Umboni ofotokoza mankhwala. Center kwa Umboni-yachokera Medicine. Mfundo za mankhwala umboni ofotokoza

EBM akuimira mulingo woyenera kusakanikirana mfundo sayansi ndi zinachitikira matenda ndi zofuna wodwalayo. Ndi ntchito zambiri ndi zomveka za kupambana bwino masiku ano m'kati kupanga zisankho mankhwalawa kwa wodwala. Iwo amagwiritsa ntchito mfundo zimene zichokera kwa ndemanga mwadongosolo. mankhwala umboni ofotokoza ndi kukomoka kafukufuku zogwirizana, amaganizira zofuna za mtima. Chifukwa cha umboni ndi wodalirika komanso ndi lolondola mayesero matenda ndi chiphasochi, kufunika Zoneneratu ntchito, dzuwa ndi chitetezo cha mankhwala, kukhazikitsa ndi kupewa.

Nkhani ya

Mu 1940, woyamba osapanganika (mwachisawawa yogawa) Maphunziro a ntchito ndalama "Streptomycin" mu mankhwala TB sanatsatiridwe. Mu 1962, Komiti US, amene kulamulira khalidwe asatayike ndi mankhwala zakudya akhala anayambitsa malamulo umalimbana akuyendayenda mitundu yatsopano ya mankhwala. zaka zisanu ndi zinayi pambuyo matenda izi Archi Kokran mooted za kusowa umboni sayansi. Patatha zaka zitatu, tidapeza kulakwika pakati pa chiphunzitso ndi machitidwe. Cha m'ma 80 - tcheru oyambirira 90 anakopeka ndi kufunika ndemanga ndi pulogalamu malangizo kuchipatala. Kwa nthawi yoyamba mawu akuti "umboni ofotokoza mankhwala" anali akufuna mu 1988 ndi epidemiologists ndi clinicians amene ankagwira ntchito ku Canada McMaster University. Archi Kokran linafotokoza mmene azipereka kafukufuku kwa akatswiri a. Komanso, linapangitsa chakuti zotsatira awo anali muyezo pokambirana ndi kusanthula zolondola. Cochran ndi anzake, omwe mu Medical Council Research British, khama olowa ayesetsa kuti chitukuko cha mankhwala amakono umboni ofotokoza. Iye ndiye anali mu 1979 anabwera zoti sayansi sikokwanira anapezazo yovuta mayesero osapanganika ankalamulira. Cochran anakhazikitsidwa woyamba Center kwa Umboni-yachokera Medicine, amene dzina lake. Iye anayamba kugwira ntchito Oxford zaka 10 zapitazo. Pali panopa 15 ngati malo padziko lonse. Iwo kutsogolera ntchito ya gulu lonse la ofufuza.

masiteji

Pali magulu asanu a mankhwala umboni ofotokoza:

1. Funsani funso limene pali kuthekera kuti yankho.
2. Pezani yotsimikiza bwino.
3. Amayang'anitsitsa otsutsa deta.
4. Taonani umboni zochokera matenda ukatswiri ndi zofuna za munthu wodwalayo.
5. Unikani momwe zotheka kugwiritsa ntchito njira zamakono akuthandiza.

Mfundo za mankhwala umboni ofotokoza. Kupeza umboni bwino

Akatswiri kuyang'ana umboni, zochokera mawu: wodwala, phukusi, poyerekezera, zakambidwa. Choyamba, muyenera chitani ndemanga mwadongosolo ndi osapanganika mayesero ankalamulira chifukwa iwo amakhala odalirika. Ngati umboni ali osavomerezeka kuyamba kufunafuna umboni mlingo m'munsi. Zikuphatikizapo kuphunzira gululo, "choncho kudziletsa" ndi ena.

Tili ziyenera a umboni

Ndi ziyenera izi, mukhoza kuona odalirika umboni wopezeka ndi zotsatira za phunzirolo. Kuti muone kudalirika kwa maphunziro mosintha anagawira ankalamulira, muyenera kuyankha mafunso otsatirawa:

1. Kodi randomization odwala zinachitikadi?
2. Kodi odwala onse kutenga mbali pa phunziroli Adakwaniritsira?
3. Pakhala Khadili odwala magulu amene anali osapanganika?
4. Anali mankhwalawa "akhungu" chifukwa ofufuza ndi odwala?
5. Kodi kufanana anati magulu isanayambe phunziro?
6. Kodi mankhwala womwewu ntchito, kupatulapo katswiri woyendetsa?

