# 一名7歲持續性氣喘兒童的父母擔心長期吸入budesonide會影響生長。哪個回答最正確？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391773&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一名7歲持續性氣喘兒童的父母擔心長期吸入budesonide會影響生長。哪個回答最正確？

## 選項

1. 「應改用高劑量口服類固醇以避免生長問題。」
2. 「吸入型皮質類固醇可能使成人最終身高小幅降低約1-2 cm；會監測生長速度並使用最低有效劑量。」 **✔ 正確答案**
3. 「立即停藥以保護身高。」
4. 「吸入型皮質類固醇不會影響生長。」

**正確答案: 2**

## 解析

正解 (2): ICS在第一年可能造成輕微生長速度下降，最終成人身高約減少1-2 cm，遠小於未控制氣喘或全身性類固醇的危害。每次門診監測生長速度並使用最低有效劑量。(1) 影響存在但小。(3) 口服類固醇抑制更強。(4) 停藥會導致氣喘控制惡化。

## 深入解析

Memory Tip 兒童ICS：生長影響小，但效益大於風險。每次量身高、使用最低有效劑量並加spacer。

## 臨床情境

Scenario 7歲兒童因持續性氣喘使用budesonide 180 mcg BID。父母在門診追蹤時詢問生長影響。

## 重要概念

- **生長速度** — 每年身高增加速度；兒童ICS使用者需追蹤。
- **兒童ICS劑量** — 最低有效劑量原則；控制穩定時可降階。
- **全身性與吸入性類固醇** — 口服/IV全身性類固醇比治療劑量吸入型造成更強HPA與生長抑制。

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