医患共同决策的具象问题思考——以肺结节诊疗为例

随着健康体检观念的深入及低剂量CT的广泛开展,肺结节的检出率大大提高,而对于其诊断及治疗方案的选择则具有较多的争议,过度诊疗或重视不足都会对患者造成伤害,如何做到正确的诊治从而保证患者的权益,患者的参与及接受程度显得十分重要,医患共同决策(shared decision making,SDM)这一方式在肺结节诊疗过程中的作用不言而喻。通过相关案例初步探索SDM在肺结节诊疗过程中的应用及效果,从而为临床医生及肺结节患者在诊疗过程中提供一种新的思路,也期望这种模式能够得到医患双方的共同认可,减少临床决策中的医患冲突,取得更佳的治疗方案。

Specific Issues of Shared Decision-making:Case Study of Diagnosis and Treatment of Pulmonary Nodules

With the deepening of the concept of health examination and the wide application of low-dose CT,the detection rate of pulmonary nodules has been greatly increased.However,there are many controversies about the choice of diagnosis and treatment plan.Either over-diagnosis and over-treatment or insufficient attention will cause harm to patients.Therefore,it is significant to make correct diagnosis and treatment to protect the rights and interests of patients,and promote the participation and acceptance of patients with the application of shared decision-making(SDM)in the diagnosis and treatment of pulmonary nodules.The application and effect of SDM in the diagnosis and treatment of pulmonary nodules are explored preliminarily through relevant cases,so as to provide a new concept for clinicians and patients in the diagnosis and treatment of pulmonary nodules.It is also expected that this mode can be recognized by both doctors and patients,reduce the doctor-patient conflict in clinical decision-making,and achieve better treatment plans.