儿科学英文课件：01 儿科学绪论

1、1Overview of Pediatrics2Pediatrics is concerned with the childs physical, mental, and psychosocial health. The field of pediatrics is about childrens health and the factors that affect their health. 3Children:0-18years42009年世界各国15岁以下人口排名 排名国家 15岁以下人口（万） 占世界比例 占该国总人口比例 1 印度 38370 20.9% 32% 2 中国 25360

2、 13.8% 19% 3 尼日利亚 6834 3.7% 45% 6 美国 6147 3.3% 20% 7 巴西 5361 2.9% 28% 15 俄罗斯 2121 1.2% 15% 18 日本 1658 0.9% 13%美国全球健康政策协会（global health policy)2009年世界共有15岁以下儿童人口18.36亿，占世界总人口27% 5A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.- WHO,1948H

3、EALTH6Childrens health should be defined as the extent to which individual children or groups of children are able or enabled to :develop and realize their potentialsatisfy their needsdevelop the capacities to allow them to interact successfully with their biological, physical, and social environmen

4、tRudolphs Pediatrics,20107Developmental PediatricsPreventive PediatricsClinical Pediatrics Community pediatricsThe Scope of Pediatrics8Its the science to study of growth and development of child from moment of conception through adolescence, including physical growth and neuro-psychological developm

5、ent.Research on various factors that will influence growth and development and promotion to achieve full potential in adult.Developmental Pediatrics9Preventive pediatricsPreventive in the health care of infants, children, and adolescents is at the core of the field of pediatrics.10 Primary Preventio

6、nthe measures of health promotion: e.g. nutrition, health education, physical activity, Immunization, accident prevention, mental health and well environment, etc. Secondary Preventionthe measures of preventing diseases to happen. e.g. growth supervision, newborns screening, prenatal examination etc

7、. treatment of ill children and rehabilitation Tertiary Prevention11Clinical pediatricsPrimarily focused on diagnosis and treatment of diseases in childhood.12Clinical pediatrics divides into sub-speciality according to diseases related to organ systemDigestive systemRespiratory systemCardiovascular

8、 systemNephrology and urologyEndocrinologyDermatologyHematologyNeurology.Infectious disease Metabolic disordersImmunologyAllergy ect.13Clinical pediatrics divides into sub-speciality based on childs agePerinatologyNeonatologyAdolescent medicine14Pediatrics divides into sub-speciality basing on healt

9、h care systemPrimary health careIntensive careEmergency careRehabilitation care15Community pediatricsResearch on social factors influence child health, e.g. economic, education, environment, family and so on.16 Is a kid miniature of a adult?17Anatomye.g.size and proportion of body18PhysiologyNormal

10、resting pulse rate and respiratory rate in children Age beats/min breaths/min newborn 140 40 5ys 100 25 15ys 70 20 19e.g. Typical sleep requirements in children20Pathologyacute lobar pneumonia bronchopneumonia21miliary tuberculosisadvanced pulmonary tuberculosis (Arrows indicate the location of cavi

11、ties within these light areas )Pathology22Clinical aspectthe category of diseases ex. congenital Infectiousthe manifestation of diseasesex. acute changeful23the diagnosis of diseaseThe treatment of diseasethe prognosis of diseaseClinical aspect24 Is a kid miniature of a adult?25The Developmental Per

12、iods Across ChildhoodFETUSINFANCYTODDLERPRE-SCHOOLSCHOOL CHILDRENADOLESCENCE26The illnesses and problems children encounter are highly age-dependent. The childs age will determine the questions you ask on history-taking, how you conduct the examination, the diagnosis or differential diagnosis and yo

13、ur management plan. 27Embryo: 0-12 wsMiddle fetus: 13-28 wsLate fetus: 29-40 wsFetal PeriodFetal periodEmbryonic period28 致畸敏感期29Full-term infant 37 ws GA 42wsPreterm infant GA 37ws Post-term infant GA 42ws*the meaning of several termsGA: gestational age30Infant Period (0-12mo)neonatal period(0-28ds

14、)Infancy is a period of rapid but decelerating growth rate.Growth of brain occurs rapidly.Attention on nutrition and rearing.31Perinatal PeriodThis period is the interval from 28ws of gestation until the 7th day after birth.This period is the time of life with the highest mortality rate of any age i

15、nterval.*Close cooperation between the professionals involved in the care of pregnant women and those for caring for the newborn infants.32Toddler period (1-3y)Growth rate slows down.Psychological changes are in bursting phase.Mobility increases; Walking independently; Interested in imitation.Attent

16、ion on education (nature, nurture and nutrition).33Preschool years (3-5y)Physical growth further slows down.Development of cognition and widening social sphere.Emphasizing the behavior and emotional development.Prevention of accident.34School age(6-11y)Wide range presents normally in this age group.

17、Physical coordination and mental maturity.Emphasizing school fundamental education and social ability.35Adolescence (teenager)10-20year36胎儿后期胎儿中期胚胎期围产期：胎儿28周-新生儿1周40周 28周 12周0幼儿期（1-2岁组）不足1岁28日 1周 婴儿期（0岁组） 学前期（3-5岁组）不足6岁 学龄期（6-11岁组）不足12岁青春后期（3-4年）青春期（2-4年）青春前期（2-3年）21岁 18岁13岁体格生长停止第二性征性发育成熟第二性征出现女9-1

18、1岁,男11-13岁 婴儿 新生儿不足3岁*summary37 Health disparitiesUnder 18 year :constitute approximately 1/3 of whole populationCurrent Challenges In Pediatrics38based on UNICEF, State of the Worlds Children, 2011 Health disparities39The category of disease has changeda greater percentage of preterm, low birth wei

19、ght, or very low birth weight newborns are surviving congenital malformations mental retardation40Environmental factors that affect optimal outcome of child healthe.g. natural and social environmentothers41Change in Role and Practice Environment beween 20th and 21st Centuries20th-century Pediatrician 21st-Century PedatricianFocus of clinical knowledgeInfections and syndromes,empiric behavior and developmentGenomics, environment, neuroscience-based behavior and developmentWho controls carePhysicianPatient/familyConsistency of careHighly variable: individual provider basedHighly r