Henderson Simone
Dent Update. 2014 May;41(4):342-4. doi: 10.12968/denu.2014.41.4.342.
Patients with primary adrenal insufficiency (Addison's disease) lack the endogenous steroid hormones cortisol and aldosterone and require daily steroid therapy (usually hydrocortisone and fludrocortisone) to replace them. These patients are unable to adapt physiologically to stress and may need supplemental steroid therapy when having dental procedures, to prevent adrenal crisis. This paper provides guidance on dental procedures for which steroid supplementation may be required in patients with primary adrenal insufficiency and gives advice on doses and timing of supplementation. It does not address the management of patients with secondary adrenal insufficiency caused by long-term use of high doses of steroids. This document is for guidance only. Patients with primary adrenal insufficiency should be assessed individually as steroid requirements will vary.
Although patients with primary adrenal insufficiency (Addison's disease) are invariably very well informed about their steroid requirements prior to a dental procedure, dental staff should have an understanding of the steroid supplementation that may be required.
原发性肾上腺皮质功能减退症（艾迪生病）患者缺乏内源性类固醇激素皮质醇和醛固酮，需要每日进行类固醇治疗（通常为氢化可的松和氟氢可的松）来替代它们。这些患者无法在生理上适应应激状态，在进行牙科手术时可能需要补充类固醇治疗，以预防肾上腺危象。本文针对原发性肾上腺皮质功能减退症患者可能需要补充类固醇的牙科手术提供指导，并就补充剂量和时间给出建议。本文不涉及长期使用高剂量类固醇导致的继发性肾上腺皮质功能减退症患者的管理。本文件仅作指导之用。原发性肾上腺皮质功能减退症患者应进行个体评估，因为类固醇需求会有所不同。
尽管原发性肾上腺皮质功能减退症（艾迪生病）患者在进行牙科手术前通常对其类固醇需求非常了解，但牙科工作人员仍应了解可能需要的类固醇补充情况。
