多囊卵巢综合征青少年的护理：多学科诊所的发展和处方模式。
Care for Adolescents With Polycystic Ovary Syndrome: Development and Prescribing Patterns of a Multidisciplinary Clinic.
机构信息
(1)Department of Surgery, Division of Dermatology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Department of Pediatrics, Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
出版信息
J Pediatr Adolesc Gynecol. 2021 Oct;34(5):617-625. doi: 10.1016/j.jpag.2021.02.002. Epub 2021 Mar 29.
STUDY OBJECTIVE
Based on updated guidelines and expressed patient needs, we created a multidisciplinary clinic including endocrinology, gynecology/adolescent medicine, dermatology, psychology, and nutrition to provide comprehensive care to adolescent girls with polycystic ovary syndrome (PCOS). We describe the patient population presenting to this clinic, and prescribing patterns when a multidisciplinary approach is used.
DESIGN
Retrospective chart review.
SETTING
Tertiary care hospital.
PARTICIPANTS
Female patients, aged 11-24 years, presenting for initial assessment in a multidisciplinary PCOS clinic.
INTERVENTIONS
None.
MAIN OUTCOME MEASURES
Medical history, physical examination findings, laboratory measurements and prescribed therapies.
RESULTS
A total of 92 patients seen from 2014 to 2018 are described (age 15.9 years, range 11-24 years, body mass index 35.6 kg/m, range 19.9-53.5). Metabolic syndrome features were common: 26% had a prediabetes hemoglobin A1c (>5.6%), 83% had a high-density lipoprotein (HDL) <50 mg/dL, 40% had a systolic blood pressure >120 mm Hg, and 43% had an alanine aminotransferase level of >30 U/L. Dermatologic findings included acne 93%, hirsutism 38%, acanthosis nigricans 85%, hidradenitis suppurativa 16%, and androgenic alopecia 2%. Of the patients, 33% had a diagnosis of depression or anxiety, 16% of patients had a diagnosis of obstructive sleep apnea, and an additional 59% had symptoms warranting a sleep study The most commonly prescribed medications were topical acne preparations (62%), followed by estrogen-containing hormonal therapy (56%) and metformin (40%).
CONCLUSION
In adolescents with PCOS and obesity, metabolic, dermatologic, and psychologic co-morbidities are common. The use of a multidisciplinary clinic model including dermatology in addition to endocrinology, gynecology, psychology, and lifestyle experts provides care for most aspects of PCOS.
研究目的
根据最新指南和患者的需求，我们创建了一个多学科诊所，包括内分泌科、妇科/青春期医学、皮肤科、心理学和营养科，为患有多囊卵巢综合征（PCOS）的青春期女孩提供全面的护理。我们描述了就诊于该诊所的患者人群，并介绍了多学科方法的处方模式。
设计
回顾性病历分析。
地点
三级保健医院。
参与者
年龄在 11-24 岁之间的女性患者，因多囊卵巢综合征就诊于多学科诊所进行初步评估。
干预措施
无。
主要观察指标
病史、体格检查结果、实验室测量值和规定的治疗方法。
结果
共描述了 2014 年至 2018 年间就诊的 92 名患者（年龄 15.9 岁，范围 11-24 岁，体重指数 35.6kg/m，范围 19.9-53.5）。代谢综合征的特征很常见：26%的患者糖化血红蛋白（HbA1c）>5.6%（提示糖尿病前期），83%的高密度脂蛋白（HDL）<50mg/dL，40%的收缩压>120mmHg，43%的丙氨酸氨基转移酶水平>30U/L。皮肤科表现包括痤疮 93%、多毛症 38%、黑棘皮症 85%、化脓性汗腺炎 16%和雄激素性脱发 2%。33%的患者被诊断为抑郁或焦虑，16%的患者被诊断为阻塞性睡眠呼吸暂停，另有 59%的患者有睡眠研究指征。最常开的药物是局部痤疮制剂（62%），其次是含雌激素的激素治疗（56%）和二甲双胍（40%）。
结论
患有肥胖症的多囊卵巢综合征青少年中，代谢、皮肤和心理合并症很常见。多学科诊所模式的应用包括皮肤科，以及内分泌科、妇科、心理学和生活方式专家，为多囊卵巢综合征的大多数方面提供了护理。
Zotero 插件