Pankhani ya kafukufuku Mkhalidwe akhoza chitani wounikira zotsatira.

kusanthula miyambo

ziyenera izi limodzi ndi mafunso otsatirawa:

1. Ine ndikuchita chiyani?
2. Pakuti zimene wachita, zimene zotsatira inakonzedwa kulandira?
3. ndi ufulu wachibadidwe woperekedwa ndi efficacy ndi chitetezo cha ntchito imeneyi?
4. Kodi pali bwino, zoyenerera kwambiri njira kukwaniritsa cholinga ichi?

mwayi kuphunzira

Kufufuza mfundo ndi kusanthula ovuta ali wapamwamba, ndi clinician tiyenera kukhala ndi ukatswiri zofunika ndi nthawi. Komanso akhoza kugwiritsa ntchito magazini mabuku nkhani ndi ena a sayansi. Imathandiza pofotokoza mwachidule mankhwala umboni ofotokoza, analemba ndi akatswiri ena. Izi zikhoza kukhala Cochrane Nawonso achichepere, buku M. Enkin, mabuku ena m'dera lino. Ifenso khalidwe okonzeka zopangidwa ndondomeko, amene anakonza pa maziko a mankhwala umboni ofotokoza.

Zodziwitsa review mabuku

nzeru ochiritsira limanena kuti akuluakulu umboni sayansi ndi mbali yaing'ono chabe ya zikunena zaumoyo. Ndi pafupifupi 15%. Tsiku lililonse, anthu ogwira ntchito mankhwala mu dziko chofunika kupeza kwambiri umboni watsopano koyenera kuti dzuwa ndi mankhwalawa kwa wodwala. Kuti tichite zimenezi, madokotala ayenera kupeza tsatanetsatane mu mbiri imeneyi. Ndi bwino ntchito mabuku zachipatala, amene panopa kwambiri. kuchuluka kwake mu 1970 ali kawiri. Komanso kukula tsiku lililonse. Chaka chilichonse, mkonzi bolodi zonena za 6000 nkhani m'madera monga matenda achikazi ndi obstetrics. Kuti agwirizane mlingo wa nzeru za masiku ano, dokotala chofunika kuwerenga nkhani 20 patsiku. Funso lina ndi ngati pali nthawi iyi, ntchito za umoyo? Zimafunika kuganizira mfundo yakuti ambiri Nkhani satsatira ngakhale mfundo osachepera khalidwe.

kugwira bwino ntchito

Gawo la zamankhwala anazindikira olakwika kapena lotha patatha zaka zisanu pambuyo wophunzira sukulu ku bungwe apamwamba maphunziro. N'zoona osadziwika mmene. Books mankhwala angayerekezedwe nkhalango, chifukwa kumawonjezera mofulumira kwambiri, pali ambiri "mitengo akufa", "akangaude" ndi "njoka", koma penapake chuma chonse chobisika.

mudziwe Basic

mankhwala umboni ofotokoza ndi kufika kwa posankha zochita. Mu nkhani iyi, clinician amagwiritsa mfundo zabwino zimene zilipo, ndi zimene zinachitikira dokotala. Chigamulo akutengedwa ndi wodwala, kutenga nkhani zofuna zake. Tsiku lililonse, antchito ntchito a zachipatala amafuna osiyanasiyana magwero kupeza mayankho a mafunso mobwerezabwereza. Mwachitsanzo, ophunzira kuphunzira m'dera amafunika kudziwa zofunika, kugwirizanitsa zimayambitsa matenda ndi pathogenesis ake, zinthu zachilengedwe ndiponso zinthu zina. deta Basic a sayansi osiyana. Izi, makamaka, Maphunziro Akakhalidwe Kazolengedwa, pathogenesis, thunthu, etiology. mfundo zikuluzikulu ndi n'zochepa khola, ndi mu mabukhu, mabuku, ndi zina ambiri mankhwala. Komabe, madokotala ambiri tiyenera kuyankha mafunso mwachindunji zokhudzana ndi kusamalira wodwalayo komanso chithandizo. Nazi zitsanzo zina za nkhani yomwe ikukhudzana bwanji ndi matenda kapena chikhalidwe, koma satanthauza kwenikweni mchitidwe matenda:

• Kutanthauza ...?
• Kodi otitis TV?
• Kodi tizilombo chinathandiza TV otitis?

