Evidence-based medicine (EBM) is the practice of making medical decisions with the most relevant information and (the best evidence) through careful, clear and wise confirmation and evaluation.
The core content is that any diagnosis (such as X-ray), treatment (such as prescribing antihypertensive drugs) or preventive health care (such as gynecological examination once a year) measures suggested or implemented by doctors should be based on reliable evidence as far as possible to prove that such measures are really beneficial to patients and have a better cost-benefit ratio as far as possible.
2, the main content of the inquiry and medical history collection
The main contents include: (1) The patient is general; (2) chief complaint; (3) current medical history; (4) past history; (5) Personal history and family history. Women should also include menstrual history and birth history.
3. Basic methods of physical examination
Visual inspection, palpation, percussion (direct percussion, indirect percussion) and auscultation.
4, the main content of clinical laboratory examination
Including hematology, body fluids and excretions, biochemistry, immunology and etiology.
5. X-ray image changes of diseases
(1) changes in size, such as: enlargement of heart shadow;
(2) Postural changes, such as joint dislocation;
(3) Morphological changes, such as various respiratory system, circulatory system, digestive system, urinary system, skeletal system, inflammation, tumor, trauma, etc. , all produce changes in morphological structure;
(4) contour changes, such as heart disease;
(5) density changes, such as lung infiltration, abnormal lung density caused by tumor, osteitis, and bone mineral density reduction or destruction caused by tumor;
(6) Functional changes, such as functional changes of some diseases, such as pericardial effusion, weakened or disappeared heartbeat, etc.
6. Advantages and disadvantages of 6.CT examination
Advantages: CT image is a sectional image of human tissue, and its density resolution is obviously better than that of X-ray examination image. It can well display the organ structure of various parts of the human body, and besides morphological changes, it can also check the density changes of tissues, expanding the scope of imaging examination.
Disadvantages: CT examination is a body line examination method, and it is difficult to find the functional changes of organ tissue structure. Individual parts such as skull base bone artifacts can affect the examination of brain tissue in posterior cranial fossa; Due to the limitation of imaging field of vision, it is not suitable to examine the small joints of limbs, and it is difficult to display the mucosal changes of hollow organs. There was an adverse reaction of contrast agent during enhanced scanning.
7, the main purpose of ultrasonic inspection
(1) Check the size, shape and physical characteristics of solid organs;
(2) To detect the shape, trend and functional status of some cystic organs (such as gallbladder and bladder);
(3) Detecting the structure, function and hemodynamic status of the heart, great vessels and peripheral vessels, including the diagnosis of various congenital and acquired heart diseases, vascular malformations and occlusive vascular diseases;
(4) To detect the physical characteristics of various space occupying lesions in organs. According to the acoustic classification of space-occupying lesions, we can distinguish whether the lesions are solid, cystic or mixed, and some can also distinguish between benign and malignant.
(5) detect whether there is effusion (such as pleural effusion and pericardial effusion) and estimate the amount of effusion;
(6) Obstetrics can determine pregnancy, fetal position, fetal number, gestational age, evaluate fetal growth and development, find fetal malformation, and evaluate fetal physiological function. Under the guidance of ultrasound, amniotic fluid, umbilical cord blood and fetal tissue can be extracted for chromosome laboratory examination, and intrauterine treatment can also be performed on the fetus;
(7) Ultrasound-guided needle aspiration cytology or tissue biopsy, or some drainage and drug injection therapy.
8. Advantages and disadvantages of magnetic resonance imaging
Advantages: MRI images have no radiation damage; By replacing gradient field and RF field, multi-axis imaging such as sagittal, coronal, transverse and oblique can be completed. The image is not disturbed by normal human tissues, unlike CT with interference artifacts such as bones; Gadolinium contrast agent was used in MRI enhanced scanning, and there was no adverse reaction.
Disadvantages: MRI image examination takes a long time. Early MRI machines used classical quantum theory, and it took more than 16 minutes to do a T2-weighted imaging. In recent years, the rapid imaging method has been shortened to less than 5 minutes. Because the patient has fear when putting in the magnet, it is changed to a short magnet with a wide entrance, which can avoid or eliminate the fear; Due to the limitation of imaging coil and imaging field of view, the imaging of facet joints is not popular; The machine is expensive, the operation cost is high, and the detection cost is high.
The above is about the sharing of the core test sites of health managers. I hope it helps you. If you want to know more, please pay attention to this platform in time!