{"countAll":0,"orderType":null,"readLevel":"0","lyTopicReq":{"id":"1186","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":null,"content":null,"barId":"1186","topicTypeId":null,"topicThemeId":"1028","readLevel":0,"files":null,"clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":null},"lyBarModerators":{"list":[],"list4Map":null,"pageBegin":0,"pageSize":8,"pageNumber":0,"totalPage":0,"totalRow":0},"metaSearch":{"description":"为您提供:儿童性早熟可以治好吗_性早熟治疗时机等相关信息，让病友在便捷的求医路上不花一分冤枉钱。","keywords":"儿童性早熟可以治好吗_性早熟治疗时机","title":"儿童性早熟可以治好吗_性早熟治疗时机","channels":null},"data":{"list":[{"id":"8579","isDel":0,"createAt":1512180364445,"createBy":"8abb11d0af1511e7a3d800163e04584d","createName":"良药苦口","updateAt":0,"updateBy":null,"updateName":null,"userId":"8abb11d0af1511e7a3d800163e04584d","title":"警惕性早熟的危害 性早熟怎么治疗","content":"

\"警惕性早熟的危害

近来，城市儿童被食品添加剂、激素“催熟”的现象再次引发社会高度关注。据了解，目前我国城市儿童“性早熟”比例是4%-7%，我国儿童“性早熟”已成为越来越普遍的现象，甚至还有继续蔓延的趋势。儿童性早熟的危害有哪些？性早熟怎么治疗？

 

　　性早熟的危害

 

　　1、造成患儿心理障碍

 

　　过早的性征出现和生殖器官发育会导致未成熟孩子产生心理障碍，尤其是看到自己与周围人不同的性状特征极易引起孩子的自卑的心理，这种心理，很可能在其成年后都留有遗症。

 

　　2、影响患儿读书学习

 

　　性征的出现和生殖器官的发育肯定会使孩子分心，感到不安、害羞和紧张。同时，女孩身体发育过早，没有能力处理好月经给生活带来的影响，也给生活带来了诸多不便，这势必会影响孩子的读书学习。

 

　　3、影响患儿身高

 

　　性早熟的孩子由于性激素的提前催发，导致骨骺闭合也将大大提前，生长期则相应缩短。一般情况下，女孩在初潮后、男孩在首次遗精后3年内平均只能长约5厘米左右，所以，性早熟儿童的最终身高反而会矮于同龄人。

 

　　4、可致患儿系统性内分泌失调

 

　　性早熟症状较轻的患儿主要表现为性激素水平的失调，而症状严重的患儿就会导致系统性内分泌失调。比如肾上腺皮质功能紊乱会引发患儿全身性多毛症状或毛发减少、干枯，甚至脱落；而甲状腺功能失调可见毛发细软或过早灰白，减少或增多的症状。

 

　　性早熟怎么治疗

 

　　治疗方法分很多，可能要根据孩子的病情轻重，以及它的分类来采取不同的治疗。


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\"女孩性早熟的5个检查项目\"

女孩性早熟应该是很常见的现象了，女孩出现了这样的情况对家庭的影响是很大的，大家对女孩性早熟的特征应该多一些了解，发现了这样的特征及时的去治疗才能够尽早的治愈，减少影响。

 

　　一、发育信息观察

 

　　8 岁以前，乳房是否发育、腋毛生长情况、外阴有无发育、阴毛是否出现、阴唇是否着色（颜色变深）、阴道分泌物增多、不满10岁的女孩月经来潮。10岁以前孩 子身高突然增长加速也是性早熟的一个信号。正常女孩在8岁以后可以出现乳房发育。乳房有一个从小到大的发育过程，可以一侧开始出现，也可以两侧同时出现， 这些都不属于异常现象;当发现女儿10周岁后月经来潮，也不必紧张，这属于正常范围。

 

　　二、体检信息包括：

 

　　1.一般检查：包括身高、体重、乳房、腋毛、外生殖器检查。

 

