医学与哲学
醫學與哲學
의학여철학
MEDICINE AND PHILOSOPHY
2014年
18期
81-83
,共3页
张潍%陈良凤%刘淑娟%杨红%辛晓燕%王建
張濰%陳良鳳%劉淑娟%楊紅%辛曉燕%王建
장유%진량봉%류숙연%양홍%신효연%왕건
子宫内膜异位症%输尿管%深部浸润型子宫内膜异位症%膀胱
子宮內膜異位癥%輸尿管%深部浸潤型子宮內膜異位癥%膀胱
자궁내막이위증%수뇨관%심부침윤형자궁내막이위증%방광
endometriosis%ureter%DIE (deep infiltrating endometriosis)%bladder
“患者受益”作为临床处置决策的基本原则在日常的医疗工作中发挥着积极的作用。同样也在常见类型子宫内膜异位症(EM )诊疗过程中得到很好地贯彻执行。然而,对于少见的累及泌尿系的EM ,由于缺乏可靠的临床循证医学证据用以指导患者具体的临床处理,把握患者利益最大化原则就显得尤为重要。怎样掌握累及泌尿生殖系子宫内膜异位症患者临床处置决策中的关键要素,尽可能为患者保留生殖能力与泌尿系统的完整性,以提高日后的生活质量。除需要详细了解患者病史特别是手术史、盆腔影像学检查、肾脏功能评估结果外,选择个性化的干预手段并对预后进行综合评估,制定最为适合的治疗方案是至关重要的。本文结合临床典型病例就此问题做一剖析。
“患者受益”作為臨床處置決策的基本原則在日常的醫療工作中髮揮著積極的作用。同樣也在常見類型子宮內膜異位癥(EM )診療過程中得到很好地貫徹執行。然而,對于少見的纍及泌尿繫的EM ,由于缺乏可靠的臨床循證醫學證據用以指導患者具體的臨床處理,把握患者利益最大化原則就顯得尤為重要。怎樣掌握纍及泌尿生殖繫子宮內膜異位癥患者臨床處置決策中的關鍵要素,儘可能為患者保留生殖能力與泌尿繫統的完整性,以提高日後的生活質量。除需要詳細瞭解患者病史特彆是手術史、盆腔影像學檢查、腎髒功能評估結果外,選擇箇性化的榦預手段併對預後進行綜閤評估,製定最為適閤的治療方案是至關重要的。本文結閤臨床典型病例就此問題做一剖析。
“환자수익”작위림상처치결책적기본원칙재일상적의료공작중발휘착적겁적작용。동양야재상견류형자궁내막이위증(EM )진료과정중득도흔호지관철집행。연이,대우소견적루급비뇨계적EM ,유우결핍가고적림상순증의학증거용이지도환자구체적림상처리,파악환자이익최대화원칙취현득우위중요。즘양장악루급비뇨생식계자궁내막이위증환자림상처치결책중적관건요소,진가능위환자보류생식능력여비뇨계통적완정성,이제고일후적생활질량。제수요상세료해환자병사특별시수술사、분강영상학검사、신장공능평고결과외,선택개성화적간예수단병대예후진행종합평고,제정최위괄합적치료방안시지관중요적。본문결합림상전형병례취차문제주일부석。
The basic principle of "patients benefit"in clinical treatment decisions has a positive effect in daily medical work , and was also implemented nicely in the treatment process of common types of endometriosis (EM ) .Similarly ,due to a lack of reliable clinical evidence of evidence-based medicine to guide clinical treatment , maximizing "patients benefit" is especially important for rare cases of cumulative urinary tract EM .How to grasp the key factors of clinical management decisions in patients with EM which involves the urinary tract ,to retain as much integrity as possible of the reproductive and urinary system for patients ,in order to improve the future quality of life .In addition to a detailed understanding of patient history ,especially a history of pelvic operation ,imaging examination ,and renal function assessment results ,how to choose personalized interventions and evaluate prognosis ,and to develop the most suitable treatment plan is uttermost important .This manuscript analyzes this issue using typical clinical cases .