Clinic was busy yesterday, work until nearly a point at noon, followed by two is bustling about one afternoon. Also happy, many patients hav
Clinic was busy yesterday, work until nearly a point at noon, followed by two is bustling about one afternoon. Also happy, many patients have symptoms improved or recovered to return; but there are also some friends worry, the effect is not good, I don't have a reason. Although with the accumulation of clinical experience, the efficiency has gradually improved, but there are still many friends, I can not solve the problem, this time it is very annoying, and no one can guide, only slowly groping.
What I want to say today is another question about the test sheet.
Do not say that patients with friends, our clinicians have a long time to understand the clinical value of a variety of laboratory tests and checklists. We must first admit that the single laboratory, check list is an important basis and means for doctor diagnosis and treatment, to determine efficacy, some results on disease diagnosis plays a decisive role, so the test results we called the "gold standard" for diagnosis of XX's disease, such as ECG for arrhythmia, six items of hepatitis B for hepatitis b....... Unfortunately, not all diseases have a "gold standard"! These results are attributed to the "auxiliary examination" items in our medical records, which is to assist the physician in accordance with the history, symptoms and signs of the comprehensive judgment! It was a few years ago that I really understood.
Especially in the male such a new subject, diagnosis of many diseases have a lot of controversy in the professional scope, the concept is not yet fully established, various theories often just a theory, but what about the confirmation of the gold standard, especially by many diseases are products of psychosomatic diseases with the objectivity itself needs to be verified! For example, "impotent", saying that "no", but is not "really", is not all the time, "no" is not specific and all are "no", is not a sure thing; go to the hospital to check, the change of the environment and psychological impact, not really "impotence" sometimes scared the true. So what is the diagnosis? In fact, it is mainly their own feelings, as long as their own or their spouses feel that the life of the couple is insufficient. Premature ejaculation is also the case, it is said that ejaculation latency (from the time of insertion to ejaculation) is too short, but to what extent is short? Some people say that to make the opposite sex climax to judge, but whether the specific climax or required amount of stimulation and is not fixed, in this way you can make this stimulus specific climax, whether with another can? Can you guarantee that the opposite sex orgasm every time? The basic no accepted method of confirmation, so we can only be a "unit in harmony" to broadly defined impotence and premature ejaculation problems (see previous article about personal clinical diagnosis and treatment of premature ejaculation premature ejaculation "new"). For prostatitis or male infertility, a rough look seems to prostate fluid, semen analysis should be the gold standard of it, in fact, otherwise!
I met a friend yesterday, because of infertility, semen analysis belongs to the first "little" and "weak" category, their only some scrotum wet symptoms, no obvious discomfort, after treatment, the scrotum is damp soon disappeared, he is very happy, I also like the semen analysis; review after January, sperm the density increases from 9 million /ml to 16 million /ml, but the survival rate and sperm a/b declined, he was very upset, I too, his frustration is how energy is more and more low, my distress is a "reference" how can he can understand the semen analysis only male fertility. Male medical circles once a pregnant lady just later the normal production of the men had 2 consecutive years of every 2 weeks a semen analysis monitoring result, the doctors were shocked that a part of the inspection results are almost sterile samples, and good results are beyond the vast majority of the reference standard! That is to say, one man, one of the inspection results often is a combination of many factors, but also can only partly reflect their fertility, two can not be equated! Therefore, a diagnosis of male fertility can not only rely on the once the semen analysis results, and the treatment process of semen analysis results should make comprehensive judgment, the level of change should not be limited to a particular index! My clinical judgment, the results of all kinds of patients as long as there is a good test results, it shows that the basic physiological function is good, and a poor outcome is the result of a variety of adverse factors! We just need to get rid of the influence of various adverse factors, as far as possible to restore the body to achieve the purpose of treatment.
Time is limited, some problems too late, there are doubts of friends can follow questions. I'll take the time to analyze it in detail.