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【医学ppt课件】一般人群查体检验

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Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 一般人群查体检验 医疗学院 杨春兰 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 常见查体项目分类 • 年轻人群查体项目 • 中老年人群查体项目 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 年轻人群的健康查体检验项目 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. •目的要求 • 1.了解年轻人群查体的意义 • 2.熟悉年轻人群健康查体的常用检验项目 • 3.掌握年轻人群健康查体常用检测项目的 临床意义 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 常见体检人群 招生 招工 招聘公务员 征兵 企事业单位职工 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 一、年轻人群健康查体的意义 1.健康体检对他们适应环境、新工 作作为保障是十分重要的,是培 养合格人才的重要条件,也是保 证工作人员全以身心健康投入工 作的保障。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 2.群体定期健康体检大有裨益 ①可早期发现身体潜在的疾病,以便早期发现、 早期诊断、早期治疗疾病,从而达到预防保健 和养生的目的; ②是制定疾病预防措施和卫生政策的重要依据; ③社会性体检是发现某些职业禁忌证或某些人群 的传染病、遗传病、保证正常工作和生活的重 要手段。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 3.对人群健康进行评估和干预 通过体检,掌握身体的状况,建立 健康档案,对疾病早期进行预防和治 疗,降低发病率、致残率、死亡率。 有效提高生活质量和工作效率,保持 健康状态。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 二、健康查体的项目 一般的常规体检检验包括: 三大常规:血、尿、粪 血生化:血脂、血糖、肝功、肾功等项目 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 1.实验室检 查:主要 查检验项 目有: ①血常规:通过检查可提示部分血液系统疾 病及感染性疾病,进行性贫血提示有肿瘤的 可能。 ②尿常规:可了解有无尿路感染、肾炎、泌 尿系统结石、肿瘤等。 ③大便常规+隐血试验:检查大便隐血可早 期发现消化道肿瘤。 ④血脂、血糖等生化项目检查:可以早期发 现高血脂、糖尿病、肝炎、消化道肿瘤等疾 病。 ⑤癌胚抗原(CEA)、甲胎蛋白(AFP):CEA 升高往往提示部分消化道肿瘤及肺癌可能。 AFP升高提示肝癌可能。 ⑥肝功能:对于慢性乙肝患者尤其要经常检 查肝功能,如异常,应进一步检查乙肝两对 半、丙肝抗体等,了解有无急慢性肝炎。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 2.检验项目及 其意义 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 白细胞计数(WBC)主要担任防卫工作,白细胞 增加或减少,需配合白细胞分类,来初步判定 为细菌感染或病毒性感染或为白血病 (1)血常规18项 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 红细胞计数(RBC)贫血或失血都会影响 红细胞数目。 高值时可能患红细胞增多 症或地中海型贫血;低值时可能为贫血 。 • 血红蛋白(HGB)主要用于检查是否贫血 • 红细胞压积(HCT)指红细胞在血中所占 体积的百分比,能更正确的了解贫血之 程度 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 平均红细胞体积(MCV)红细胞血球指 数,是鉴别各种贫血的参考指标 • 平均红细胞血红蛋白含量(MCH) • 平均红细胞血红蛋白浓度(MCHC) • 红细胞体积分布宽度(RDW)当红细胞 血球大小相差较大时,RDW会上升,可 为诊断贫血的参考 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 血小板计数(PLT)高值时可能与红细胞血球增 多症、慢性骨髓性白血病、骨髓纤维化、脾脏 切除、慢性感染症或急性感染恢复期有关。血 小板值过低时可能有出血倾向,凝血情形不良 之再生不良性贫血 • 平均血小板体积(MPV) • 血小板分布宽度(PDW) • 血小板压积(PCT) Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 单核细胞(MON) 有助于各种疾病之 诊断治疗 • 淋巴细胞相对百分比(LRR%) • 粒细胞相对百分比(RPR%) • 单核细胞相对百分比(MPR%) Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 尿比重(SG) 成人任意尿成年人其正常值为1.010 ~1.030。