四川大学华西临床医学院 -...

四川大学华西临床医学院

麻醉学

教学大纲（适用专业：临床医学八年制）

麻醉与危重病教研室/(教研组)

修订日期： 2018 年 1 月

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目录

1.课程介绍…………………………………………………………………3

2.绪论和麻醉前准备与评估………………………………………………6

3.全身麻醉…………………………………………………………………7

4.气道控制…………………………………………………………………8

5.呼吸功能的监测…………………………………………………………10

6.血流动力学测……………………………………………………………11

7.体外循环……………………………………………………………… 13

8.氧供需平衡…………………………………………………………… 14

9.休克…………………………………………………………………… 16

10.神经阻滞麻醉和椎管内阻滞麻醉……………………………………17

11.体液酸碱平衡的监测…………………………………………………19

12.急性肺损伤（ALI）和急性呼吸窘迫综合征（ARDS） ……………21

13.多器官功能障碍综合征………………………………………………22

14.疼痛诊疗………………………………………………………………24

15.心肺脑复苏……………………………………………………………26

16.输血与血液保护………………………………………………………29

17.危重病人的营养支持…………………………………………………30

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“麻醉学”课程介绍

一、课程基本信息

课程名称：麻醉学英文名：Anesthesiology 课程号：502115030

课程类别：专业与服务课程群必修课学时：54（讲 36，习 18）学分：3

二、教学团队

教学单位负责人：左云霞教授，tel：18980601541，e-mail：[email protected]

课程秘书：李崎副教授，tel：18980601467，e-mail：[email protected]

课程助教：黄力立 tel：18428365870， e-mail：[email protected]

三、课程教学目的

认知教学目标：掌握麻醉学领域相关理论知识、临床常用监测意义等，熟悉目前常用麻

醉技术，麻醉前评估。

技能教学目标：掌握临床常用监测运用，CPR等技术，熟悉气管插管指征、操作流程等。

职业素养教学目标：培养合格、较全面的临床医师。

四、临床医学八年制教学计划表

教学内容

教学形式合计

大课见习技能

训练

病案讨论

/PBL

自

学

绪论和麻醉前准备与评估 2 2

全身麻醉 2 2 4

气道控制 1 3 4

呼吸功能监测 1 2 3

血流动力学监测 1 1 2

体外循环 1 1

氧供需平衡 2 2

休克 2 2

神经阻滞麻醉和椎管内阻滞麻醉 3 1 4

mailto:[email protected]

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体液酸碱平衡的监测 4 1 5

急性肺损伤（ALI）和急性呼吸窘迫

综合征（ARDS）2 1 3

多器官功能障碍综合征 2 2

疼痛诊疗 4 3 7

心肺脑复苏 2 3 5

输血与血液保护 2 2

危重病人的营养支持 3 1 4

专题答疑 2 2

总计 36 12 6 54

五、教材：《麻醉学》杨拔贤、李文志主编，人民卫生出版社，

978-7-117-17076-5/R.17077 2013 3 版 1 次

六、主要参考资料：《现代麻醉学》第三版，庄心良主编，人民卫生出版社，

978-7-117-05518-5，2009

七、成绩评定办法（期末考试占成绩 40%、平时成绩 60%；平时考核成绩包括 4

次随堂测试和见习）

课程过程考核计划（已完成的考核内容如实填写，考核次数不少于 6 次）

序号考核形式考核内容

第 1 次大课后考核随堂考核血流动力学监测、呼吸功能监测

第 2 次大课后考核随堂考核氧供需平衡以及休克

第 3 次大课后考核随堂考核神经阻滞和椎管内阻滞麻醉

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第 4 次大课后考核随堂考核疼痛诊疗

第 5 次期末试卷考试 100 分，占 40%总成绩；70 道单选+3 道简答

八、周末见习：每周末 8:00-20:00 在急诊手术室见习麻醉，由麻醉科住院总安

排（18980601558），提前报名至麻醉学助教黄力立（18428365870）.

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绪论和麻醉前准备与评估

Introduction of Anesthesiology& Preoperative evaluation

Introduction of Anesthesiologe evaluation

一、【目的要求】：

1.了解麻醉学近代发展史

2.了解麻醉及麻醉学的概念、麻醉工作的任务

3.掌握麻醉前对病人的检查、评估与准备

4.掌握麻醉前用药的种类及药理特点，使用原则

Course Objective: History of anesthesiology, the concepts of anesthesia and anesthesiology,

classification of anesthesia, preoperative physical examination, evaluation and preparation,

general anesthesia and the complications of general anesthesia and their management.