　　2.B超检查：B超是诊断性早熟的常规检查方法之一，可以发现乳房发育情况，鉴别乳房炎症或肿瘤;子宫及卵巢的发育情况，有无内生殖器官的疾病等;另外，也可发现与性早熟有关的肾上腺肿瘤。

 

　　3.妇科激素水平检测：女童性早熟是少女科常见的内分泌病，根据激素水平高低可推测性早熟的原因或病变部位。

 

　　4.测骨龄：在性早熟中，骨龄指标非常重要，X线测骨龄比实际年龄提前2年以上为骨龄提前，假性性早熟骨龄与年龄相符，而真性性早熟约95%的患儿骨龄提前。

 

　　5.必要的时候，还可做头颅CT或核磁共振检查，以便排除颅内肿瘤。

 

　　女孩性早熟的特征大家应该知道了吧，这些特征都是很明显的，也是对孩子很有影响的，特别是女孩的特征就会更明显了，乳房过早的发育了，如果家长能够尽早的发现，尽早的去治疗，很多的患者都能够得到很好的治疗的。


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\"1475911339.jpg\"/

外周性性早熟会不会转变为中枢性性早熟?

   外周性性早熟会转变为中枢性性早熟，也就是说，假性性早熟可转变为真性性早熟。其机制是，外周性性早熟患儿，由于摄入外源性的性激素或内源性的性激素合成、分泌增加，体内性激素水平的增高，一方面可作用于骨骼，使其成熟加速；另一方面性激素还可直接作用于中枢而激发下丘脑-垂体-性腺轴的活动。

 

    近年来的研究发现，在促性腺激素释放激素基因内存在经典的雌激素应答成分，外周 性激素水平，如雌激素持久增高，可刺激促性腺激素释放激素的合成、分泌增加，从而诱发真性性早熟。在临床上这些患儿发病初期表现为外周性性早熟，但当骨龄突增时，则转变为中枢性性早熟。


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\"56cd1ad144c45.jpg\"/

关于性早熟

性早熟是指男孩9岁或9岁半前，女孩8岁前出现第二性征的病变，女孩10岁前出现月经也属于性早熟。其中以单纯性乳房早发育多见。由于生活条件改善等原因，性早熟比例有逐年增加的趋势。据统计，国内各大城市性早熟比例已达3%。

 

性早熟病因很多，有体质性、外源性雌激素摄入、头颅外伤、肿瘤、感染，等，或是某些综合征的症状之一。明确病因需要做进一步的检查，例如性激素检测，骨龄检查、LHRHa激发试验等。

 

性早熟的危害，除了原发病的影响外，主要是对患儿造成不良的心理影响，甚至可以导致性格上的畸形发展而影响终生。真性早熟则因为青春期过早发动、青春期时相缩短而影响其成年终身高。对于特发性中枢性性早熟，治疗的主要目的有四：①改善成年终身高；②抑制第二性征的发展，恢复与实际年龄相符的心理行为；③推迟初潮年龄；④延长青春时相。若能及时施治，一般可以达到上述治疗目的。


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\"1475911339.jpg\"/

性早熟分为三类，既真性性早熟、假性性早熟和部分性别性别早熟。

    1、真性性早熟（true precocious puberty）  也称GnRH依赖性性早熟和中枢性性早熟（CPP），它必须具有下丘脑—垂体—性腺轴（HPGA）的发动、成熟呈进行性直至具有生育力。CPP临床上除表现与性别相一致的第二性征外，同时有生长加速、骨龄提前和具备生育能力。

    CPP病因有下列4种：

    1.1 特发性早熟或体质性早熟  它是非器质病变所致，约占全部性早熟病例 80-90%，尤以女孩多见，15-20%的病例发生于2.5岁以前出现性征，有家族倾向，发育顺序与正常青春发育相似，但提前并加速。女孩首先出现乳房发育，继而外生殖器发育，阴道分泌物增多及阴毛生长，然后月经来潮和腋毛出现。男孩首先出现睾丸及阴茎增大，以后可有阴茎勃起、排精，并出现阴毛、痤疮和声音低沉，体格较一般同龄儿强壮。