Mayankho a mafunso a mtundu angapezeke mu mabuku, mabuku ndi zina.

Information pa kasamalidwe ka odwala

Kuwonjezera Kudziŵako, dokotala ayenera kudziwa za kufunika mwachindunji kwa kasamalidwe wodwala, njira matenda, mankhwala ndi madokotala ananena zawo. Limachita ndi mavuto mankhwala umboni ofotokoza. Mawu ofunika pano ndi "matenda, mankhwala, madokotala ananena zawo." Kuti bwino ndi uthenga wabwino n'kofunika zopanga funso molondola.

Mwachitsanzo yachipatala

Mukhoza kuona phwando "diethylstilbestrol" mankhwala kuteteza padera mu akazi. chifukwa ntchito chida amachita kusokoneza pafupipafupi mimba. Pa nkhani imeneyi, udindo timafunika kuti mankhwala kuteteza padera imatengedwa zomveka. Odwala kumutenga mankhwala, mimba, makamaka anapulumutsidwa. Mu 50 chifukwa cha asanu ndi maphunziro si osapanganika akhala zikutsimikiziridwa ndi kuchepetsa chiwerengero cha mimba pa utsogoleli wa mankhwala "diethylstilbestrol." Ndiponso maphunziro asanu, imene odwala anagawidwa m'magulu awiri ndi zochepa chabe pamalangizo mwachisawawa. Woyamba adakwatira mankhwala "diethylstilbestrol", wachiwiri - placebo. Malinga ndi zotsatira za kafukufuku pa akazi ntchito chida ichi, padera anachitika 7% ya milandu. Kuchotsa mimbayo mu Gulu lachiwiri anali 5%. Chifukwa zotsatira izi zimapezeka umboni wakuti mankhwala si abwino. Koma, ngakhale, ntchito yake kupitirirabe. Pamaso 1970, iwo ankapatsidwa ndi akazi ambiri. Umboni ofotokoza mankhwala amafuna osati chofunika zipangizo kuwerenga pa nthawi inayake. N'zochititsa chidwi kusintha makhalidwe anu ndiponso anthu ena zochokera zatsopano. mankhwala umboni ofotokoza amatipatsa prerequisites kwa cholinga ziyenera a mphamvu ya zikunena zachipatala, komanso zotsatira za ntchito yake kuchita matenda. N'zoona kuti si kwapafupi, chifukwa ndi kufunafuna umboni, ndi kugawa awo ndi kukhazikitsa kusintha, angapezeke zopinga zimene zimachitika mu ndondomekoyi.

mapangidwe malingaliro

Umboni ofotokoza mankhwala aliyense mu dziko osauka kupitilira geometrical. Kuyambira ndi '90s, nthawi mapangidwe ake, ndipo lero chiwerengero cha mabuku, maonekedwe ndi malo malowa Akuti mu makumi, ndipo chiwerengero cha mabuku - mwa mazana. Mu 1997, 12 Malo oterewa alandira amapereka kwa zaka 5 ku US Agency malamulo, sayansi ndi thanzi. mabungwe awa inakhazikitsidwa pa mayunivesite otchuka ndi mabungwe kafukufuku limati osiyana. Kuchuluka chiwerengero cha malo nkhani apadera kwambiri monga ana ndi maganizo, thandizo ndi m'madera ena. General kutchula iwo ndi mfundo za umboni pa nkhani iliyonse ya zopangira zisankho ku chikhalidwe poyera pulogalamu kutsiriza ndi kuika mankhwala payekha. Mu Russia, ndi establishments wotchuka zili St. Petersburg ndi Moscow. Pakati nkhawa pamwamba ndi chipatala umboni ofotokoza mankhwala, Nizhnevartovsk. Institution makamaka matenda, ubongo, Pediatrics ndi urology, andrology ndi matenda achikazi, gastroenterology ndi matenda ENT.