二、【讲授内容】：

1.麻醉学近代发展史

2.麻醉及麻醉学的概念、麻醉工作的任务

3.麻醉前的一般准备

4.麻醉前对病人的检查、评估与准备；麻醉前用药的种类及药理特点，使用原则

三、【重点难点】：

1.麻醉前病人评估；

2.麻醉前用药的种类及药理特点，使用原则。

Course Description：This course will start with introduction of modern history of anesthetic

practice. Then we will introduce the concepts of anesthesia and anesthesiology and the tasks of

anesthesiologists. The following topics will cover preoperative evaluation and preparation;

including the pharmacokinetic characteristics and the principle of usage of drugs used before

anesthesia. And the content of preoperative evaluation and preparation and the usage of

preoperative medication are key points in this course.

四、【讲授时数】：2 学时

五、【参考书】：

《现代麻醉学》第三版

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全身麻醉

General Anesthesia


1.掌握吸入麻醉药的分配系数、最低肺泡有效浓度（MAC）的概念

2.掌握常用的全身麻醉方法及特点及全麻后病人的去向

3.掌握全麻后的常见并发症因。

4.熟悉全身麻醉的主要优缺点和适应症。

5.熟悉肌肉松弛药的分类和使用原则。

6.了解靶浓度控制输注。

7.了解肌肉松弛药的药理作用。

Course Description：To master concepts of coefficient of distribution and minimum alveolar

concentration (MAC) of inhaled anesthetic, the application and characteristics of general

anesthesia ways commonly used, where the patients recover from general anesthesia transported

to and the complications of general anesthesia are requested. And students should be familiar with

the principles of anesthesia selection, indications of general anesthesia, the classification and

principles of muscle relaxants application. From this course, students will acquire general

understanding target controlled infusion (TCI) and the pharmacokinetic effect of muscle relaxants.


1.睡眠、镇静和全麻醉的差别

2.吸入麻醉的特点和实施

3.静脉麻醉的特点和实施

4.常见全麻并发症


1.决定吸入麻醉药进入和排出体内的因素

2.全身麻醉的并发症

【教学时数】：2学时

四、【自学内容】：

肌肉松弛剂的作用原理

常用全身麻醉药物的药理特点

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Course Description：We will introduce the knowledge of general anesthesia. We will help

students differentiate the sleep, the sedation and the general anesthesia. Then we will introduce the

characteristics and the practice of inhalation anesthesia and intravenous anesthesia. The factors

that determine intake and elimination of inhaled anesthetic and complications of general

anesthesia are important and difficult to learn in this course.

Prerequisite：The prerequisite of this course includes, but is not limited to, the knowledge of,

diagnostics and pharmacology. Those who are not familiar with this knowledge are encouraged to

read related text books and/or my lecture notes before hand.

五、【参考文献】：


六、【见习内容】：

地点：手术室

内容：麻醉前准备:患者准备、麻醉剂准备、常规麻醉药及抢救药准备；

常用去极化/非去极化肌松药的作用机理、种类、特点以及应用；

全身麻醉的诱导、维持、常见并发症。

学时：2学时

气道控制

Airway Management


1. 掌握呼吸道梗阻的原因及处理

2. 掌握常见人工气道建立的方法及其特点。

3. 掌握气管插管的适应症和并发症

4. 熟悉气管插管的操作、困难气道的处理

5. 了解肺隔离术

Objectives: To master the following key concepts and principles: 1 Reasons and treatments of

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airway obstructions.2 Methods and characteristics of common artificial airway managements.3

Indications and complications of endo-tracheal intubation. To be familiar with： the process of

endo-tracheal intubation and algorithm of difficult airway management. To acquire a general

understanding: techniques of lung isolation.


1. 上、下呼吸道梗阻的常见原因、临床表现及处理

2. 通过面罩、喉罩、气管插管和气管切开所建立的人工通气技术的特点

3. 气管插管的适应症、并发症。

4. 气管插管术

5. 困难气道的评估及处理原则


影响气道通畅的原因及处理

Description: Brief contents of this chapter:

Usual reasons, clinical manifestations and treatments of upper and lower airway obstruction.

Characteristics of artificial airway management like mask ventilation, laryngeal mask airway

(LMA), endo-tracheal intubation and tracheostomy.

