ͯΪ*

ڣ2021-06-22 11:31:31

ʮ ͯھ*
Child and Adolescents Psychiatry

ҽƴѧҽѧ

һ עȱද*
? attention deficit and hyperactive disorderADHD

? ֳ֢ƶͯදۺ
Cָڶͯʱڣͬͯȣע ѡעʱݡȻ嶯ΪҪ һۺ

? һвѧ
CԼΪ3-5
Cк4-91 C1/24ǰ


? ? ֢IJ򼰷Ʋ壬йأ 1ŴأӼ飬˫ӼӵоʾֻŴ ءද֢һͯ껼жදΪ϶ĸ׻˫׻ද֢ ŮͬΣߡ˫ͬԸ˫˫ӡ 2ѧأ֢ϵͳӳٻڴƤʵľ Ѳ㡣ද֢ͯԵͼշλ(VEP)쳣ʸߡʾ֢ ѧ 3΢أǰΧԼԭ΢ˡӰ ϵͳĹܣɵעкͻȣԵӰ졣 4أ񾭵ʴлȱйأ ѪжͰȥعܵ£5-HTܿ 5أͥͽķʽӰ졣ͥ͡ĸѡ ĸʱӹ簮ξӶͯද֢Σԡ

?

? ? ? ?

? 6ӪأֻѪǦˮ*ߣѪпˮ*͡

ٴ֡
? 1ע*DZҪ֢״
C רΡҵҲIJɣģ̼תע̶ ߶ijЩȤĻض߶κλעɢ

?

2ó嶯
C СرöڼһУ˷ܶදܰΣС ࣬סؿõͼɣűˡ

C г嶯Եص㣬ҿ㣬˼ľٶ׼ 嶯˺ȣһЩС¾ͷƢк֡

?

3֪*ѧ*
C ֢*

C עкͻȶӰѧ*ѧҵද֢ ӡӡ˶ȱݣɷ汿׾Э

?

4Ϊ*
C ӸĸʦĹܶءܡż˵ѡѧؼɻ Ʒм⡣ C ֢

ġϺͼ
? һϱ׼ ? 1ʱ׼
C ѧǰ7꣩ٳ6¡

? 2֢״׼ͬʱ߱
C ע*ȡó嶯

C Ṧܣѧҵ˼ʹϵȣӰ졣

? 3ų׼
C ͡ C ͯ¶֢ C ͯھ񲡡 C * C Ʒ*

C ϵͳ

? м
? 1ͣ
C ¶ͯжද֢״Ҫ֢״ºӦȱݣ ѧ*ɼܴﵽϵˮ*ض߲ܽܽ жȴද֢߲ߣɷֱϡ

? 2֢ͯ
C ڿעСදΪı䣬С˼ά* Ȼ֢״

? 3Ʒ*
C ijЩƷ*ĶͯҲֲѧ*දͻԷ ġΥ׼ַ˺͹ķΪ


C ݻ߼ͥص㣬ȡԸĸĽѵԺӵ ƺҩϵۺƷ

? һԸĸĽѵͥƷ
C ѵԲȡͥСʽҪ

C мͥĸߣṩԸĸĽѵ
C ԻصĽн͹ C ĸעΪõİ C չͨļɣͻìܣԻӡͷ Ľ C ʹѧ*Ծԣ˷עɢͶද C źճϢʱ䣬õ*ߡ


? 1ΪƷòԭʱԻΪǿ ǿıΪģʽµЧΪ ? 2֪Ʒ嶯Ϊ⣬ѧ*ν⣬ ԼΪĺѡǡΪ ? 3оͳ(Sensatory integration therapy)

ҩ
? 1˷ܼƶද֢ѡҩ
C ߴ׼ֳ֣ritalin, ЧԼΪ75-80ʼ5mg/գ 40mg/աͼڸע߼ƶද嶯Ϊ⡣ C ֳƥĪ֣pemolineиι𺦡ʼ5mg/գ 100mg/ա C (amphetamine)ֳưü20mg/գ40mg/

C ˷ܼĸӦΪʳˡʹͷ衢ʧߵ֢״һر ɵҩʱ䣬緹ҩɼӦ

?

