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中华诊断学电子杂志 ›› 2015, Vol. 03 ›› Issue (02) : 90 -97. doi: 10.3877/cma.j.issn.2095-655X.2015.02.004

所属专题: 文献

临床思维

临床思维及其动态特征
吴东1,()   
  1. 1. 100032 中国医学科学院北京协和医院消化科
  • 收稿日期:2014-09-23 出版日期:2015-05-26
  • 通信作者: 吴东
  • 基金资助:
    首都卫生发展科研专项(首发2011-4001-01)

Clinical thinking and its dynamic characteristics

Dong Wu1,()   

  1. 1. Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100032, China
  • Received:2014-09-23 Published:2015-05-26
  • Corresponding author: Dong Wu
  • About author:
    Corresponding author: Wu Dong, Email:
引用本文:

吴东. 临床思维及其动态特征[J]. 中华诊断学电子杂志, 2015, 03(02): 90-97.

Dong Wu. Clinical thinking and its dynamic characteristics[J]. Chinese Journal of Diagnostics(Electronic Edition), 2015, 03(02): 90-97.

信息资源的快速增长和方便获取,并不会直接带来诊疗水平的提高,医生的临床思维能力仍然是医疗行为的核心环节,是保证医疗质量的关键。临床思维就是对疾病现象进行调查、分析、综合、判断、推理等一系列的思维活动,以认识疾病的本质。临床思维的培养必须在医疗实践中进行,具体内容包括:通过临床调查掌握病情资料;分析各项病情资料的诊断意义,分清主次;综合考虑病情资料,提出诊断假设;动态观察病情变化以验证或推翻诊断假设;判断因果关联;正确对待临床工作的不确定性。培养清晰、严谨、高效的思维方式,有助于青年医生更快、更好地成长。

The rapid growth and easy availability of information doesn′t bring good medical service.Physicians′ clinical thinking remain the cornerstone of medical quality.Clinical thinking includes a series of cognitive behaviors such as investigation, analysis, integration, judgment, and inference so as to unveil the essence of diseases.The thinking capability can be achieved by no means other than medical practice itself, which is comprised of collecting data relevant to the problem of interest, evaluating the value of diagnostic clues, formulating diagnostic hypotheses, obtaining more information to accept or exclude the diagnostic hypothesis, assessing causal relationship, dealing with the inherent uncertainties in medicine.To build a successful medical career, young physicians need to improve the ability to think clearly, rigorously, and efficiently.

表1 演绎、溯因和归纳三种逻辑推理方法的区别
常见的临床诊断和治疗流程
危重患者常用诊断和治疗流程
表2 因果关系判断的求同原则
表3 因果关系判断的求异原则
表4 因果关系判断的共变原则
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