低比重尿:见于尿崩症、多囊性肾或 使用利尿剂及水份摄取过多者。高比重尿:见于 糖尿病、充血性心脏衰竭、脱水、呕吐 • 尿酸碱度(PH) 新鲜尿液正常时呈弱酸性 ,酸度 在5至8左右。若酸碱度大于8即表示尿液呈碱性 ,可能有尿路感染、发炎或肾功能不良等情形。 若酸碱度小于5即表示尿液呈酸性,可能正值饥 饿状态或酮酸症 (2)尿常规10项 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 白细胞(LEU) 试纸测试尿中有没有白细胞。若 尿中白细胞增加,表示泌尿道有发炎现象,可 配合尿蛋白及亚硝酸盐做判读。但女性常因阴 道分泌物污染检验结果呈阳性,故在收集尿液 前应先清洁会阴部 • 亚硝酸盐(NIT) 定泌尿系统是否有细菌感染 ﹔若有亚硝酸盐反应,需再进一步以显微镜检 查,以便了解是何种细菌感染 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 尿蛋白(PRO) 正常情况下,尿液有微量蛋白质 (150mg/天),以试纸测试呈阴性(-);若 呈阳性(+), 则可能是:生理性蛋白尿:肌 肉过度运动、冷水浴过 久、食入蛋白质过多。 体位性蛋白尿:有的人站立过久出现蛋白尿。 病理性蛋白尿:肾脏发炎、肾病症候群 、发高 烧、妊娠毒血症等情形 • 尿糖(GLU) 正常情况下尿中没有糖份为阴性( -),或有微量糖份出现。尿糖为阳性(+) 时,则应考虑是否为糖尿病,必须再连续追踪 检查 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 尿酮体(KET) 体内脂肪代谢不完全而形成酮体, 正 常尿中没有酮体为阴性(-),若尿中有酮体为阳 性(+),经常见于糖尿病患者,但也见于饥饿、 发烧、长期腹泻、呕吐等患者。限制淀粉类食物的 减肥者,尿中也会出现酮体 • 尿胆原 (UBG) 若尿中的尿胆原过高,表示可能有溶 血性黄疸、急性肝炎、肝硬化等疾病。若尿中没有 尿胆原,表示可能有胆道阻 • 胆红素(U-BiL) 正常尿中没有胆红素,故呈阴性 (-)。当尿中有胆红素时呈阳性(+),表示可 能有胆道阻塞或肝脏疾病等 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 尿红细胞(ERY) 测定尿中是否带有血。尿 中没有血呈阴性(-);若尿中有血则呈 阳性(+),可能是尿路结石、肾脏发炎 或泌尿系统癌症等。但若尿液样本放置过 久、生理期妇女等情形可能造成假阳性﹔ 吃大量维生素C时,则会造成假阴性 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 谷丙转氨酶(ALT) sGPT在血清中的数值代表 肝细胞受损程度。急性肝炎者的数值可能高达 500~1000 IU/L以上。另慢性肝炎、酒精性肝 障碍、肝硬化、肝癌等亦会造成值偏高 • 谷草转氨酶(GOT) 为体内酵素,存在于肝脏 、心脏中,也存在于脑部或血球等器官或细胞 。sGOT偏高代表这些部位有可能发生病变 • 谷氨酰转肽酶(GGT) 是一种存在于肝脏、胰 脏、脾脏及肾脏的酵素,最常用于筛检肝脏机 能障碍及肝硬化,尤其是酒精性肝障碍和药物 性肝障碍 (3)肝功能11项 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 碱性磷酸酶(ALP) 为体内的一种酵素,当 细胞受伤时,ALP值即升高,正值发育期间的 小孩或少年,其值虽可高达2~3倍,但仍属 正常。值高时可能为肝胆方面问题、骨癌或 骨转移等 • 乳酸脱氢酶(LDH) 高值时表示可能患有心肌梗塞 、肺栓塞、肝脏损伤、肌肉发育不良、白血病、贫 血或癌症,通常需配合其它检查项目一起做判断。 超过正常值10%为正常值的极限,故超过50 单位以 上时,应加以判断是何种疾病所致 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 总胆红素(TBS) 高值时可能有肝胆问题 或溶血性疾病。若皮肤泛黄,即称为黄疸 • 直接胆红素 高值时可能有肝胆方面的问 题 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 总蛋白(TPO) 检查营养状态、肝脏功能、 肾脏功能、感染症之用 • 白蛋白(ALB) 白蛋白是用来维持血浆的渗 透压,在肝脏制造,故肝脏发生疾病、肚泻 、营养失调等情况时,白蛋白会明显减少 • 球蛋白(GLO) 在感染、肝病、肾病、自体 免疫疾病及癌症时均可能发生增减,应由医 生配合其它检查结果判读 • 白蛋白/球蛋白(A/G) Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • ①总胆固醇 体内最具代表性的脂肪 。