病理学绪论Introduction to Pathology
病理学的内容和任务The Contents and Tasks of Pathology(1)
病理学在医学中的地位The Roles of Pathology in Medicine(2)
病理学的研究方法Methods of Pathological Research(3)
病理学的观察方法Methods of Pathological Observation(5)
病理学的发展史 History of Pathological Development (6)
病理学的学习方法Methods of Learning Pathology(8)
Outline
Pathology is the study on disease including etiology,pathogenesis,pathological changes,clinical pathological correlation and prognosis by scientific methods.
Pathology is a discipline bridging between clinical practice and basic medicine, Pathology diagnosis is authentic diagnosis with unsubstitutional.Pathologists are “doctor’s doctor”.
Pathology includes two major parts, general pathology and systemic pathology.General pathology is the study of the basic principles of pathological processes involved in disease (e.g.cell and tissue adaptation and injury,repair for injury,local fluid and hemodynamic derangement, inflammation, and tumor).It is the foundation of knowledge that has to be laid down before one can begin to study the systematic pathology of specific disease.And systematic pathology in the study of structure and functional abnormalities of a specific disease of body organs or system, such as respiratory system (lung cancer), digestive system (appendities) and so forth.
Pathological research methods include two major parts, too.Human pathology and experimental pathology.Human pathology includes autopsy, biopsy and cytology.Experimental pathology includes animal experiment and tissue and cell cultures.There are various methods for pathological observations, such as gross pathology, light microscopy, histochemistry, immunohistochemistry, electron microscopy and so on.
In recent years, a series of new technologies have been established, new branches of science such as cell biology, molecular biology, environmental medicine and modern immunology have been rised.This had a profound impact on development of medical science and also pathology, promoting the establishment of the immunopathology ,molecular pathology ,genetic pathology and quantitative pathology.And new techniques such as specialized laboratory tests of a biochemical, immunologic or molecular nature have been using for the study and diagnosis of disease.We are now entering a golden age for pathology which is full of promises.
病理学(pathology)是用自然科学的方法研究疾病的病因、发病机制、病理变化、结局和转归的医学基础学科。病理学的研究目的是认识和掌握疾病的本质和发生、发展的规律,从而为防治疾病提供必要的理论基础和实践依据。在临床医疗实践中,病理学为许多疾病诊断、鉴别诊断,并提供治疗的依据,是临床医学的重要学科之一。
第一节 病理学的内容和任务The Contents and Tasks of Pathology
病理学研究的主要对象是疾病(disease)。所谓疾病是指机体在病原因子作用下,在结构或功能上发生的一些异常改变,表现出一定的症状和体征。但病理学并不仅是病变组织形态学的同义词,病理学包括了从病变分子水平到机体出现疾病时的功能、结构变化的知识和对此的理解。
一般将病理学分为基础病理学(basic pathology)和临床病理学(clinical pathology),后者又称外科病理学(surgical pathology)或诊断病理学(diagnosis pathology)。基础病理学侧重于病理学的基础理论研究,临床病理学侧重于对疾病的临床病理诊断。本教材的内容侧重于基础病理学。基础病理学一般包括总论和各论两大部分。病理学总论又称为普通病理学(general pathology),主要阐述涉及疾病病理过程的基本病理变化、各种不同疾病发生、发展的共同规律(如组织和细胞的损伤、损伤修复、局部血液循环障碍、炎症和肿瘤)。如不同炎症性疾病都有炎症的三大基本改变,即变质、渗出和增生。病理学各论或称为系统病理学(systemic pathology),侧重阐述各种不同疾病发生、发展过程中的特殊规律,即以疾病为单位研究疾病的病因、发病机制、病理变化的发生、发展规律及其与临床的联系。如大叶性肺炎和小叶性肺炎其病因、病理变化和临床表现等可以完全不同。学习总论认识疾病的共同规律有利于对各论中具体疾病的理解,认识疾病的特殊规律。而各论研究特定器官或系统疾病的特殊性,又加深了对总论普遍规律的认识。因此,病理学总论和各论之间有着十分密切的内在联系,学习时应互相参考。
病理学的主要任务是研究和阐明:①病因学(etiology):疾病的原因,包括内因和外因,及其相互关系;②发病学(pathogenesis):即在病因的作用下导致疾病发生、发展的具体环节、发病机制和过程;③病理变化(pathological change)或病变(lesions):即在疾病发生、发展过程中机体的功能代谢和形态结构的变化,以及这些变化与和临床表现(症状与体征)之间的关系,即临床与病理的联系(clinical pathological correlation);④疾病的转归与结局,包括疾病的发展和预后(prognosis):疾病的预期治疗结果,复发以及并发症(complication)、后遗症(sequelae)等。
What is disease?
Disease may be identified as an abnormal variation in the morphological, structure and function of any part of body.In other words, a disease is abnormal condition of body caused a loss of normal health (disease).
第二节 病理学在医学中的地位
The Roles of Pathology in Medicine
病理学长期以来被喻为“桥梁学科”,病理诊断为“权威诊断”,这充分表明它在医学中,特别是在临床医学中占有不可替代的重要地位。加拿大著名医生和医学教育家SirWillian Osler(1849~1919)曾写道:“As is our pathology, so is our medicine”(病理为医学之本)。
(一) 病理学是基础医学与临床医学之间的桥梁学科Pathology is a bridge between clinical and basic medicine
病理学是以解剖学、组织胚胎学、细胞生物学、生理学和生物化学等各学科知识为基础,研究疾病状态下机体、器官、组织和细胞的形态结构、功能及代谢的改变,以回答这些改变与临床上出现的症状、体征之间的关系、疾病的诊断、转归和结局等临床医学中的问题。病理学本身作为基础医学的主干学科,同时又是临床医学各门课程的基础。对医学生来说病理学是一门极其重要的专业基础课程,是从医学生成长为临床医生的必修课程。通过学习疾病的基本病变、相应的功能和代谢改变以及临床表现,掌握疾病的规律和特点,为今后临床医学课程的学习打下坚实的基础。因此,在医学教育中,病理学是基础医学和临床医学之间的桥梁学科。
Clinical pathological conference (CPC)
The object of the pathological discussion comes from the autopsy cases.In order to make improvement as well as draw the lesson from the experience, the diseases cause, pathogenesis and pathology under the combination of clinical and autopsy condition were discussed.Autopsy materials would be the most important contents in the clinical pathological conferences .
(二) 在疾病诊断中病理诊断具有权威性Pathological diagnosis has authority in diagnosis
病理诊断是通过观测器官的大体(肉眼)改变、镜下观察组织结构和细胞病变特
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