    1.2 神经疾病所致性早熟  松果体瘤使松果体破坏引起褪黑激素分泌减少可导致HPGA的提前启动；间脑错构瘤可产生黄体激素释放激素（LHRH）；神经纤维瘤、颅咽管瘤或其它肿瘤等脑部病变（如结节性脑硬化症等）以及脑炎、脑外伤可破坏抑制促性别腺中枢的神经结构导致性早熟发生。继发于颅内肿瘤者，男孩远多于女孩。此类性早熟常常是首先出现的症状，病情发展至一定阶段方出现中枢占位性症状与体征，故应警惕。

1.3 原发性甲状腺功能减低  患儿出现矮小、智力落后、粘液性别水肿为特征。部分患儿第二性征提前出现，表现为女孩乳房发育，男孩睾丸增大，但生长仍缓慢，骨龄仍延迟。可能由于甲状腺机制减退时，负反馈作用减弱，导致下丘脑促甲状腺激素释放激素分泌增多，刺激垂体催乳素、促甲状腺素分泌增加，且可能FSH、LH分泌也同时增加之故（TSH、FSH、LH)三者均为糖蛋白，均由α链和β链组成，而三者的α链相同，β链不同，这是分泌同时增加的原因。补充甲状腺激素后性早熟消失。

    1.4  促性腺激素和性激素药物应用。


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\"1475911339.jpg\"/

　

