儿科学概论ppt课件.ppt

儿科学概论IntroductionofPediatrics,儿科学,1研究儿童生长发育的规律及其影响因素；Concernwiththegrowthanddevelopmentandtheimpactfactors.2研究儿童各种疾病的发生、发展规律以及临床诊断和治疗的理论和技术；-mechanismofdiseasesandthetechnologiesofdiagnosisandtherapies.3研究各种疾病的预防措施；-prophylaxismethod.4研究儿童中各种疾病的康复可能性以及具体方法。-methodsofrecoveryfromthediseases.,Pediatricsisconcernedwiththehealthofinfants,children,andadolescents;theirgrowthanddevelopment;andtheiropportunitytoachievefullpotentialasadults.Asphysicianswhoassumearesponsibilityforchildrensphysical,mental,andemotionalprogressfromconceptiontomaturity,pediatriciansmustbeconcernedwithsocialandenvironmentalinfluences,whichhaveamajorimpactonthehealthandwell-beingofchildrenandtheirfamilies,aswellaswithparticularorgansystemsandbiologicprocesses.,ButifIdontwanttobeapediatrician,ClinicalmedicineisanintegratedknowledgesystemBarreltheory,longboardsandtheshortestboard:keyfactorofthevolume.Youhavechancestomeetchildreninanyotherdepartment.,儿童的重要性,5岁以下婴幼儿死亡率是联合国衡量一个国家或地区国民经济和社会发展水平的重要指标。Themortalityofchildrenunder5yrsisanindexofeconomic-socialdevelopmentinacertaincountry.中国政府对国际社会有承诺。TheChinesegovernmenthasacommitmenttotheinternationalcommunity.,儿童的重要性,人类的未来。联合国千年目标消灭极端贫穷和饥饿；普及小学教育；促进两性平等并赋予妇女权力；降低儿童死亡率改善产妇保健；与艾滋病、疟疾和其他疾病作斗争；确保环境的可持续能量；全球合作促进发展。,联合国所有192个会员国已承诺最迟在2015年实现,1.Eradicateextremepovertyandhunger,2.Achieveuniversalprimaryeducation,3.Promotegenderequalityandempowerwomen,4.Reducechildmortality,5.Improvematernalhealth,6.CombatHIV/AIDS,malariaandotherdiseases,7.Ensureenvironmentalsustainability,8.Developpeaglobalpartnershipfordevelopment,儿科学的历史,自19世纪至20世纪末，西方儿科学的重大贡献主要在于有效地防治传染病和营养不良方面，两者为当时儿童中死亡的首要原因。Morethanacenturyago,pediatricswasemergedasamedicalspecialtyinresponsetoincreasingawarenessthatthehealthproblemsofchildrendifferfromthoseofadultsandthatachildsresponsetoillnessandstressvarieswithage.,Inthelate19thcenturyintheUnitedStates,ofevery1,000childrenbornalive,200mightbeexpectedtodiebeforetheageof1yrofconditionssuchasdysentery,pneumonia,measles,diphtheria,andwhoopingcough.Theeffortsofpediatricians,combinedwiththoseofscientistsandpioneersinpublichealth,haveledtosuchbetterunderstandingoftheoriginandmanagementofmanyproblemsofinfantsthatinthepasthalfcenturytheinfantmortalityrateintheUnitedStateshasdecreasedfromaround75/1,000livebirthsin1925toapproximately6.9/1,000in2000.,1943年，我国现代儿科学的奠基人诸福棠教授主编的实用儿科学首版问世。,WaldoENelson(1898-1997),agiantinthefieldofpediatrics,adistinguishedmedicaleducator,wasthechairmanofthedepartmentofpediatricsatTempleUniversityandthemedicaldirectorofSt.ChristophersHospital,bothinPhiladelphia.ManydoctorstrainedbyDr.Nelsonarenowleadersinpediatrics.Dr.NelsonwasalsotheeditorofTheJournalofPediatricsfrom1959through1978.Dr.Nelsongainedworldwidefameasthelongtimeeditorofthegreenbible,theNelsonTextbookofPediatrics,whichwaspublishedthroughnumerouseditionsandtranslatedintodozensoflanguages.,Stagesofchildren,fetalperiod：fertilization受精卵beforebirth出生前。neonatalperiod：ligationofthecord脐带结扎28days生后28天。婴儿期infantperiod：thefirstyear幼儿期toddlersage：13years。,学龄前期preschoolyears：37years学龄期schoolyears：7yrsbeforeadolescence青春期adolescence：SecondarysexcharacteristicsConsolidationofsexualidentity,Slowergrowth,Characteristicofchildren,anatomy：immature、changing、developing。physiology：highmetabolism、functioninsufficient。immunology：insufficient、Socialpsychology：lackofcapability，needprotection，incident。,儿科学特点,diseases：genetic、emergent,severe、uncertainties。Patientmanagement：differentmanifestationbyage、gnosis：quickrecovery恢复快、mildsequela后遗症轻。prophylaxis预防特点：screenofgeneticdiseases先天性疾病筛查、VaccinesandImmunization计划免疫、healthcare儿保。,儿科学发展展望,从技术角度来看：treatmentofcriticaldiseases危重症救治、lifesupporttechniques生命支持技术、functionalrehabilitation功能康复治疗从社会角度来看：先天性疾病筛查、合nutritionbalance理均衡营养、preventionofepidemicdisease重大传染病预防、disability残疾儿功能康复,我们的儿科regionalreferralcenter,1983年妇儿科，编制儿科床位15张1986年组建独立儿科(编制25张,开放40张)1989年建立NICU及转运网络1994年扩建NICU、开展早期干预1997年扩建PICU(总编制35张,开放80张)2002年引进造血干细胞移植2003年扩建发育