2࿹ҩ
C ѡ˷ܼЧϲ֢Ʒ*鶯*ʱѡá

C ҩУ֡ʼ 25mg/ գ bid ÿ 3-6 1mg/kgأ100mg/գƳ1ϣ

?

3 2-ȥ弤
C ֶ clonidine ںϲ鶯֢״ΪΥΪʧߵĶ ֢ߡ

ڶ Ʒ*conduct disorder
? ָͯ귴ֵij־õΥӦ ַ˻򹫹ΪΪΪͶ ΥΪƷ*Ʒ*ͶΥ* ? һвѧ
C 1.45-7.35%ԸŮ91߷13꣬иũ塣

C Ӣ4%6-16%

?
C 1ѧأŴо˫ӡĸԼˮ*5HTˮ*̵ͣͣΧڲ֢ C 2ͥأ⸸ĸ*͡Υ ӹϵʽĮޡӡֱŰݡ簮 ĸϵ־ӡ죩 C 3ỷأӴɫΧ˵IJȷ¹ۺͼֵۣ ̡ͬơܡթƭ͵ԡ

ٴ
C 1 ΪΥ¹淶׼򣩣ѧߡޡԡ ١ǿ顢Űˡݻ C 2 Ϊ˵ĹͶԲƲƻΪԹŮԣ ͶԹԣܡŰСмˡС  C 3 ΥΪ˵ѣΪӱܳͷǻܾ Ҫ涨Լʧˣ븸ĸʦԿ ˻Υ涨 C 4 ⣺ද֢ǡ׼ǣҲɰз* ̵͡˶Э

? ġ̺Ԥ
C ֻڸĸ졢תѧύ֮ͬ𽥷Ϊ⣬û ʱԤ𽥼سΪƷ*ԤԼչΪΥ ˸*


? һϣCCMD-3Ʒ*Ϊ֣
C 1Ʒ*ٴֵ123ϣ Ӱ˼ʹϵѧҵų*񾭾*
C 2ԿƷ*10£ûٴֵ123

? ϣ
C 1ද֢Եעȱݣ˷ܼҩЧ C 2ͣȷеºӦ֤ݡ

C 3֢þ롢˼ά*ҩЧ
C 4*ԵǺ͵䣬ҩЧ C 5 ϵͳˡʷ֢ʵҼɷ ϵͳ֤ݡ


? һ
C 1 ͥƣӹϵʽЭͥԱ֮Ĺϵ ͥ¼ĸΪ C 2 ΪƷǿΪΪģʽٽ ӦΪʽķչ C 3 ֪Ʒܺܺõǵ֪ȥֹΪij֣ ֪ƷҪǸı˼άʽ⡢ԭ򡢿ǺѰҽ İ취ӶٲʵΪij֡ C 4 ڹƷͨкǿ˽ȱͬ ģָ֧ˣע⣩

