糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件

糖皮質(zhì)激素的圍術(shù)期應(yīng)用糖皮質(zhì)激素的圍術(shù)期應(yīng)用1目錄糖皮質(zhì)激素的來源和分類■糖皮質(zhì)激素的生理和藥理作用■圍術(shù)期應(yīng)用原則■藥物介紹目錄2腎上腺結(jié)構(gòu)與功能示意圖腎上腺球狀帶鹽皮質(zhì)激素束狀帶糖皮質(zhì)激素質(zhì)皮髓質(zhì)網(wǎng)狀帶性激素腎上腺結(jié)構(gòu)與功能示意圖3糖皮質(zhì)激素的分類按作用持續(xù)時間分類短效藥物(8-12h)氫化可的松和可的松中效藥物(12-36h)潑尼松、潑尼松龍、甲基潑尼松龍長效藥物(36-54h)地塞米松、倍他米松糖皮質(zhì)激素的分類4糖皮質(zhì)激素的結(jié)構(gòu)21CH2OH腎上腺皮質(zhì)激素的基本結(jié)構(gòu)甾核20c=018OHB必需基團(tuán):C3的酮基、C20的羰基及C4-5的雙鍵糖皮質(zhì)激素的結(jié)構(gòu)5糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件6糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件7糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件8糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件9糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件10糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件11糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件12糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件13糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件14糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件15糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件16糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件17糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件18糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件19糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件20糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件21糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件22糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件23糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件24糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件25糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件26糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件27糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件28糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件29糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件30糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件31糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件32糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件33糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件34糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件35糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件36糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件37糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件38糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件39糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件40糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件41糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件42糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件43糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件44糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件45糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件46糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件47糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件48糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件49糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件50糖皮質(zhì)激素的圍術(shù)期應(yīng)用糖皮質(zhì)激素的圍術(shù)期應(yīng)用51目錄糖皮質(zhì)激素的來源和分類■糖皮質(zhì)激素的生理和藥理作用■圍術(shù)期應(yīng)用原則■藥物介紹目錄52腎上腺結(jié)構(gòu)與功能示意圖腎上腺球狀帶鹽皮質(zhì)激素束狀帶糖皮質(zhì)激素質(zhì)皮髓質(zhì)網(wǎng)狀帶性激素腎上腺結(jié)構(gòu)與功能示意圖53糖皮質(zhì)激素的分類按作用持續(xù)時間分類短效藥物(8-12h)氫化可的松和可的松中效藥物(12-36h)潑尼松、潑尼松龍、甲基潑尼松龍長效藥物(36-54h)地塞米松、倍他米松糖皮質(zhì)激素的分類54糖皮質(zhì)激素的結(jié)構(gòu)21CH2OH腎上腺皮質(zhì)激素的基本結(jié)構(gòu)甾核20c=018OHB必需基團(tuán):C3的酮基、C20的羰基及C4-5的雙鍵糖皮質(zhì)激素的結(jié)構(gòu)55糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件56糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件57糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件58糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件59糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件60糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件61糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件62糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件63糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件64糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件65糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件66糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件67糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件68糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件69糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件70糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件71糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件72糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件73糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件74糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件75糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件76糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件77糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件78糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件79糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件80糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件81糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件82糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件83糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件84糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件85糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件86糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件87糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件88糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件89糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件90糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件91糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件92糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件93糖皮質(zhì)激素圍術(shù)期合理應(yīng)用課件