16臨床思維方法與診斷步驟(編輯修改稿)
2025-02-01 23:56 本頁面
【文章內(nèi)容簡介】 ighly sensitive test such as the HIV antibody test. 診斷步驟和臨床思維 screening, ie, to identify risk factors for disease and to detect occult disease in asymptomatic persons. Criteria for use of screening procedures Characteristics of population 1. Sufficiently high prevalence of disease. 2. Likely to be pliant with subsequent tests and treatments. Characteristics of disease 1. Significant morbidity and mortality. 2. Effective and acceptable treatment available. 3. Presymptomatic period detectable. 4. Improved oute from early treatment. Characteristics of test 1. Good sensitivity and specificity. 2. Low cost and risk. 3. Confirmatory test available and practical. 發(fā) 熱頭痛關(guān)節(jié)痛 咽喉痛皮疹 腰背痛咳嗽小便 腹痛 熱輻射氣急咳痰前傾惡心嘔吐眩暈意識病毒感染發(fā)疹性疾病尿感腎盂腎炎中暑急腹疹肺炎支氣管炎關(guān)節(jié)痛病毒感染腦膜炎腦炎腹瀉胃腸炎 腹 痛類似發(fā)作腹瀉腰背部放射痛右季肋部痛燒灼痛伴皮膚壓痛暴飲暴食劇烈疼痛嘔吐發(fā)熱腹痛腹塊胃腸炎I B S發(fā)熱膽石癥帶狀泡疹皮膚過敏胰腺炎胃炎腸梗阻闌尾炎穿孔膽石癥腎盂腎炎 尿石癥G E R DPUFDI B D膽囊炎 Scheme of Diagnosis Procedure History PE Synthesis analysis inference Medical knowledge Clinical experience Primary diagnosis Therapy observation definite diagnosis Special Tests 臨床思維的原則 : 努力尋找主要診斷根據(jù) 怎樣否定某一疾病 怎樣肯定某一疾病 3.“一元化”原則 臨床上常見誤診的原因 ? .病史資料不完整 ,不確切 ? .觀察不細(xì)致或檢驗結(jié)果誤差 ? .先入為主 ,主觀臆斷 ? .醫(yī)學(xué)知識不足 ,缺乏臨床經(jīng)驗 警惕見病不見人
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