Ndeapi Marudzi Akasiyana eVakadzi?

by Naveed Saleh, MD, MS

Unoshamisika kuti chii chinonzi pulmonologist? Zvakadini ne oncologist?

Mhando dzakasiyana dzechiremba vanoita mhando dzakasiyana dzemishonga. Munhu wose anoziva kuti chiremba wemhuri haana kurovedzwa kuti aite mwoyo wekugadzira. Zvisinei, chii chaicho kuita marudzi akasiyana echiremba, uye ndezvipi zvavanowanzobata?

Ngatitarisei pane zvakasiyana siyana zvakasiyana uye subspecialties. Tichatanga kutanga nekutarisa kune vanachiremba vanoita basa rekutarisira kwekutanga uye tinozoona mamwe mimwe minda.

Ruzivo rwehuwandu urwu runobva kumawebsite ehurumende anomirira vanachiremba ava. Kana wakangwara, hukama huchagoverwa kuti udzidze zvakawanda nezveminda iyi.

Chinangwa chechinyorwa ichi hachisi chekupa zvakazara. Pane kudaro, nyaya ino inofanira kushandira kukupa simba semurwere uye kukubatsira kuti udzike muhurukuro inowedzera mushonga. Nokunzwisisa izvo dzimwe nyanzvi dzakajairika uye vatsigiri vese vanoita, unogona kunzwisisa zviri nani kutarisira kwaunogamuchira uye mabasa uye basa rechiremba anokupa kurapwa.

Chiremba Mukuru Wokurapa

Chiremba mukuru wekuchengetedza ndicho chikonzero chekutanga kuonana.Zviki rezviitiko zvekare zvinosanganisira mishonga yemhuri, mushonga wepamberi, nekurapa. Vanachiremba vanonyanya kutarisira vanoporesa varwere vane "zvisinafferentiated" zvinetso zveutano uye vanofanira kufungidzira varwere maererano nezviratidzo, zviratidzo, uye kliniki yezvakaitika.

Chiyero chekurapa kwepakutanga zvakakura uye chinosanganisira chero zvikamu zvehutano kana kuongororwa pamwe chete nedzipi zvimwe zvipenyu, zvepfungwa, kana zvehupfumi.

Maererano neAmerican Academy of Family Physicians (AAFP), pano pane mamwe mabasa evanotarisira vana vekutanga:

kudzivirira zvirwere
utano hwakanaka
kupa zano
dzidzo yekushivirira
utano hwehutano
kurapwa uye kurapwa kwechirwere chakaipa uye chisingaperi
urongwa hwehutano mune zvakasiyana-siyana, zvakadai sechipatara (kliniki, nguva refu yekuchengetedza nezvakadaro), uye zvirongwa zvepachientara (kusanganisira kutarisira kukuru)

Vanachiremba vanonyanya kuchengetedza nguva dzose vanobatana mukuenderera kwekutarisira uye kuona varwere munguva yeupenyu hwose. Colloquially, apo munhu mukuru anoreva "chiremba" wake, zvichida achitaura nezvechiremba wake wemudzimai kana chiremba wemhuri.

Kana zvichidiwa, chiremba wekunyanya kutarisira anogona kutumira murwere kune mumwe muongorori uye saizvozvo kuronga kushanda kwakanaka uye kwakakwana.

General Internist

Mumwe mudzidzisi anobata varwere vakuru. General internists ndivo vanonyanya kutarisira vanachiremba vanoshanda vose vari mucheche (chipatara) uye kunze kwekugadzirisa. Vamwe vashandi vanoona nezvekurapa varwere chete muchipatara, uye vanonzi vanachipatara .

Mushure mekuchikoro chechiremba, vakuru vekudzidzira vanopedza makore matatu ekugara kana kudzidzira mahure. Mushure mekugara, vanachiremba ava vanogona kuita sevashandi vekudzidzira kana kuramba vari nehutano hwokudzidzisa.