当血清 中胆固醇含量过高,易引起高血压、动脉硬化 及脑中风;含量太低则可能有贫血、肝障碍及 营养不良 • ②甘油三脂 甘油三脂之形成,大多来自酦酵 类及碳水化合物(米饭、面包等谷类),当中 性脂肪数值偏高,则易患糖尿病、动脉硬化、 心肌梗塞、肥胖症 (4)血脂4项 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • ③高密度脂蛋白-胆固醇(HDL-Cholesterol) 这就是俗称〝好的〞胆固醇,对血管有保护作 用。血中含量不可低于40mg/dl (0.91mmol/L ),否则易患血管硬化 • ④低密度脂蛋白-胆固醇(LDL-Cholesterol) 这就是〝坏的〞胆固醇,愈高愈不好。是预防 冠状动脉心脏病及治疗高脂血症重要指针。 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 尿素氮BUN 肾脏滤过代谢之最终产物,当肾功能障碍时 ,产物无法适当排出,此时血清中之尿素氮数值升高。 但此数值极易受药物剂量影响,必须配合其它检查数值 一起诊断 • 肌酐CR 肌酐是肌肉运动的主要能源是肌酸所分解的一种 物质,只要肾脏功能正常,肌酐会经由尿液排泄至体外 。测定肌酸酐就可得知肾脏的排泄功能 • 尿酸Ua 体内普林/嘌呤(Purine)的代谢物,以动物的 内脏普林/嘌呤含量最多。饮酒过量、糖尿病、痛风、肾 炎、铅中毒、副甲状腺机能亢进等尿酸会偏高 (5)肾功能3项 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 空腹血糖 指空腹时血液中的葡萄糖含量。是 筛检糖尿病最基本的方法。当健检时发现空腹 血糖大于110mg/dl(6.1mmol/L)时,为确 定有无糖尿病,建议另择一日再测定一次空腹 血糖,以确定诊断 (6)血糖 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 一般健检都检查幽门螺旋杆菌抗体,只要抽 血即可,较为方便。抗体若为阳性,代表 的意义有三种: • ①体内有该菌感染且造成疾病。 • ②体内有该菌感染但不造成疾病。 • ③该菌已根除,但抗体仍未消失。 (7)幽门螺旋杆菌 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 钙(Ca) 血钙升高时,主要见于恶性肿瘤、副甲状腺功能 亢进症和维他命D中毒,降低时,主要见于骨软化症、佝偻 病、维他命D缺乏和副甲状腺功能低下症。应与磷(P)同时 判读。 • 磷(P)血磷应与钙一起判读。当钙升高时,若磷也升高, 要考虑可能有恶性肿瘤;若磷下降,可能为副甲状腺功能亢 进症或维他命D过剩症。当钙下降时,若磷也下降,可能为 骨软化症、佝偻病或维他命D缺乏;若磷升高,则可能为副 甲状腺功能低下症或慢性肾功能不全。 • 铁(Fe/SI) 血清铁的测定主要在筛检身体是否有缺铁的现 象。 (8)微量元素 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 三碘甲状腺原氨酸(T3) 甲亢时,T3升高,甲 减时降低。 • 组织发炎筛检甲状腺素(T4) T4为一种甲状腺 激素,分析其血中含量,可知甲状腺功能,最 好和TSH一起判读。T4升高为甲状腺功能亢进, T4降低为功能低下。 • 促甲状腺激素(TSH) 由脑下腺前叶所分泌之 荷尔蒙,可刺激甲状腺分泌甲状腺素。检查TSH 可筛检甲状腺功能,通常必须和甲状腺素(T4 )一起判读。一般而言,甲状腺功能亢进时, TSH下降;功能低下时,TSH上升。 (9)甲状腺 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • 乙肝表面抗原(HbsAg) 可了解是否感染乙肝 病毒,是否产生对肝炎病毒的抗体,是否应该 注射疫苗,以及注射疫苗后的效果 • 乙肝表面抗体(HbsAb) • 乙肝e抗原(HbeAg) • 乙肝e抗体(HbeAb) • 乙肝核心抗体(HbcAb) (10)乙肝五项 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. • ①癌胚抗原(CEA) • ②甲胎蛋白(a-FA/AFP) • ③前列腺肿瘤标记(PSA) • ④乳腺肿瘤标记(CA 15-3) • ⑤胰腺肿瘤标记(CA 19-9) • ⑥卵巢肿瘤标记(CA125) • ⑦肿瘤特异性生长因子(TSGF) (11)肿瘤标志物 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. 中老年人的健康查体检验项目 Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate rights and interests, to ensure that our City's tourism sustainable, healthy and coordinated Development. Through this publicity campaign, further improve the sense of business integrity of tourism enterprises to help tourism consumers and operators to safeguard the legitimate
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