Indications and complications of endo-tracheal intubation.

Endo-tracheal intubation.

Evaluation and management of difficult airway.

四、【讲授时数】：1学时

五、【参考书】：《现代麻醉学》第三版

六、【见习内容】

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新八教临床技能教室见习：

通过面罩、喉罩、气管插管和气管切开所建立的人工通气技术的特点

气管插管的适应症、并发症。

气管插管术

困难气道的评估及处理原则

呼吸功能的监控

本章授课前请自学《生理学》呼吸系统各论内容


1.掌握呼吸功能监测的基本原理和方法

2.熟悉术前呼吸功能评估的常用方法，掌握术前改善呼吸功能的措施

3.掌握肺通气功能以及肺换气功能的监测，尤其是呼气末二氧化碳监测的意义

4.熟悉呼吸机治疗的基本原理和常见通气模式


1.术中通气功能的监测

2.呼气末 CO2的监测及其意义

3.术前常用呼吸功能的评估，术前改善呼吸功能的措施

4.常用机械通气模式及其并发症


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通气功能监测，换气功能的监测



《临床监测学》



地点：手术室

内容：目前临床常用呼吸功能监测指标以及意义

学时：1学时

血流动力学监控

Hemodynamic monitoring and management

本章授课前请自学《生理学》循环系统各论内容


1. 掌握临床监测血流动力学的常用指标和特点；

2. 掌握低血压的判断和调控；

3. 熟悉直接动脉压导管和中心静脉导管放置方法

4. 了解肺动脉漂浮导管放置方法；控制性降压的概念及实施原则。

Objective: This chapter is designed for senior undergraduate students in the School of Medicine.

They could master the indication of common clinical monitoring of hemodynamic , the judgement

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and regulation of hypotension; To be familiar with: catheterization of arterial catheter and

central venous catheter. To acquire a general understanding: Swan- Ganz catheter, the method,

concept and practical principle of control hypotension.


1、临床常用的监测循环功能的指标和方法；

2、动脉血压测定的方法、意义，影响血压的因素；

3、中心静脉压监测和肺动脉漂浮导管监测的方法及临床意义；

4、低血压原因的分析、判断、血压的调控；

5、控制性低血压的概念、适应症和禁忌症，实施方法及注意事项。


1、动脉血压与组织血流灌注的关系。

2、低血压原因的分析

Description: This chapter will introduce the indicator of cardiac preload, such as systolic pressure

variation and pulse pressure variation, a better predictor of volume than central venous pressure

(CVP) or pulmonary capillary wedge pressure.

【讲授时数】：1学时

四、【自学内容】：

1、中心静脉和肺动脉导管的置入方法及并发症；

2、外周血管阻力的计算。


现代麻醉学

现代麻醉学技术。

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地点：手术室

内容：目前临床常用血流动力学监测指标以及意义

学时：1学时

体外循环

Cardiopulmonary Bypass


1、掌握体外循环的概念和临床应用。

2、熟悉体外循环的原理。

3、了解体外循环的材料、监测、体外膜式氧合的概念。

Objectives: This chapter is designed for undergraduate students in the School of Medicine. The

students should master the following key concepts of cardiopulmonary bypass and the clinical

indication of the cardiopulmonary bypass. To be familiar with: the principle of cardiopulmonary

bypass. To acquire a general understanding: the material during cardiopulmonary bypass.


1、体外循环的历史和基本概念

2、体外循环的原理和方法

3、体外循环的材料和监测

4、体外循环的临床应用（治疗作用和生命支持作用）

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5、体外膜式氧合器氧合疗法（ECMO）的概念、临床应用和发展趋势


1.体外循环的发展历程，在临床各个领域的应用将来的发展趋势。

2.体外膜式气合器氧合疗法的概念，国内外应用现状，未来的发展前景。

Description

This chapter will introduce the principle and concept of the cardiopulmonary bypass. We should

master the clinical indications of the cardiopulmonary bypass.