HOA

mankhwala umboni ofotokoza ndi Federation Chirasha komanso osauka kwambiri. Mu Russia uko Interregional condominiums ammudzi. Iwo walandira kulembetsa mu 2003. Foni ya mankhwala umboni ofotokoza ndi zaufulu sanali phindu kucheza. Mozama pansi hayala lapansi. zinthu zazikulu za condominiums:

1. Kuphunzitsa ntchito kugwirizana ndi mavuto methodological wa AIDS ndi matenda maphunziro systematics mudziwe m'munda wa mabuku sayansi ndi kufufuza kusanthula zowerengera deta.
2. Nkhani za zotsatira za kafukufuku wawo zofunika sayansi.
3. Mawu oyamba a patsogolo yochizira matenda.
4. Kuphunzira khalidwe la mabuku sayansi, ndondomeko odwala ndi anthu ena.
5. Sotsioepidemiologicheskie ndi kafukufuku Biomedical.

Mfundo za mamembala a condominiums:

- kufalitsa nkhani kafukufuku ofotokoza za phukusi zachipatala ndi mungachite kuti kupeza Deta yotere;

- kupewa kulengeza za nkhani ntchito, zomwe sichinayambe chatsimikiziridwirapo mwasayansi;

- kulengeza za umboni alipo zinthu.

Ogwira ntchito za bungwe ndi madokotala amene amatsatira mfundo zimenezi ndi kuzitsatira iwo kuchita. Pakali pano, mu zigawo United 17 ndi anthu oposa 300. Mutu wa maudindo dera amapatsa oyenerera chithandizo thanzi.

Center kwa Umboni-yachokera Medicine (Education, 14, St. Petersburg)

Iwo amagwira ntchito malo ndi zisanu ndi zitatu m'mawa mpaka asanu pa usiku ndipo ali ndi linanena bungwe umodzi, zomwe udzachitika Lamlungu. The chakumadzulo Center kwa Umboni-yachokera Medicine amapereka osiyanasiyana zothandizira anthu. Kodi mukhoza kupeza malangizo ndi chithandizo kwa madokotala a specialization yopapatiza, kudali zasayansi diagnostics, colposcopy, ultrasound, kutikita Inde. Umboni-yachokera Medicine Center komanso amachita polojekiti tsiku la ECG + magazi. ndodo zonse ntchito mu bungwe ndi madokotala kwambiri oyenerera. Chakumadzulo Center kwa Umboni-yachokera Medicine imakhazikika matenda monga:

- osteochondrosis, kukula vertebral Cervicalgia, discogenic radiculitis ndi lumbodynia;

- psinjika neuropathy, ischemic, lomwe ndi chizindikiro cha dzanzi zala;

- deforming osteoarthrosis pamisinkhu yosiyanasiyana (monga mankhwala ntchito medikametoznye anatseka misewu ntchito asidi hyaluronic);

- matenda pathological wa tendons ndi Mitsemphayi (tendovaginitah, enthesopathies ndi ena);

- kudwala a kapisozi limodzi "chimathandiza" pa zidendene.

A yachiwiri mabungwe odziwika wa St. Petersburg

Center kwa Umboni-yachokera Medicine (Lenin 88) akuthamanga kuchokera eyiti m'mawa mpaka eyiti usiku. Kukhazikitsidwa lili nyumba zogona pansi woyamba. zipangizo zamakono, mkulu mlingo wa utumiki, njira zamakono za matenda - uwu si mndandanda wa ubwino kuti Center kwa Umboni-yachokera Medicine. Reviews odwala ambiri akusonyeza kuti apa wina Mlendo lidzazondedwa pazipita. Kuyamikira anasonyeza kuti khalidwe la ntchito. Mungathe kupempha thandizo la akatswiri monga gynecologist ndi gastroenterologist, ndi katswiriyu ndi internist, cardiologist ndi maso, m'thupi yemwenso, urologist, ndi zina zotero. Chipatala akhoza kupeza mankhwala umboni ofotokoza ndi diagnostics mu labu, atagwira ultrasound, echocardiography, kalposkopii, kutikitirako electrocardiography. The dokotala wamkulu wa bungwe yoikidwiratu oncologist Beynusov Dmitriy Sergeevich. zotsatira angapezeke powatchula kapena kuwalandira iwo mu makalata. Kuwonjezera pakati zachipatala, ntchito ya akatswiri amachita ku chipatala mzinda. wazachipatala ndalama 1200 rubles.