? ҩƣⲿֺϲ֢״
C 嶯ΪСȱມऴ* C ࣺߴ׼˷ܼ C ǣ

鶯*tic disorders
? 
C ָڶͯʱڣԲġĿġġٵһ λಿλ˶鶯ͷ鶯ΪҪһۺ

? һвѧ
C ԼΪ1-7жŮ3-41Է4-7ռ

?
C 1Ŵ C 2أͰȥء5ɫʧйء C 3أΧ(ˡϢ)йءĸijЩӦ ¼ﷴӦءӦ C 4أͯܵˡȽŵӰշس ֢״ C 5أ̷ȾߡijЩҩ(絨 ܼͿҩ)鶯*

ٴ
? ͬص㣺
C ⡢ͻ١ظͷǽԣ

C ־ƶʱݲ
C ̼ܵš弲Ӧ·Ƶ˯ʱ ֢״ʧ

? 1Գ鶯*ֳƳ鶯֢
C ٴ͡ C ҪΪ˶鶯գۡҧ¶ݡǡҡͷ ͷʼȲ鶯

C ΪԷĶַɤȡ

? 2˶鶯*
C 18ǰ C г鶯*˶鶯ͷ鶯ͬʱڣ C ֢״Բ䣬ɳꡢ

? 3˶ϳ鶯*
C ֳTourettes syndromeTSɳƳ鶯ۺ C 1825ItardTS֢״ C TSٴΪಿλʽֶ˶鶯ۡ濪ʼ չ֫壬ȫಿλĶ

C ɱΪ˶鶯գۡüתࡢࡢתͷ ʼ硢ͦȣ˶鶯̴š· סػ򷴸һϵĶ
C ͬʱֻȺַ鶯

C ̻չ֢״µ֢״ɵ֢״

ġϺͼ
? һ
C Ҫݲʷٴ飬ϸֱӹ۲鶯֢״һΪ֣ Ҫá鶯*ҽʦǰܶݿƳ鶯ױӶ ©

? 1Գ鶯*ϱ׼
C ͯꣻ
C ˶鶯鶯 C ۳鶯־ƶʱ(Сʱ) C ֢״ǿȻ鶯λԸı䣺 C ݲٳ1µ1ꣻ C ų׶ϵ񾭼ԭ⾷

?

2Touretteۺϱ׼
C 21ǰ2-15֮䣻

C иԡظġٵġĿij鶯Ӱ鼡⣻
C ۶ֳ鶯һַֻ鶯ͬʱijЩʱ򵫲һͬʱڣ C ־Сʱ C ܻ֢״ǿб仯

C ޳鶯ÿ췢Σˡ̳1ϣͬ1 ֢֮״ⲻ 2ϣ
C ųС赸֢ζ״˱ԡAηҩԴԲ˶׶ ϵ䡣

? 3˶鶯*ϱ׼
C (1)϶Գ鶯*Т١ڡ C (2)鶯ڳֶΣÿ˻ЪԳ֡ǿһɲ 䡣ڳ1ꡣ


C ԶԳ鶯*֢״߲Ϊҩƣ TS 鶯*ҩΪơ

? 1ҩơ
C 1 ऴЧ 70-80% ״μ 0.5-1mg/ գÿ 1-2 Σü 1-10mg/ա C 2̩Ч76-87%ü50-100 mg/գÿ2-3Σ

C 3 壺跢දЧã״μ 0.5-1mg/ գÿ 1-2 Σü 1-12mg/ա
C 4ֶЧ50-86% 2-弤ȥ صĺϳͷţʼΪ 0.05mg գÿ 2-3 Σü 0.050.075mgաãɳʧ

? ?

2
C ͥơ֪ƺΪƣ*תѵ

3
C TouretteۺλҶԵϵͳԡСԵȡ

*
? ԣ12꣬Сѧ꼶ѧϿעСѧ
*׶԰𼴿ʼöסܰ »򿴵ӡ6ѧԺʦӳϿСࡢ סעСдҵҲдҪ ˶ٲɣҾĴģ ࡢ廰²磬ȶΪС¶Ƣѧ*ɼ 6070֡

? ⣺
C 1ϣ C 2ԭʲô C 3ҩƵѡҩ

*
? ԣ10꣬Сѧ꼶ѧۡ졢
ǰԭּۡʱǡ죬 ʼ֢״ϳ֣һǰ֢״Ƶ֣ͬʱʼ硢 ֫ͻȻ鶯ȡ*һ֢꣬״⣬ֳƵ ͻȻк·ʱʱ¶ףӰѧ֢״Ըпգ ޷ơ

? ⣺
C 1ϣϵľٴͣ

C 2ԭʲô
C 3ҩӦѡʲôҩ

лл

maofq@eyou.com

ڹ
http://blog.sina.com.cn/maofq1968


Ƽ