体外循环学（龙村主编）

现代麻醉学（第三版）

氧供需平衡的监控

Monitoring and control of the balance between oxygen supply and demand

本章授课前请自学《病理生理学》缺氧、氧解离曲线部分内容


1、掌握氧供、氧耗、氧需、缺氧的概念；

2、掌握术中氧运输过程的监测

3、熟悉氧供需平衡监测；

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4、熟悉氧疗的基本概念和方法

Objectives: This chapter is designed for undergraduate students in the School of Medicine. To

master the following key concepts and principle: oxygen supply, oxygen consumption, oxygen

demand, hypoxia, and the monitoring item of oxygen transportation process. To be familiar with:

the balance between oxygen supply and demand. To acquire a general understanding: the basic

concepts and methods of oxygen therapy


1、氧输送的过程

2、氧供的监测和计算方法

3、氧供需平衡的监控

4、氧疗的基本概念和方法


氧运输的过程及监测、氧供和氧耗的计算

Description：The brief contents in this chapter are including: oxygen transport process: O2

cascade, the influence factors for oxygen transport, the calculation formula for oxygen supply, the

monitoring during oxygen transport: arterial oxygen saturation, oxygen pressure, oxygen capacity,

oxygen-Hb dissociation curve, shunt fraction,the monitoring of the balance between oxygen

supply and demand, the basic concepts and methods of oxygen therapy

四、【讲授时数】：

2学时



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休克

Shock


1、掌握休克的分类；

2、掌握休克的临床表现、诊断、急救处理和治疗要点；

3、熟悉休克的特殊监测；

4、熟悉使用血管活性药物的适应症及注意事项；

5、了解休克治疗的进展。

Objective: This chapter is designed for undergraduate students in the School of Medicine. Five

main points are covered in this chapter including: 1. Cellular alterations. 2. Impairment of cellular

metabolism. 3. Organ response. 4. Types of shock. 5. Treatment for shock. All of the above

contents need to be well understood and mastered by the students.


1、休克的概念、病因、分类

2、休克时微循环的变化特点及与疾病发展变化的关系

3、休克的临床表现

4、休克的急救措施，综合治疗要点

5、休克液体治疗的原则和注意事项


休克的诊断和处理

Description ： In the first part of this course, we will introduce the pathogenesis and

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pathophysiology of shock, including cellular alteration, impairment of cellular metabolism,

neuroendocrine response, cardiovascular response, pulmonary response and renal response. And

then, six specific forms of shock will be introduced, including cardiogenic, hypovolemic,

neurogenic, anaphylactic, septic and traumatic shock. At last, the approach to the patient with

shock will be introduced, including monitoring, diagnosis and treatment.

Prerequisite：The prerequisite of this course includes, but is not limited to, the knowledge of

histology, physiology, and pathology of some important organs, such as, brain, heart, lung, kidney.

Those who are not familiar with that knowledge are encouraged to read related text books before

hand.




神经阻滞麻醉和椎管内阻滞麻醉

Periphery nerve block and Neuraxial block


1、掌握常用局部麻醉药的药理特点

2、掌握局麻药的毒性反应及防治

3、熟悉常用神经阻滞的优缺点

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4、掌握椎管内麻醉的概念、适应症与禁忌症、严重并发症

5、熟悉椎管的解剖及椎管内麻醉的生理

6、熟悉影响椎管内麻醉平面的因素

7、了解神经丛阻滞的操作方法

8、了解椎管内麻醉操作方法


main points are covered in this chapter including: 1. Pharmacological characteristics of local

anesthetics. 2. Toxicity of local anesthetics and ways of prevention. 3. Anatomy of peripheral

nerve plexus and central nervous system. 4. Concept of neuraxial block and its indications,

contraindications and complications. 5. Major periphery nerve plexus blocks. The first two and the

4th points need to be mastered. The 5th point needs to be familiar with and the 3rd point needs to

be understood by students.


1、局部麻醉药的药理及毒性反应

2、椎管内麻醉：椎管解剖、椎管内麻醉穿刺技术、影响椎管内麻醉的

因素、椎管内麻醉的并发症、适应症与禁忌症

3、神经阻滞麻醉：臂丛神经阻滞麻醉、颈丛神经阻滞、下肢神经丛阻滞麻醉方法

三、【重点难点】：麻醉药的药理特点、毒性反应及防治、椎管内麻醉严重并发症


五、【自学内容】：椎管内麻醉的生理、颈丛神经阻滞麻醉、腰麻硬膜外联合麻醉

Description: Basic concepts of peripheral nerve plexus block and neuraxial block are introduced,

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and the indication, contraindications and complications of peripheral nerve plexus block and

neuraxial block are also introduced in this chapter.

Prerequisite: The prerequisite of this course includes, but is not limited to, the knowledge of the

anatomy of major peripheral nerve plexus and neuraxial system. Those who are not familiar with

that knowledge are encouraged to read related textbook beforehand.

