季節性過敏性結膜炎如何進行藥物治療
發布時間:2022-07-23

季節性過敏性結膜炎


季節性(xing)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)性(xing)結膜炎(yan)(seasonal allergic conjunctivitis,SAC),有對單(dan)價(jia)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)原(yuan)(yuan)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)者(zhe)(單(dan)純對某(mou)一種過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)原(yuan)(yuan)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min),如單(dan)獨對塵(chen)螨(man)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min),或(huo)單(dan)獨對春季花(hua)粉(fen)(fen)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)等),也有對多價(jia)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)原(yuan)(yuan)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)者(zhe)(對兩(liang)種及兩(liang)種以(yi)上的過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)原(yuan)(yuan)同時(shi)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min),如對塵(chen)螨(man)和蟑螂同時(shi)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min),或(huo)對春季花(hua)粉(fen)(fen)、夏秋季花(hua)粉(fen)(fen)和霉菌混(hun)合同時(shi)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)等)。研(yan)究結果顯示,以(yi)花(hua)粉(fen)(fen)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)原(yuan)(yuan)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)陽性(xing)比例最高(gao),春季花(hua)粉(fen)(fen)及秋季花(hua)粉(fen)(fen)兩(liang)者(zhe)比例相當;以(yi)多價(jia)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)原(yuan)(yuan)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)為主合并呼(hu)吸道(dao)過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)性(xing)疾病(bing),如過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)性(xing)鼻炎(yan)(allergic rhinitis,AR)、人過(guo)(guo)(guo)(guo)敏(min)(min)(min)(min)(min)(min)(min)性(xing)哮喘(allergic asthma,AA)也較(jiao)為常見。

疾病表現


季(ji)節性(xing)(xing)過(guo)敏(min)性(xing)(xing)結(jie)膜炎主要表現為(wei)難以忍受(shou)的瘙癢,可有(you)灼(zhuo)燒感(gan)、異物感(gan)畏光、流淚等,可在(zai)數分鐘內迅速水(shui)腫、結(jie)膜充血、出現漿液性(xing)(xing)分泌物,可同(tong)時伴發(fa)(fa)過(guo)敏(min)性(xing)(xing)鼻炎或哮喘的發(fa)(fa)作,可雙眼同(tong)時發(fa)(fa)病,一般(ban)不累及角膜。脫離過(guo)敏(min)原(yuan)時,癥狀(zhuang)可在(zai)數小(xiao)時內消失,不留痕跡;再(zai)次接觸過(guo)敏(min)原(yuan)時,可立即(ji)發(fa)(fa)作。

治療原則

01

避免接觸過敏原。

02

局部抗過敏治療:

  1. 血管收縮劑:如復方萘(nai)甲唑啉滴(di)眼液,每(mei)(mei)日3~4次,每(mei)(mei)次1滴(di);萘(nai)敏維(wei)滴(di)眼液,每(mei)(mei)日3次,每(mei)(mei)次1滴(di)。

  2. 抗組(zu)胺藥物(wu):如依(yi)美斯汀滴眼液,每日2次,每次1滴。

  3. 肥大細胞穩定劑:如色甘酸鈉(na)滴眼液,每(mei)日4次(ci),每(mei)次(ci)1滴。

  4.  皮質類(lei)固醇:主要用于重癥(zheng)患(huan)者,如1%潑尼松(song)龍(long)滴眼(yan)(yan)液(ye),每(mei)(mei)日2~4次(ci),每(mei)(mei)次(ci)1滴;0.1%氟米松(song)龍(long)滴眼(yan)(yan)液(ye),每(mei)(mei)日2~4次(ci),每(mei)(mei)次(ci)1滴。該(gai)類(lei)藥物治(zhi)療期間,應監測眼(yan)(yan)壓(ya),避免激素性青光眼(yan)(yan)或(huo)繼發(fa)感染(ran)。

03

口服抗組胺藥物,如氯苯那敏,每(mei)日3次(ci)(ci),每(mei)次(ci)(ci)4mg;氯雷他(ta)定,每(mei)日1次(ci)(ci),每(mei)次(ci)(ci)5mg,體重小于30kg者每(mei)次(ci)(ci)2.5mg。服(fu)用該(gai)類(lei)藥物期間,應避免駕(jia)駛車輛、管理機器和高空作業。