基于临床决策思维角度急诊诊疗同质化的探讨  

Discussion on the homogenization of emergency diagnosis and treatment based on clinical decision thinking

作　　者：李建国[1] 齐惠军 郭慧[1] Li Jianguo;Qi Huijun;Guo Hui(Department of Emergency,Hebei General Hospital affiliated to Hebei Medical University,Shijiazhuang 050051,Hebei,China)

机构地区：[1]河北医科大学附属河北省人民医院急诊科,河北石家庄050051

出　　处：《中国中西医结合急救杂志》2022年第6期646-649,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：河北省政府资助临床医学人才培养项目(2021-9)

摘　　要：目前急诊的临床决策方式仍经验为主,但有时会产生不同的诊疗结果。急诊是医院的窗口、分级诊疗的前沿,实现急诊诊疗的同质化意义重大。急诊诊疗的同质化,不仅需要规范、指南、共识等共同的知识体系,还需要建立临床决策思维体系。降阶梯思维、抢先思维、流程化思维在急诊临床决策中具有科学性;急诊初始诊疗模式是以症状为导向,建立症状学“病因清单”可以加快系统化“慢思维”临床决策;在急诊诊疗全过程中,动态观察是贯穿始终的核心思维之一。本研究基于临床思维的基本原则,探讨临床决策思维在急诊诊疗中的作用,或有利于实现急诊诊疗效果的同质化,并缩短年轻急诊医生的培养过程。At present,clinical decision-making in department of emergency is still experienced,but the empirical model sometimes produces different medical outcomes.Department of emergency is the window of the hospital and the forefront of hierarchical diagnosis and treatment.So it is of great significance to realize the homogenization of medical outcomes in department of emergency.The homogenization of emergency diagnosis and treatment requires not only the common knowledge system,but also a unified emergency decision-making thinking.The step-down thinking,first-aid thinking,and process thinking are scientific clinical decision-making in emergency diagnosis and treatment.The initial mode of emergency treatment is symptom-oriented."Etiology check list"is established to accelerate the systematic"slow-thinking".Dynamic observation is one of the key thinking used throughout the emergency diagnosis and treatment process.Based on the basic principles of clinical thinking,this study explores the role of clinical decisionmaking thinking in emergency diagnosis and treatment,which may help to realize the homogenization of emergency diagnosis and treatment effect,and shorten the training process of young emergency doctors.

关 键 词：临床决策 医疗同质化 抢先检查 思维清单 流程化思维 

分 类 号：R47[医药卫生—护理学]