六、【参考书】：

1、《现代麻醉学》第三版

2、 ANESTHESIA（Miller）—7th Edition

体液酸碱平衡的监控

Fluid，electrolyte and acid-base balance


1、掌握各型水钠代谢障碍，低、高钾病理、临床症状、治疗原则；

2、掌握各型酸碱中毒的病理生理、临床症状、诊治原则；

3、熟悉正常水、电解质代谢和酸碱平衡的基础理论；

4、熟悉体液失调临床处理的基本原则。

5、了解其他电解质失衡的临床表现和处理原则；


main points are covered in this chapter including: 1. Clinical manifestations and principles of

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therapy of dehydration and hypokaleamia and hyperkaleamia. 2. Diagnosis and treatment of

simple acid-base balance. 3. Basic theories of normal homeostasis of internal environment. 4.

Distribution and adjustment of fluid in different compartment. 5. Concept and treatment of other

disturbance of internal environment. The first two main points need to be mastered, the third and

forth points should be familiar with, and the fifth point should be understood by the students.


1. 各型水钠代谢障碍，低、高钾病理、临床症状、治疗原则；

2. 各型酸碱中毒的病理生理、临床症状、诊治原则；

3. 正常水、电解质代谢和酸碱平衡的基础理论；

4. 体液失调临床处理的基本原则。


重点：各型脱水，低、高钾血症，代谢性酸中毒的诊治原则。

难点：各型脱水的诊断，酸碱失衡的临床分析方法。

Description：The concepts of dehydration and electrolyte abnomities and acid-base disturbance

are introduced, also are the clinical manifestations and principles of therapy.


normal components in the body fluid. Those who are not familiar with that knowledge are

encouraged to read related text books beforehand.



张文武主编，急诊内科学，第六篇水、电解质和酸碱平衡失调，589~635。人民卫生

出版社

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急性肺损伤（ALI）和急性呼吸窘迫综合征（ARDS）

ALI &ARDS


1、掌握 ALI和 ARDS的定义和诊断标准；

2、掌握 ALI与 ARDS的临床表现和诊治原则。

3、熟悉 ARDS的病理改变和病理生理过程和掌握 ARDS 呼吸支持治疗的原则。

4、了解 ALI和 ARDS的病因；

Course Objective: This chapter is designed for undergraduate students in the School of Medicine.

Five main points are covered in this chapter including: 1. Concepts and diagnosis of Acute Lung

Injury（ALI）and Acute Respiratory Distress Syndrome（ARDS）. 2. Clinical manifestations and

principles of therapy of ALI & ARDS. 3. Principles of ventilation support for patients with ARDS.

4. Pathophysiological and physiological changes of ARDS. 5. Etiology of ALI & ARDS. The first

three main points need to be mastered, the forth point should be familiar with, and the fifth point

should be understood by the students.


目的要求中的内容。


重点：ALI与 ARDS 的诊断标准，临床表现与治疗原则。

难点：ALI与 ARDS 的治疗原则。

Course Description：The concept and diagnostic standard，as well as principles of treatment for

patients with ALI & ARDS are introduced. The pathophysiological and physiological changes are

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introduced also.


physiology, and normal respiratory circle of lung. Those who are not familiar with that knowledge

are encouraged to read related text books before hand.



急性呼吸窘迫综合征。毛宝龄主编，人民卫生出版社

多器官功能障碍综合征

Multiple Organ Dysfunction Syndrome（MODS）


1、熟悉MODS的定义以及MODS、MOF、SIRS三者概念上的相互关系；

2、熟悉MODS的病因、发病机制、诊断标准；

3、掌握 SIRS的诊断标准，MODS的临床特征与防治原则；

4、了解急性肾衰、急性呼吸窘迫综合征、应激性溃疡、急性肝衰竭的基本概念、发病

原因；

5、掌握急性肾衰、急性呼吸窘迫综合征与应激性溃疡、急性肝衰竭的临床表现与治疗

原则。


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Five main points are covered in this chapter including: 1. Concepts of Systematic Inflammatory

Reaction Syndrome (SIRS), MODS and Multiple Organ Failure (MOF) and the relationship

between them. 2. Etiology、pathogenesis and diagnosis of MODS. 3. Diagnosis of SIRS，clinical

features and principle of therapy of MODS. 4. Clinical manifestations and principles of therapy of

acute renal failure, ARDS, stress ulcer and acute hepatic failure. 5.Basic concept and etiology of

acute renal failure, ARDS, stress ulcer and acute hepatic failure. The first two main points should

be familiar with， the third and fourth points need to be mastered, and the fifth point should be

understood by the students.

