复旦大学：《儿科学》课程教学资源（PPT课件讲稿）第三讲 青春期医学概论

Introduction of Adolescent Medicine 青春期医学概论 Childrens hospital Fu Dan University 复旦大学附属儿科医院俞建

Adolescence Adolescence, puberty between childhood and adulthood feature stressful developmental major changes physical maturity sexuality cognitive认知 emotional feelings relationships with others Range: boy 11-19 girl 10-21

Adolescent Medicine Objective teenager juvenile youngster addressing identified health concerns 1. the complicated interactions of developmental changes on healthcare needs the effectiveness of treatment 3. health education 4. health promotion

Contents Preclinical Medicine Clinical Medicine Pedagogy or Education Psychology Hygiene Social Medicine Behavior medicine

Normal developmental period Puberty 1. Physiological basis 2. Development changes Sexual character by stages Physical build, constitution, statue Mentality behavior

Classification of Sex Maturity Stages in Girls Inner breast pubic hairs stages 乳房 阴毛 PI prepubertal BI PHI P2 early stage B2 PH2 P3 metaphase B3 PH3 P4 anaphase B4 PH4 P5 adult stage B5 PH5

Classification of Sex Maturity Stages in Boys Tanner Genitalia Pubic hairs stages 外生殖器 阴毛 PI prepubertal GI PHI None P2 early stage G2 PH2 Scanty, long, slightly pigmented pI P3 metaphase G3 PH3 Darker start to curl small in amount P4 anaphase G4 PH4 Resembles adult type less in quantity, curly P5 adult stage G5 PH5 adult distribution rhombus in shape

Precocious Puberty a Definition Onset of secondary sexual characteristics before &y in girls and 9Y in boys Global Incidence 0.6-1% boys girls =1 5 1998 Shanghai30,0001%

Classification and Conditions Causing Precocious Puberty True PP Pseudo, PP Incomplete P.P. 1. Idiopathic 1.Tumors 1. Premature thelarche 特发性(体质性) Ovarian T 单纯性乳房早发育 2. CNS Disorders Leydig cell T 2. Premature adrenarche *space-occupying 2. adrenal disorders 单纯性阴毛早现 esions *Congenital adrenal 3. Premature menarche congenital CNS hyperplasia 孤立性早潮 anomalies *Secondary adrenal pc postinfection or hyperplasia tramua *adrenal tumor 3. Hypothyroidism 3. GnRH induced Tumor 4. Exogenous sex hormones 5. McCune-Albright Syndrome

Gonadotrophin-dependent P.P. (True P.P.) Idiopathic P.P. Encephalic Tumor Congenital Hypothyroidism