临床指南和个体化治疗辩证应用--以肺癌筛查及综合治疗方案选择为例  

Dialectical Application of Clinical Guidelines and Individualized Treatment:Take the Lung Cancer Screening and Comprehensive Treatment Options as An Example

作　　者：史文松 胡玉缀 常国涛[1] 杨玉伦[1] 李向楠[2] 赵晓刚[4] SHI Wen-song;HU Yu-zhui;CHANG Guo-tao(Department of Thoracic Surgery,People's Hospital of Zhengzhou/People's Hospital of Henan University of Chinese Medicine,Zhengzhou 450053,China)

机构地区：[1]郑州人民医院/河南中医药大学人民医院胸外科,河南郑州450053 [2]郑州大学第一附属医院胸外科,河南郑州450052 [3]郑州市第九人民医院老年医学科,河南郑州450053 [4]同济大学附属上海市肺科医院胸外科,上海200433

出　　处：《医学与哲学》2021年第18期21-24,共4页Medicine and Philosophy

基　　金：2017年上海“科技创新行动计划”科普项目(17dz2303200)。

摘　　要：肺癌筛查的方法,以外科为主的综合治疗方案(化疗、靶向治疗、放疗、免疫治疗等序贯或联合)的选择差异及患者的真实世界,都直接影响患者预后。另外,现实世界中临床医生多采取自己擅长的方法去治疗,有时忽略了对患者最有益的方案。建议在循证医学的指导下,以临床指南为基石,结合患者个体化病情,胸外科、肿瘤科、放疗科、中医科及呼吸与危重症医学科等多学科会诊讨论后,给予精准诊断和治疗。同时,将医患共同决策的模式与个体化指南相结合,最大可能使患者获益。The difference in the choice of lung cancer screening and surgery-based comprehensive treatment options(sequential or combined application of chemotherapy,targeted therapy,radiotherapy,immunotherapy,etc.)and the authentic world of patients directly affects the prognosis.In addition,in clinical practice doctors usually prefer the methods they are good at and ignore which plan is most beneficial to the patients.Based on evidence-based medicine and clinical guidelines,taking into account the patient's individualized condition,precise diagnosis and treatment become possible after consultation and discussion with the department of thoracic surgery,department of oncology,department of radiotherapy,department of Traditional Chinese Medicine,and department of respiratory and critical care medicine.We call for the model of the combination of shared decision-making and individualized guidelines applying to clinical practice to maximize the benefit of patients.

关 键 词：循证医学 精准医学 个体化指南 医患共同决策 肺癌综合治疗 

分 类 号：R-02[医药卫生]