二、【讲授内容】：同目的要求。


重点：MODS的病因、发病机制、诊断标准与防治原则。

难点：MODS的病因、发病机制、诊断标准与防治原则。

Course Description：The concepts and diagnosis of MODS and SIRS are introduced，as well as .

the clinical manifestations and principles of therapy. Basic concepts and etiology and principles of

therapy of acute renal failure、ARDS、stress ulcer and acute hepatic failure are introduced also.


normal organ function. Those who are not familiar with that knowledge are encouraged to read

related text books before hand



多器官功能障碍综合征。盛志勇主编，人民卫生出版社


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地点：ICU病房

内容：休克、ARDS/MODS、酸碱平衡、电解质的监测调节、外科营养

学时：4学时

疼痛诊疗

Pain and Pain Management

一【目的要求】：

1. 掌握术后镇痛重要性及病人自控镇痛应用

2. 掌握慢性疼痛治疗的基本方法及治疗原则

3．掌握癌痛药物治疗的三阶梯原则

4. 熟悉疼痛的恶性循环及传导通路，神经阻滞治疗疼痛的机理；

5. 了解疼痛的简史、分类、机理和测量评估

Objective: This course is designed for overseas junior undergraduate students in the School of

Medicine. The definition of pain and general principles of pain management are covered. The

intention is that the material will provide a foundation for theoretical and applied introduction in

pain and pain management.

二【讲授内容】：

1、疼痛基本知识（概念、发展简史、疼痛的测定与评估、发生机理及传导通路）

2、慢性疼痛的治疗方法及原则，神经阻滞治疗疼痛的机理及适应症、禁忌症

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3、癌痛治疗方法

4、术后镇痛：定义、术后疼痛对机体的影响、术后镇痛的意义及方法；

5、病人自控镇痛：定义、方法、分类及适应症、基本术语及意义。


难点：疼痛的发病机理及传导通路；

重点：1.疼痛的恶性循环及神经阻滞治疗疼痛的机理；

2.慢性疼痛的治疗方法及癌痛的三阶梯药物治疗；

3.术后疼痛对机体的影响及术后镇痛的意义。

Description: This course will introduce both the definition of pain and general principles of pain

management. We will start with introduction of the definition of analgesiology, the task of pain

management, the history of analgesiology and the pain epidemiology. Then we will introduce the

mechanism of pain which include following four parts: the definition of pain, the anatomy basis of

pain, the pain and tissue injury or trauma and the modulation of nervous system in pain. Then the

following topics will cover the harm of pain to the body, the classification of pain and the

assessment techniques of pain. In the assessment techniques of pain, we will learn the verbal

rating scale(VAS), the numerical rating scale(NRS), the visual analogue scale, the face expression

rating scale, the pain questionnaires and the others of the pain assessment techniques. Afterwards,

the following topics will focus on the typical acute pain and the chronic pain. In the typical acute

pain, we will learn the postoperative pain and the patient control analgesia (PCA). In the typical

chronic pain, we will also teach the pain management which contains: the general principles, the

methods of pain management, the drugs, the physical therapy, the nerve block the nerve

destruction and some advancement in the chronic pain management.

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Prerequisite：The prerequisite of this course includes, but is not limited to, the experience of pain

and how fashionable the pain topic in some magazines and newspapers. Those who are not

familiar with this knowledge are encouraged to read related text books before hand.


五、【参考书】：疼痛诊疗学第一版


地点：疼痛病房

内容：常见疼痛科疾病的诊治、常用的神经阻滞方法

学时：3学时

心肺脑复苏

Cardiopulmonary Resuscitation


1. 掌握心跳骤停的诊断；

2. 掌握基础生命支持的内容和方法；

3. 掌握进一步生命支持的主要内容和方法；

4. 熟悉导致心跳骤停的常见原因；

5. 熟悉心脑后期生命支持的治疗原则；

6. 熟悉脑死亡的概念；

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7. 了解脑死亡的诊断标准和方法；

Objectives: To master the following key concepts and principles: etiology and diagnosis of

cardiac arrest, strategies of basic life support, strategies of advanced life support. To be familiar

with：pathophysiology of cerebral ischemia To acquire a general understanding: mechanisms of

action of chest compressions, Management after initial Cardiopulmonary resuscitation, brain

death.


