u6240\u7ecf\u5386\u5927\u591a\u6570\u53d1\u4f5c(\u7ea680%)\u90fd\u662f\u5916\u90e8\u523a\u6fc0\uff0c\u5982\u75bc\u75db\u3001\u566a\u58f0\u3001\u5f3a\u5149\u3001\u5c3f\u6f74\u7559\u3001\u8eab\u4f53\u79fb\u52a8\u6240\u81f4\u3002\u56e0\u6b64\uff0c\u9700\u5c3d\u65e9\u53d1\u73b0\u548c\u5c3d\u53ef\u80fd\u7ec8\u6b62\u523a\u6fc0\u3002(2)\u963f\u7247\u7c7b\u836f\u7269\uff1a\u5417\u5561\u901a\u8fc7\u8c03\u8282\u53c2\u4e0e\u53d1\u4f5c\u7684\u4e2d\u67a2\u901a\u8def\u800c\u975e\u9547\u75db\u4f5c\u7528\u8fbe\u5230\u63a7\u5236\u75c7\u72b6\u7684\u76ee\u7684\uff0c\u53ef\u4f5c\u4e3a\u4e00\u7ebf\u836f\u7269\u7528\u4e8ePSH\u53d1\u4f5c\u671f\uff0c\u6291\u5236\u60a3\u8005\u7684\u8d85\u654f\u53cd\u5e94\uff1b\u7528\u836f\u65b9\u6cd5\uff1a1~10mg,\u9759\u8109\u63a8\u6ce8\u3002\u82ac\u592a\u5c3c\u8d34\u7247\u4e5f\u53ef\u7528\u4e8e\u9884\u9632\u6216\u7ec8\u6b62PSH\u53d1\u4f5c\uff0c\u7528\u836f\u65b9\u6cd5\uff1a12~100\u03bcg\/h,\u8d34\u5242\u5916\u7528\u3002\u901a\u5e38\u963f\u7247\u7c7b\u836f\u7269\u6cbb\u7597\u7684\u6301\u7eed\u65f6\u95f4\u53d6\u51b3\u4e8ePSH\u75c7\u72b6\u7684\u6301\u7eed\u65f6\u95f4\u548c\u4e25\u91cd\u7a0b\u5ea6\uff0c\u5c3d\u7ba1\u4e34\u5e8a\u533b\u751f\u60f3\u7aed\u529b\u907f\u514d\u957f\u671f\u4f7f\u7528\u963f\u7247\u7c7b\u836f\u7269\uff0c\u4f46\u8fd9\u4e00\u6cbb\u7597\u5f80\u5f80\u9700\u8981\u5ef6\u7eed\u5230\u5eb7\u590d\u9636\u6bb5\u3002(3)a\u2082\u53d7\u4f53\u6fc0\u52a8\u5242\uff1a\u901a\u8fc7\u4e2d\u67a2\u548c\u5916\u5468\u6291\u5236\u80be\u4e0a\u817a\u7d20\u80fd\u91ca\u653e\u51cf\u8f7bPSH\u3002\u53ef\u4e50\u5b9a\u53ef\u964d\u4f4e\u5faa\u73af\u4e2d\u7684\u513f\u8336\u915a\u80fa\uff0c\u4ece\u800c\u63a7\u5236\u5fc3\u7387\u548c\u8840\u538b\uff0c\u4f46\u5bf9\u4f53\u6e29\u7684\u63a7\u5236\u6548\u679c\u4e0d\u4f73\uff1b\u7528\u836f\u65b9\u6cd5\uff1a100\u03bcg,\u6bcf8~12\u5c0f\u65f6\u53e3\u670d\u4e00\u6b21\uff0c\u53ef\u9010\u6e10\u6ef4\u5b9a\u5230\u6bcf\u65e51200\u03bcg\u3002\u4f46\u662f\uff0c\u53ef\u4e50\u5b9a\u53e3\u670d\u5236\u5242\u5bf9PSH\u60a3\u8005\u53ef\u80fd\u4e0d\u5408\u9002\uff0c\u5bb9\u6613\u5f15\u8d77\u53d1\u4f5c\u95f4\u671f\u4f4e\u8840