性早熟分为生理性早熟和心理性早熟。一般来说，人们往往忽视心理性早熟，而提到的，仅仅是生理上的性早熟。 
　　 
　　青春期发育受到遗传、种族、光照、营养、地域和生活条件等多种因素的影响。如生活在热带地区的人其青春期来得早些，印度作家泰戈尔在《沉船》一书中写道：10岁的少女还未找到夫家，已被认为是嫁不出去的姑娘了。住在寒带的人其青春期来得较晚，西伯利亚的苏联妇女一般要在18岁左右才有月经初潮。因此，青春期发育的时间，稍有提前或错后不用担心，属正常的生理变化。 
　　关于性的发育成熟年龄，我国古代的医学经典《黄帝内经》中早有记载：“丈夫……二八肾气盛，……精溢泻，阴阳和，故能有子。”又说“女子……二七而天癸至，任脉通，太冲脉盛，月事以时下。”明确指出男子在1６岁开始排精，并具有生殖能力。女子在14岁左右月经初潮。由于人类物质生活与精神生活水平的提高，现代人的性成熟比古代人提前了两年，即男性的性成熟期约在14岁，女子月经初潮则在12岁。 
　　但是，不到年龄而过早的性发育，就值得注意了。例如女孩子不足8岁，乳房发育长大，阴毛也长出来，并有月经来潮；男孩在10岁以前，睾丸迅速长大，外生殖器如成人。医学上把这种现象叫性早熟。 
　　性早熟是性发育异常的重要症状之一，它是以第二性征异常早期出现为标志。一般分为两种不同情况，一类是“真性性早熟”，不但第二性征出现得早，而且生育能力也早熟，有排卵性月经周期和生育能力，又称完全性性早熟；另一类是“假性性早熟”，只有某些第二性征提前出现，并不具有生育能力，又称不完全性性早熟。一般在性早熟患者中，女孩多于男孩。 
　　本病为一种罕见的内分泌疾病，如对夭折的性早熟孩子做尸体解剖，发现一些性早熟的根源在于脑垂体、下丘脑或松果腺功能不正常。脑垂体、下丘脑或松果腺是主管人体发育的重要机构，它们通过分泌的激素来指挥人体的生长发育，如果它们分泌的激素过多，就会出现性早熟。还有的毛病出在性腺（睾丸、卵巢等）或肾上腺皮质上，如睾丸、卵巢或肾上腺皮质上长了肿瘤，致使性激素分泌过盛，就会出现程度不同的性早熟。 
　　不管是哪种因素造成的性早熟，都要去医院进行系统的检查，如进行腹膜后充分造影，进一步确诊是否为“双侧肾上腺增生”，或一侧肾上腺肿瘤，亦有可能为异位肿瘤（如精索肿瘤，但比较少见）。对增生性的可选用氢化考的松治疗，以减少雄性激素的分泌（或雌性激素），同时也补充了肾上腺皮质素。对因为肿瘤引起的应尽快施行肿瘤切除，切除肿瘤后，常可完全恢复。 
　　 
　　性早熟的病因很复杂，医生在咨询时无法提出特别有针对性的建议。 
　　要想诊断清楚，必须通过一系列的检查和化验才能判断。首先要除外一切显而易见的导致性早熟的原因，如有无误服内分泌药物等。这需要有一详细而完整的病史采集，包括性征发育、阴道出血情况等。进行仔细的全面体格检查，如身体、体重、指间距、骨骼检查、基础体温、阴道细胞涂片等。血激素水平的测定有助于鉴别真性和假性性早熟，真性者的ＦＳＨ和ＬＨ水平增高，且有周期性波动，假性者多测不出这两种激素。 
　　治疗应针对具体病因而定，如有卵巢或肾上腺皮质肿瘤就必须手术治疗，而神经系统疾病所致者则无特殊疗法。性早熟中的80-90％属于体质性问题，找不到明显原因，也就没有特殊的药物治疗方法。可供选择的方法仅有长效甲孕酮注射或口服安宫黄体酮，这些都不是自行使用的药物，必须到大医院的内分泌科接受科学的治疗。 
　　除了采取检查和治疗措施之外，父母要特别注意关心孩子的心理变化，明确诊断后向孩子讲一些必要的知识，帮助她适应自己身体的新变化，防止坏人乘孩子年龄小、不懂事，钻空子，干坏事。所以，保护好孩子是家长的当务之急，国内外均有性早熟女孩妊娠，甚至产子的报道。同时也要有思想准备，因为有些性早熟是缺乏有效治疗方法的，那就更要依靠父母的悉心照料了。目前市场上有些儿童营养保健食品中含有激素成分，吃多了可导致性早熟，应引起家长的注意。 
　　 
　
　　性早熟的诊断和治疗 
　　男孩9岁以前，女孩8岁以前开始性发育称为性早熟。以第二性征发育为特征，女孩以乳房发育，男孩以睾丸发育增大为最早特征。 
　　女孩发育的早期征象：①身高加速增长和骨盆发育。②乳房下有硬节，肿痛。③乳晕、乳房增大，隆起，着色。④大阴唇、

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性早熟指男孩在10岁以前，女孩在8岁以前出现了第二性征。

中枢性性早熟　又称真性性早熟。由于下丘脑－垂体－性腺轴功能提前激活所致。患儿除了表现与性别相一致的第二性征外，同时有生长加速、骨龄增加和具有生殖能力。女孩比男孩多见。女孩先发现乳房发育、阴毛出现，以后出现白带及月经，可能有排卵。男孩先发现阴茎增大、变声、喉结，以后有阴毛、腋毛、痤疮、面须及遗精；事实上在阴茎增大前已有睾丸增大。多数为原发性，少数是由颅内肿瘤引起。

周围性性早熟　又称假性性早熟，其下丘脑－垂体－性腺轴并未成熟，由于外周组织产生的性激素而致同性或异性性早熟症状的出现，即男孩可以出现阴茎大、阴毛、腋毛和喉结，但是睾丸并不增大，而且男孩也可出现女性的第二性征表现如女性型乳房；同样女孩可以有乳房发育、阴毛和腋毛出现，也可以出现男性的第二性征表现如有胡须、阴蒂增大。假性性早熟并不具备生育的能力。