1、心跳骤停原因，心跳骤停后的病理生理改变，心跳骤停临床表现和诊断；

2、基础生命支持的内容和方法；

3、进一步生命支持的主要内容和方法，心肺复苏流程-2010年国际指南。

4、心脑后期支持的治疗原则和方法；

5、脑死亡概念和诊断方法。


心跳骤停临床表现，原因及预防的重要性；

早期诊断和尽快采取 ABC治疗及其 ABC的实施方法；

早期去颤是复苏成功的关键，去颤的机制和实施方法；

心肺复苏流程-2010年国际指南；

Prerequisite：

Brief Contents:

Common causes of Cardiac Arrest (CA)

Diagnosis of cardiac arrest

Clinical signs of CA

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ECG patterns of CA

Basic life support

Chest compression

Airway

Breathing

Defibrillation

Advanced life support

Advanced airway controlling and oxygenation

ECG monitoring

Resuscitating drug administration

Management after initial resuscitation

Maintainace of oxygenation and circulation

Fluid, electrolyte, acid-base balance

Arrhythmia recognition and treatment

Cerebral protection

Pathophysiology of cerebral ischemia

Principles of brain protection from ischemia

Concepts of brain death



2010年心肺复苏和心血管急救国际指南。原版主编：美国心脏学会。


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地点：新八教临床技能教室

内容：参考 2010年 AHA心肺复苏指南，掌握 BLS

学时：4学时

输血与血液保护

Allogeneic Blood Transfusion and Blood Conservation


1. 掌握输血的概念与目的

2. 掌握自体输血、成分输血的概念

3. 掌握血液保护的概念与基本方法

4. 熟悉输血并发症及处理

5. 了解自体输血的方法和成分输血的制备


Five main points are covered in this chapter including: 1. Concepts and purpose of allogenic blood

transfusion. 2. Autologus transfusion and component transfusion. 3. Concepts and principal

methods of blood conservation. 4. Transfusion complications and the management. 5. Methods of

autologus transfusion and preparation of component transfusion. The first three main points need

to be mastered, the forth point should be familiar with, and the fifth point should be understood by

the students.

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1. 输血的适应症、并发症、自体输血、成分输血

2. 血液保护的基本概念与方法

三、【重点难点】：输血的指征、成分输血

Course Description：The indications and complications of transfusion, autologus transfusion, and

component transfusion are introduced. Basic concepts and principal methods of blood

conservation are introduced also.


histology, physiology, and components of blood system. Those who are not familiar with that

knowledge are encouraged to read related text books before hand.

四、【讲授时数】：

输血：2学时

六、【自学内容】

七、【参考书】：

基础输血学—2001年第一版

危重病人的营养支持

Surgical nutrition


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1、掌握营养状况的评估方法；

2、熟悉饥饿及应激状态时机体的代谢变化；

3、掌握营养支持的实施原则，肠内以及肠外营养实施的方法、适应症以及并发症；

4、掌握全胃肠外营养（TPN）的配制原则。

5、了解七种营养素的基本生理功能；

6、了解特殊病人的营养支持。

Objective: This chapter is designed for undergraduate students in the School of Medicine. Six

main points are covered in this chapter including: 1. Assessment of nutrition status. 2. Principles，

methods，indications，and complications of enteral or parenteral nutrition. 3. Principles for making

out a Total Parenteral Nutrition prescription. 4. Metabolic changes of body at hungry or stress. 5.

Physiological functions of seven essential nutrients. 6. Nutrition support for patients with specific

diseases. The first three main points need to be mastered, the fourth and fifth points should be

familiar with, and the sixth point should be understood by the students.


目的要求中的内容。


重点：营养支持的实施原则，肠内以及肠外营养实施的方法、适应症以及并发症，TPN

的配制原则。

难点：营养状况的评估方法，TPN的配制方法。

Description：Malnutrition is very common in critically ill patients. The course introduces the

indications and complications of enteral or parenteral nutrition, and the detailed methods are also

introduced.

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Prerequisite：The prerequisite of this course includes the knowledge of seven essential nutrient.

Those who are not familiar with that knowledge are encouraged to read related text books before

hand.



临床营养基础。Lubos Sobotka 主编，复旦大学出版社

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