\u538b\u548c\u5fc3\u52a8\u8fc7\u7f13\u3002\u7136\u800c\uff0c\u53ef\u4e50\u5b9a\u8d34\u7247\u53ef\u6709\u6548\u63a7\u5236\u4ea4\u611f\u98ce\u66b4\uff0c\u7528\u836f\u65b9\u6cd5\uff1a\u6bcf\u5468\u4e00\u8d34\u5916\u7528\uff0c\u9996\u6b21\u5242\u91cf2.5mg,\u6bcf\u5468\u8c03\u6574\u4e00\u6b21\uff0c\u6bcf\u6b21\u589e\u52a02.5mg,\u6700\u5927\u5242\u91cf7.5mg\u3002\u53f3\u7f8e\u6258\u54aa\u5b9a\u5bf9PSH\u4e5f\u6709\u6cbb\u7597\u4f5c\u7528\uff0c\u7528\u836f\u65b9\u6cd5\uff1a\u9759\u8109\u6cf5\u6ce8\uff0c0.2~0.7\u03bcg\/(kg\u00b7h)\u3002(4)\u975e\u9009\u62e9\u6027\u03b2\u53d7\u4f53\u963b\u6ede\u5242\uff1a\u666e\u8418\u6d1b\u5c14\u662f\u6700\u5e38\u7528\u7684\u03b2\u53d7\u4f53\u963b\u6ede\u5242\uff0c\u5177\u6709\u4eb2\u8102\u6027\u4f18\u52bf\uff0c\u53ef\u901a\u8fc7\u8840\u8111\u5c4f\u969c\uff0c\u76f4\u63a5\u4f5c\u7528\u4e8e\u4e2d\u67a2\u795e\u7ecf\u7cfb\u7edf\u3002\u4e0e\u5176\u4ed6\u03b2\u53d7\u4f53\u963b\u6ede\u5242\u6bd4\u5bf9\uff0c\u91c7\u7528\u666e\u8418\u6d1b\u5c14\u6cbb\u7597\u7684\u60a3\u8005\u75c5\u6b7b\u7387\u66f4\u4f4e\uff1b\u7528\u836f\u65b9\u6cd5\uff1a20~60mg,\u6bcf4~6\u5c0f\u65f6\u53e3\u670d\u4e00\u6b21\u3002\u6b64\u5916\uff0c\u03b2\u53d7\u4f53\u963b\u6ede\u5242\u8fd8\u53ef\u4ee5\u964d\u4f4ePSH\u60a3\u8005\u7684\u4ee3\u8c22\u7387\u3002\u9009\u62e9\u6027\u03b2\u53d7\u4f53\u963b\u6ede\u5242(\u5982\u7f8e\u6258\u6d1b\u5c14)\u53ef\u80fd\u4e0d\u5982\u975e\u9009\u62e9\u6027\u03b2\u53d7\u4f53\u963b\u6ede\u5242\u6709\u6548\u3002(5)\u795e\u7ecf\u8c03\u8282\u5242\uff1a\u6eb4\u9690\u4ead\u4e3a\u591a\u5df4\u80faD\u2082\u53d7\u4f53\u6fc0\u52a8\u5242\uff0c\u53ef\u964d\u4f4ePSH\u60a3\u8005\u4f53\u6e29\u548c\u51fa\u6c57\uff0c\u7528\u836f\u65b9\u6cd5\uff1a1.25mg,\u6bcf12\u5c0f\u65f6\u53e3\u670d\u4e00\u6b21\uff0c\u9010\u6e10\u589e\u81f3\u6700\u5927\u5242\u91cf40mg\/d\u3002\u5df4\u6c2f\u82ac\u662f\u810a\u9ad3\u6291\u5236\u6027\u4e2d\u95f4\u795e\u7ecf\u5143\u7684GABA\u53d7\u4f53\u6fc0\u52a8\u5242\uff0c\u53ef\u7528\u4e8e\u96be\u6cbb\u6027PSH\u60a3\u8005\uff0c\u7528\u836f\u65b9\u6cd5\uff1a100mg,\u6bcf8\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