1.儿科学概论.ppt

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,儿科学概论,Introduction,of Pediatrics,南方医科大学第二临床学院 儿科教研室,珠江医院 儿 科,王斌,儿科学,1,研究儿童,生长发育,的规律及其影响因素；,Concern with the growth and development and the impact factors.,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；,-mechanism of diseases and the technologies of diagnosis and therapies.,3,研究各种疾病的,预防,措施；,-prophylaxis method.,4,研究儿童中各种疾病的,康复,可能性以及具体方法。,-methods of recovery from the diseases.,Pediatrics is concerned with the health of infants,children,and adolescents;their growth and development;and their opportunity to achieve full potential as adults.,As physicians who assume a responsibility for childrens physical,mental,and emotional progress from conception to maturity,pediatricians must be concerned with social and environmental influences,which have a major impact on the health and well-being of children and their families,as well as with particular organ systems and biologic processes.,But if I dont want to be a pediatrician,Clinical medicine is an integrated knowledge system,Barrel theory,long boards and the shortest board:key factor of the volume.,You have chances to meet children in any other department.,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。,The mortality of children under 5 yrs is an index of economic-social development in a certain country.,中国政府对国际社会有承诺。,The Chinese government has a commitment to the international community.,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.Eradicate extreme poverty and hunger,4.Reduce child mortality,5.Improve maternal health,6.Combat HIV/AIDS,malaria and other diseases,7.Ensure environmental sustainability,8.Developpe a global partnership for development,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。,More than a century ago,pediatrics was emerged as a medical specialty in response to increasing awareness that the health problems of children differ from those of adults and that a childs response to illness and stress varies with age.,In the late 19th century in the United States,of every 1,000 children born alive,200 might be expected to die before the age of 1 yr of conditions such as,dysentery,pneumonia,measles,diphtheria,and whooping cough,.,The efforts of pediatricians,combined with those of scientists and pioneers in public health,have led to such better understanding of the origin and management of many problems of infants that in the past half century the infant mortality rate in the United States has decreased from around 75/1,000 live births in 1925 to approximately 6.9/1,000 in 2000.,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。,Waldo E Nelson(1898-1997),a giant in the field of pediatrics,a distinguished medical educator,was the chairman of the department of pediatrics at Temple University and the medical director of St.Christophers Hospital,both in Philadelphia.Many doctors trained by Dr.Nelson are now leaders in pediatrics.Dr.Nelson was also the editor of The Journal of Pediatrics from 1959 through 1978.,Dr.Nelson gained worldwide fame as the longtime editor of the green bible,the Nelson Textbook of Pediatrics,which was published through numerous editions and translated into dozens of languages.,Stages of children,fetal period,：,fertilization,受精卵,before birth,出生前。,neonatal period,：,ligation of the cord,脐带结扎,28 days,生后,28,天。,婴儿期,infant period,：,the first year,幼儿期,toddlers age,：,13years,。,学龄前期,preschool years,：,3,7years,学龄期,school years,：,7yrs,before adolescence,青春期,adolescence,：,Secondary sex characteristics,Consolidation of sexual identity,Slower growth,Characteristic of children,anatomy,：,immature,、,changing,、,developing,。,physiology,：,high metabolism,、,function insufficient,。,immunology,：,insufficient,、,Social psychology,：,lack of capability,，,need protection,，,incident,。,儿科学特点,diseases,：,genetic,、,emergent,severe,、,uncertainties,。,Patient management,：,different manifestation by age,、,inaccurate describe,。,prognosis,：,quick recovery,恢复快、,mild sequela,后遗症轻。,prophylaxis,预防特点：,screen of genetic diseases,先天性疾病筛查、,Vaccines and Immunization,计划免疫、,health care,儿保。,儿科学发展展望,从技术角度来看：,treatment of critical diseases,危重症救治、,life support techniques,生命支持技术、,functional rehabilitation,功能康复治疗,从社会角度来看：先天性疾病筛查、合,nutrition balance,理均衡营养、,prevention of epidemic disease,重大传染病预防、,disability,残疾儿功能康复,我们的儿科,regional referral center,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 扩建发育儿科专业，建立发育儿科训练园地、血液化疗洁净病房,（总开放床位,120,张,2007,总开放床位,200,张,2017,年出院病人,6000,人,经省发改委批准，,整合现有,PICU,、,NICU,、儿科急诊、儿科实验室、微生物实验室、检验中心等学科平台，改建旧门诊大楼，筹建,有,120,张床位约,8000,平方米的区域性儿科重症医学中心。,预计三年投入,4500,万,元,届时医院配套资金比例将,1,：,10,教学改革,教考分离,以症状为主线，以问题为中心,双语教学,