论疾病诊治中的顾此失彼

Caring for This but Losing That in the Diagnosis and Treatment of Diseases

"顾此失彼"指在疾病的诊治中发现、意识或处理了事物的一个方面或一个事物,而遗漏、忽视了事物的另一个方面或另一个事物。首先,表现在没有全面地收集和分析相关的临床资料。其次,表现为疾病诊断的不全面。再次,表现为疾病治疗的总体安排、治疗方案或药学监护等方面的顾此失彼。与疾病诊断和治疗有关的"彼"是必须被发现和意识的。但在处理时,则根据"彼"与诊断或治疗关系的程度分别对待。为减少或减轻疾病诊治中"顾此失彼"的不良后果,需要采取一系列相应对策,如实施毕业后规范化培养、学习诊治指南和临床路径、重视疾病诊治的程序、提高临床技能、积累临床经验、丰富相关知识、培养临床思维、提高职业素养等。

In medical practice, caring for this but missing that means that the medical workers auend to one thing and lose sight of another in the diagnosis and treatment of diseases. It is manifested as follow. Firstly, the clinical data were collected and analyzed incompletely. Secondly, the diagnose was made incomprehensibly. Thirdly, the therapeutic regimen or pharmaceutical care imperfectly. All the things relative to diagnosis or treatment of the diseases must be found or recognized. But in treatment, caring for this but missing that sometimes could be permitted, if which is less important or not so important. Even though something which could induce adverse events or risks we have to ignore temporarily according to the results of comparing risks and benefits. In order to reduce the negative effects of it, some countermeasures should he made, for example, carrying out standardized postgraduate training, studying the guidelines and clinical pathway, following the process of diagnosis and treatment, improving the clinical skill, accumulating the clinical experience, enriching the medical knowledge, developing the clinical thinking ability, enhancing the career competence.