整合医学在生殖内分泌病患诊治中的应用与思考
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摘要
通过分析生殖医学领域2例正反面诊疗的典型病案,我们认识到,临床面临的疾病是复杂的,从事生殖医学必须建立整合医学观。在诊治疾病中,充分认识评估发生疾病的人的整体状况,在众多因素中权衡利弊,然后有的放矢或整体调节以达到治疗目的,进而实现个体化精准医疗。
Through analyzing two typical cases of positive and negative clinical practice in the field of reproductive medicine, we realize that the clinical diseases are complex. In the field of reproductive medicine, it is necessary to establish a holistic integrative medical concept. In addition, it is also important to understand the overall assessment of the diseased person adequately. In order to achieve individualized precision medicine, we should weigh the pros and cons among many factors, and then aim at the treatment purpose with a targeted or overall adjustment.
Through analyzing two typical cases of positive and negative clinical practice in the field of reproductive medicine, we realize that the clinical diseases are complex. In the field of reproductive medicine, it is necessary to establish a holistic integrative medical concept. In addition, it is also important to understand the overall assessment of the diseased person adequately. In order to achieve individualized precision medicine, we should weigh the pros and cons among many factors, and then aim at the treatment purpose with a targeted or overall adjustment.
引文
[1]陈求珠,石秀凤,林明影,等.分娩镇痛是否越早越好?[J].医学争鸣, 2018, 9(3):19-21.
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[3]任雁林.成功的手术失败的治疗——对一例规范的“败笔”手术的思考[J].医学争鸣, 2018, 9(3):9-11.
[4]夏晓梦,方小玲.子宫肌瘤手术的相关策略与妊娠结局[J].实用妇产科杂志, 2017, 33(4):254-256.
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[7]李优.恶性潜能未定型子宫平滑肌瘤(SMTUMP)的临床研究[D].济南:山东大学, 2017.
[8]中华医学会妇产科学分会子宫内膜异位症协作组.子宫内膜异位症的诊治指南[J].中华妇产科杂志, 2015,50(3):161-169.
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[10]冷金花,戴毅.子宫内膜异位症治疗新观念[J].中华妇产科杂志, 2017, 52(7):433-435.
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[15]何辅成,李锋,李文娟.多学科协作诊疗模式对促进医院学科建设的探讨[J].中国医院, 2016, 20(7):12-13.
[16]是俊凤,陆秉,潘晨麟,等.依托学科群建设构建多学科协作诊疗模式实践与思考[J].中国医院, 2016, 20(7):3-5.
[17]中华医学会内分泌学分会性腺学组.特发性低促性腺激素性性腺功能减退症诊治专家共识[J].中华内科杂志,2015, 54(8):739-744.
[18]Teixeira L, Guimiot F, DodéC, et al. Defective migration of neuroendocrine GnRH cells in human arrhinencephalic conditions[J]. J Clin Invest, 2010, 120(10):3668-3672.
[19]Valdes-Socin H, Rubio AM, ToméFM, et al. Reproduction,smell, and neurodevelopmental disorders:genetic defects in different hypogonadotropic hypogonadal syndromes[J]. Front Endocrinol (Lausanne), 2014, 5:109.
[20]陈子江,刘嘉茵.不孕不育专家推荐诊治方案[M].北京:人民军医出版社, 2013:15-35.
[21]Kim SH. Congenital hypogonadotropic hypogonadism and Kallmann syndrome:Past, present, and future[J]. Endocrinol Metab(Seoul), 2015, 30(4):456-466.
[22]Kauffman RP. Adult-onset idiopathic hypoganadotropic hypogonadism and pregnancy in a 35-year-old women[J]. J Reprod Med, 2008, 53:132-134.
[23]孙亮,马一玮,王飞杰,等. 2017精准健康和精准营养国际研讨会会议纪要[R].中华内分泌代谢杂志, 2018,34(3):257-262.
[2]杨孜.内科疾病产科识别和风险防范[J].中国实用妇科与产科杂志, 2017, 33(3):241-244.
[3]任雁林.成功的手术失败的治疗——对一例规范的“败笔”手术的思考[J].医学争鸣, 2018, 9(3):9-11.
[4]夏晓梦,方小玲.子宫肌瘤手术的相关策略与妊娠结局[J].实用妇产科杂志, 2017, 33(4):254-256.
[5]王云霞,余艳红,钟梅,等.剖宫产后再次妊娠时机的安全性探讨[J].现代妇产科进展, 2013, 22(12):975-978.
[6]陈小芸. 4年剖宫产率及剖宫产手术指征变化研究[D].福州:福建医科大学, 2014.
[7]李优.恶性潜能未定型子宫平滑肌瘤(SMTUMP)的临床研究[D].济南:山东大学, 2017.
[8]中华医学会妇产科学分会子宫内膜异位症协作组.子宫内膜异位症的诊治指南[J].中华妇产科杂志, 2015,50(3):161-169.
[9]Dunselman GA, Vermeulen N, Becker C, et al. ESHRE guideline:management of women with endometriosis[J].Hum Reprod, 2014, 29(3):400-412.
[10]冷金花,戴毅.子宫内膜异位症治疗新观念[J].中华妇产科杂志, 2017, 52(7):433-435.
[11]郎景和.学孙子兵法精外科手术[J].中华妇产科杂志,2018, 53(4):217-218.
[12]樊代明. HIM,医学发展新时代的必由之路[J].医学争鸣,2017, 8(3)1-19.
[13]刘喆,谢国丽,王艳玲.浅谈眼科医师整合医学临床思维的建立[J].医学争鸣, 2015, 6(5):37-38.
[14]李丽君,高彦霞,陈尔秀.整合医学发展应始于急诊和重症医学[J].医学争鸣, 2014, 5(1):19-21.
[15]何辅成,李锋,李文娟.多学科协作诊疗模式对促进医院学科建设的探讨[J].中国医院, 2016, 20(7):12-13.
[16]是俊凤,陆秉,潘晨麟,等.依托学科群建设构建多学科协作诊疗模式实践与思考[J].中国医院, 2016, 20(7):3-5.
[17]中华医学会内分泌学分会性腺学组.特发性低促性腺激素性性腺功能减退症诊治专家共识[J].中华内科杂志,2015, 54(8):739-744.
[18]Teixeira L, Guimiot F, DodéC, et al. Defective migration of neuroendocrine GnRH cells in human arrhinencephalic conditions[J]. J Clin Invest, 2010, 120(10):3668-3672.
[19]Valdes-Socin H, Rubio AM, ToméFM, et al. Reproduction,smell, and neurodevelopmental disorders:genetic defects in different hypogonadotropic hypogonadal syndromes[J]. Front Endocrinol (Lausanne), 2014, 5:109.
[20]陈子江,刘嘉茵.不孕不育专家推荐诊治方案[M].北京:人民军医出版社, 2013:15-35.
[21]Kim SH. Congenital hypogonadotropic hypogonadism and Kallmann syndrome:Past, present, and future[J]. Endocrinol Metab(Seoul), 2015, 30(4):456-466.
[22]Kauffman RP. Adult-onset idiopathic hypoganadotropic hypogonadism and pregnancy in a 35-year-old women[J]. J Reprod Med, 2008, 53:132-134.
[23]孙亮,马一玮,王飞杰,等. 2017精准健康和精准营养国际研讨会会议纪要[R].中华内分泌代谢杂志, 2018,34(3):257-262.