腎上腺功能障礙患者與類固醇治療 返回 醫療衛教 發表醫師 黃茂栓 發佈日期2010/02 /18 自體免疫性疾病患者多半接受類固醇(steroid)的治療，必須注意長期服用 類固醇所造成腎上腺皮質功能不足的問題，如噁心、想吐、身體虛弱，體重減輕。 皮質功能亢進(Chushing' s syndrome)可以看到如月亮臉、肥胖、肌肉耗弱， 多髮及易瘀青，傷口不易癒合且易感染。腎上腺髓質功能亢進則造成腎上腺素過 度分泌，造成高血壓臨床表現。 而有腎上腺功能障礙與類固醇治療之患者，至牙科就醫時應注意事項： 1. 腎 上 腺 皮 質 功 能 亢 進 ， 由 於 容 易 傷 口 感 染 ， 術 前 投 以 抗 生 素 做 預 防 (prophylaxis)。 髓質功能亢進，先量病人血壓，若是過高，先會內科醫師。若是血壓在正常範 圍，盡量以減輕壓力來舒緩病人緊張程度，並以不含腎上腺素之局部麻藥麻 醉，施行手術。 腎上腺皮質功能衰退之患者，多半有接受類固醇治療。所以正在服用類固醇的患 者，手術當日服用雙倍藥量，第二天則恢復正常藥量。對於停藥沒超過一年的病 人，手術當日及術後第一、二日給予60 mg hydrocortisone，第三、四日降至 40mg，第五、六日再降到 20mg。於第七日停藥。
腎上腺功能障礙患者與類固醇治療
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