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<section data-role="paragraph" data-color="rgb(182, 228, 253)" data-custom="rgb(182, 228, 253)"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section><section><p><p><img src="image/20201014/86b79d371e9862b01189f0252a03b2cd_1.png" /></p></p></section><section><section><span><strong></strong></span></section><p><span>医疗器械媒体报道先锋</span></p><p><span>分享专业医疗器械知识</span></p></section><section><section><section><span>关注</span></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section><p><br /></p><p><span>12日0时-24时，湖北省新增新冠肺炎病例<strong>14840</strong>例，其中一则数据是<strong>临床诊断病例13332例</strong>。什么是临床诊断病例？为什么要增加临床病例的诊断？判断依据是什么？<span>中央指导组专家、北京朝阳医院副院长童朝晖</span>为我们做了权威解读。</span></p><p><br /></p><p><video width="100%" height="580" controls="controls"><source src="http://mpvideo.qpic.cn/0bf2beaauaaaxaajeesejnpfacodbieqacqa.f10002.mp4?dis_k=5a4c64e7538d8197211a4a6060b3efcf&dis_t=1602651486" type="video/mp4"></source></video></p><p><br /></p><section data-tools="gulangu" data-id="2175"><section><section data-brushtype="text"><span><strong>什么是临床诊断病例？</strong></span></section><section data-brushtype="text"><br /></section></section></section><p><span>中央指导组专家、北京朝阳医院副院长童朝晖：</span><span>我们在看病诊断肺炎时，能够拿得到的病原学，也就百分之二三十，剩下的百分之七八十要靠临床诊断。</span><span>从临床思维和临床医生的临床路径角度来说，增加临床病例的诊断，有益于临床医生对疾病多一个判断。</span></p><p><br /></p><p><span>前一段时间我们主要是靠核酸来进行确诊病例。</span><span>实际上按照我们临床诊断的标准，是有一大部分疑似病例的。</span></p><p><br /></p><p><span>在临床工作中，我们从这几个方面综合诊断：</span><span>第一，如果病人在湖北或者在武汉地区，那肯定是已经有流行病学史了；</span><span>第二是发热、呼吸道咳嗽、憋气的症状，这是临床症状；</span><span>第三是临床有体征，查体检查；</span><span>第四个是CT影像。</span><span>比如说我们常见的肺炎链球菌肺炎，实际上能拿到阳性的比例以及培养的比例也就百分之二三十，大部分是靠临床医生来对临床病例下一个临床诊断。</span></p><p><br /></p><p><span><strong><span>怎样认识核酸检测和CT检测的价值？</span></strong></span></p><p><br /></p><p><span>童朝晖：</span><span>经常会有人讨论，化验重要还是CT影像重要。</span><span>很多放射科的专家也强调CT影像的重要性，实际上在临床工作中我们都是要有依据的。</span><span>病人的病史、症状体征、临床化验、CT，都要分析，所以说这些对临床医生来讲都不可缺少，需要做综合判断，综合分析。</span></p><p><br /></p><p><span>我们不能强调核酸的重要性，也不能强调CT的重要性。</span><span>我们临床医生要会分析核酸相关的化验，对CT影像也要会分析、会看、会读。</span><span>作为一个呼吸科医生，一个临床危重症医生，我们要仔细地去询问病史，发现临床的蛛丝马迹，通过临床的查体手段，还有先进的检验技术。</span><span>其实读CT影像，既是放射科医生的看家本领，也是临床医生的看家本领。</span><span>做疾病综合诊断的时候，化验和CT影像，我们要综合分析，不能强调某一个的重要性。</span></p><p><span><br /></span></p><section data-role="outer" label="Powered by gulangu"><section data-role="paragraph" data-color="#27939d"><p><a data-miniprogram-appid="wxdc7efe409d688f37" 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发表于 2020-10-14 12:58:07