使用先进疗法管理儿童肥胖：儿科保健提供者实用指南

English | 26 November 2023 | ISBN-10: 3031373790 | 427 pages| PDF (True) | 18 MB

Treatment of pediatric obesity, to date, has largely focused on lifestyle therapy. While lifestyle therapy is essential for obesity management, it is often insufficient, particularly for youth who have severe forms of the disease. Underlying the limitations of lifestyle therapy is the recognition that obesity is a biological disorder of the energy regulatory system and accordingly, to effectively manage obesity, the underpinning pathophysiology needs to be addressed. This pathophysiology can be targeted with more advanced therapies including anti-obesity medications and metabolic and bariatric surgery, two treatment strategies supported by the American Academy of Pediatrics.

Written by leading experts in the field, A Practical Guide to Managing Pediatric Obesity is comprised of thirteen chapters, each including suggested protocols and case examples. The first chapter details the complex pathophysiology of obesity and sets the stage for why advanced therapies are critical for effective obesity management. Chapter two provides guidance on best practices for communicating with patients and families about obesity. The next three chapters provide direction on how to do a comprehensive patient assessment, and employ dietary and physical activity interventions. The heart of this guidebook is the chapter on pharmacological treatments, which details the mechanisms of action, research results, and recommendations for anti-obesity medication selection and monitoring outlined in a step-by-step fashion. Pre- and post-operative care for the pediatric bariatric surgery patient is detailed in the next chapter. Assessment and management of behavioral and psychological complications, type 2 diabetes, non-alcoholic fatty liver disease, polycystic ovary syndrome, hypertension, and dyslipidemia are covered in the subsequent five chapters. Syndromic and monogenic obesity are discussed in the final chapter.

治疗儿童肥胖症，至今大都集中在生活方式疗法上。虽然生活方式疗法在肥胖管理中至关重要，但对于一些患有严重形式疾病的孩子来说往往不够充分。导致生活方式疗法局限的原因在于认识到肥胖是一种能量调节系统失调的生物性疾病，因此有效控制肥胖需解决其底层病理生理学问题。针对这一病理生理学，可以通过更先进的治疗方法，如抗肥胖药物和代谢及减肥手术等来进行干预。这些治疗策略得到美国儿科学会的支持。 由该领域专家撰写的《儿童肥胖症管理实用指南》包含十三章内容，每章均设有建议的诊疗方案和案例示例。第一章详细描述了肥胖的复杂病理生理机制，并阐明了为何先进的疗法对于有效管理肥胖至关重要。第二章提供了与患者及家庭沟通的最佳实践指导。接下来的三章介绍了如何进行全面的患者评估，并运用饮食和身体活动干预措施。此指南的核心内容在于药物治疗章节，该章节详述了以逐步方式展开的抗肥胖药物的作用机制、研究成果以及推荐选择及监测方法。随后一章详细阐述了儿童减肥手术患者的术前术后护理。五章接下来讨论了行为及心理并发症、2型糖尿病、非酒精性脂肪肝病、多囊卵巢综合征、高血压和脂质异常管理。最后一章则探讨了综合性和单基因肥胖症。 《实用指南》详细介绍了针对肥胖的药物治疗机制、研究结果以及用药选择与监测方法。同时，也包括了儿童减肥手术患者术前术后护理指导。此外还涵盖了行为及心理并发症、2型糖尿病、非酒精性脂肪肝病、多囊卵巢综合征、高血压和脂质异常管理等内容。最后，探讨了综合性和单基因肥胖症相关问题。

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