Clinical Diagnosis - 上海交通大学医学院精品课程.ppt

Clinical Diagnostics Department of gastroenterology Ren-Ji hospital Shanghai Jiao Tong University, School of Medicine Ran Zhi Hua (冉志华） What is Clinical Diagnostics? Fundamental theory 基础理论/知识 Techniques of diagnosing disease 诊断疾病的技术 Mode of clinical thinking 临床思维的方式 What is Clinical Diagnostics? Instruct a concise logical approach to recognize the genius of the diseases 教会一种简明而又合乎逻辑的步骤去识别疾 病的本质 A fundamental course of clinical medicine 临床医学的基本课程 Fundamental elements of Diagnostics Diagnosis Diagnosis（诊断） Derived from Greek words distinguish or discern 识别/鉴别 认识 English term Diagnostic The distinguishing sign and symptoms with which it gerenally begins, continues and goes off…as it were, a history of the disease 对疾病特征的识别及对疾病的诊断 In 18th century: Nosography（病情学） 通过疾病的表现来识别疾病内在本质或属性 In modern usage: Identification of a disease by investigation of its signs and symptoms Medical terminology: Clinical diagnosis Laboratory diagnosis X-ray diagnosis Electrocardiographic diagnosis Gene diagnosis Importance of Diagnostics Content of Clinical Diagnostics Symptomatic Diagnosis Symptomatic Diagnosis Physical Diagnosis Laboratory test or ancillary tests Serum, Urine, Stool tests X-ray film EKG Endoscopy Ultrasonic imaging CT MRI PET (Positron Emission Tomography) Medical record Special terms in clinical diagnosis Differential diagnosis Preliminary diagnosis/Tentative diagnosis 初步诊断 可能性诊断 Exclusion of other diseases (排除其它疾病) Selecting a number of possibilities to explain the clinical and laboratory findings in the case in question The way of exclusion is called Differential diagnosis Evidence based medicine It is the conscientious（谨慎的）, explicit （明确的）and judicious （有见解的）use of current best evidence in making decisions about the care of the individual patient It means integrating individual clinical expertise （临床专长）with the best available externa