Norris Mark L, Hiebert Jacqueline D, Katzman Debra K
Canadian Paediatric Society, Adolescent Health Committee, Ottawa, Ontario.
Paediatr Child Health. 2018 Dec;23(8):551-552. doi: 10.1093/pch/pxy133. Epub 2018 Nov 19.
One of the challenges faced by paediatric health professionals treating children and adolescents with anorexia nervosa (AN) is determining the specific weight needed to achieve physical, emotional and cognitive recovery. Clinicians and researchers have struggled to standardize process, methods and terminology around what is now referred to as the 'treatment goal weight' (TGW). This practice point summarizes recommendations drawn from common methods used to determine TGWs in children and adolescents with AN, which are based on both the evidence-based literature and expert consensus. An individualized approach to the determination of the TGW is offered, with some specifics for special clinical situations. Multiple factors inform the process of establishing a TGW for a child or adolescent with AN but individualized attention, especially to premorbid weights, heights, body mass index percentiles, and paediatric growth charts, is essential. The need for ongoing follow-up and regular reassessment in this population is also highlighted.
治疗患有神经性厌食症(AN)的儿童和青少年的儿科健康专业人员面临的挑战之一是确定实现身体、情感和认知恢复所需的具体体重。临床医生和研究人员一直在努力规范围绕现在所谓的“治疗目标体重”(TGW)的流程、方法和术语。本实践要点总结了从用于确定患有AN的儿童和青少年的TGW的常见方法中得出的建议,这些方法基于循证文献和专家共识。提供了一种确定TGW的个性化方法,并针对特殊临床情况给出了一些具体细节。确定患有AN的儿童或青少年的TGW的过程受多种因素影响,但个性化关注,尤其是对病前体重、身高、体重指数百分位数和儿科生长图表的关注至关重要。还强调了对这一人群进行持续随访和定期重新评估的必要性。