青春发育变异　指仅乳房或阴毛单一提早发育而无其他性发育者表现为：

（1）乳房早发育：可以发生于8岁前的任何年龄，女孩比男孩多，可以单侧，但多数为双侧，可先一侧增大，以后另一侧再增大。增大的乳房直径在5厘米以内，有触痛，但乳头及乳晕正常，可以消退后一阶段又肿大。没有白带，无身高增长加速及骨龄加速现象。

（2）阴毛早发育：正常情况下女孩在乳房发育后数月出现阴毛；男孩在阴茎、睾丸发育后数月才出现阴毛。早发育者阴毛可出现于任何年龄，女孩多于男孩。阴毛量少，有时还有腋毛，但其他性征发育正常。多数食用含有激素的儿童保健食品引起。

关于中枢性性早熟及周围性性早熟需要进一步检查，查明原因。关于青春发育变异，不必处理。


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   近日，深圳儿童医院发布一组数据称，到医院就诊的性早熟儿童每天达20多例。为此，今天上午，记者走访了北京儿童医院，该院内分泌遗传代谢中心副主任医师吴迪表示，现在性早熟的孩子确实比较多，主要与吃的关系比较大，且女孩比男孩更容易患上性早熟。

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    早熟·现状   女童比男童多  约为5比1

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    儿童性早熟是指女孩8岁以前乳房发育，10岁之前来月经，男孩9岁以前，外生殖器发育。在男女儿童中，性早熟的发生率大约为0.6%，其中女孩多于男孩，比例大约为5比1。

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    据吴迪医师介绍，去年北京儿童医院接诊的性早熟病例达到了近4000例，有遗传性的、有外源性的也有器质性的。在性早熟的病例里，其中女童较多，80%都是外源性的，比如吃了或接触了含有雌性激素高的食物或物品。而男童的性早熟80%都是器质性的，比如肿瘤等造成儿童体内激素水平的变化。

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    “接诊性早熟的病例主要看小孩是不是真的发育了，如果是外源性的性早熟，是不需要治疗和用药的，只要调节一下饮食就会自愈。但要是器质性的，就不是简单的治疗性早熟了。”吴迪大夫表示。

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    早熟·危害   生理心理负担  孩子压力大

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    性早熟对儿童的成长是有很大危害的，吴迪医师也从三个方面强调了这种危害性。

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    首先，早发育的孩子长不高。由于骨骼发育过快，性早熟儿童的生长周期会明显缩短，没有足够时间发育，最终使其成年后的身高比一般人矮。真性性早熟的孩子，约半数其最终身高往往不足150厘米。

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    其次，性早熟对于女孩的危害更大。性早熟的女孩长大以后，可能还会遇到生育的问题，她们更容易患上多囊卵巢综合征，这也是导致女性不孕的常见原因。

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    最后，是心理方面的困扰。性早熟的孩子在体形、外表上与周围小伙伴都不同，可能会产生恐惧和不安情绪，造成自卑等问题，对孩子的心理健康有不利影响。

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    早熟·忌口   少吃点鸡肉等   补品是元凶

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    在吴迪医师看来，女孩子的性早熟大部分都是外源性，比如吃引起的，或者是通过哺乳的母体进入孩子的身体。

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    “很多2岁左右的小幼儿是通过母亲的乳汁吸入了太多的雌性激素，因此，我们也建议处于哺乳期的母亲尽量少用化妆品。”吴医师强调。

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    此外，在临床诊断时，医生也会问孩子们都吃过什么或喝过什么，有些家长称，孩子就喜欢喝一些饮料和吃一些雌性激素含量较高的食品。

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    “我们一般都会告诉家长，鸡肉、牛奶、蜂蜜、豆浆、蛋白粉等，这些东西都含有较高的雌性激素，特别是女孩子更要少吃这些东西。”吴医师说，现在很多禽肉类当中，都含有大量的激素，一些性激素间接进入人体后，就会导致儿童性早熟。

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    “补品是引起孩子性早熟的元凶之一。一些家长常给孩子吃保健品，而这些东西中有些也含有激素成分，不应让孩子太早就食用。”吴迪大夫特别强调。

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