General internists nyanzvi pakutsvaga nekutarisa zvakasiyana-siyana zvinowanzoenderana, kusanganisira misoro, gastroesophageal reflux chirwere (GERD) , hypertension, uye chirwere cheshuga cheshuga chemashuga. Vanopinda mukati vari kutarisira mishonga yemishonga, kupa mishonga, varayira varayiri pamishonga yekushandisa mishonga uye migumisiro yakaipa pamwe chete nekuongorora mishonga yekubatana kunogona kutyisa.

Heano mamwe mazita e subspecialties, kana kushamwaridzana , avo vanogona kudzidzira pashure pokupedzisa kugara. Chirwere chemukati chiyanano chemunharaunda chinotora makore matatu asi chinogona kupfuurira kunyange kwenguva yakareba nepamusoro pekuwedzera subspecialization. Vaya vari mukati mavo vanoita zvepasisheni mune izvi vanogamuchira zvakanyanya kufanirwa kune masangano ega ega kana mapoka ehurongwa hwemagetsi. Uyezve, vashandi vekudzidzira pasi vanogadziriswa vanogona kukwanisa kutaura zvinyorwa zvakaoma zvekurapa uye kuita zvinongororika maitiro. Mutsamba iri pasi apa, ndaisa mazita emhando idzi dzechiremba muvabereki.

utano uye immunology (allergist uye immunologist)

endocrinology, chirwere cheshuga uye metabolism (endocrinologist)
hematology kana kukanganiswa kweropa (hematologists)
gastroenterology (gastroenterologist)
oncology kana mishonga yekenza (oncologist)
nephrology kana tsvete ( nephrologist )
chirwere chepammonary kana mapapu (pulmonologist) (Izvi zvidzidzo zvekudyidzana zvinowanzobatanidzwa nekutarisira kwakanyanya uye munhu anoita mukugadzirisa kutarisa kunonzi an intensivist)
rheumatology kana joints (rheumatologist)
chirwere chepfungwa kana mishonga yemwoyo (cardiologist) (Cardiology inzvimbo yakaoma uye cardiologists inogona kuwedzera inyanzvi mukupindira kwechirwere chepfungwa, kliniki yemwoyo electrophysiology uye yakakonzerwa nemoyo kusagadzikana uye kutapurika kwemoyo)

Family Physician

Chiremba wemhuri kana chiremba wemhuri chiremba chiremba anofanirwa kurapa nhengo dzose dzemhuri, kusanganisira vana, vana, vechidiki, vakuru uye vakuru vakwegura. Vanachiremba vemhuri vanongobata kurapwa kwehutano chete asiwo ndivo vane basa rekuchengetedza hutano uye vanogona kutungamirira varwere vavo kune avo vakakodzera, vashandi vehutano, uye nzvimbo dzemunharaunda. Uyezve, chiremba wemhuri anobatanidzwa mukuchengetedza kwehutano hwekuchengetedza, izvo zvinosanganisira matanho anotaridzirwa mukudzivirira kwehutano hwemangwana. Izvi zvinogona kusanganisira kuongororwa kwekuongorora, zvakadai seku cholesterol kana kuongororwa kweshuga yeropa, kana kupa mazano pamusoro pekurasikirwa kwemazivi, kusvuta kusvuta, kunwa doro zvisina kunaka nezvimwe zvakadaro.

Vanachiremba vemhuri vanobata ruzhinji rwehutano kubva kune hutachiona hutachiona hwehutachiona hutachiona hutachiona hwehutachiona uye chirwere cheshuga. Uyezve, vanachiremba vemhuri vakawanda vanoita zvishoma zvishoma kurapwa kwakadai sekukandira kubvisa kana kubvisa suture.

Kufanana nevashandi vezvemhuri, vanachiremba vemhuri vanopedza makore matatu ekugara kana kudzidziswa kwekupedzisira. Uyezve, vanachiremba vemishonga dzemhuri vanogona kunyanya kushandisa mishonga yemitambo kana geriatrics (vakwegura). Chiremba anoita geriatrics anonzi geriatrician . Pakupedzisira, geriatrics zvakare is subspecialty yemishonga yemukati.

Tsamba pamusoro peshoko rekushandiswa: Vanachiremba vazhinji vemhuri vanonyanya kushandisa izwi rokuti "mhuri yekurapa chiremba." Nyanzvi idzi dzinoti havasi "vanoita" chero chinhu uye vari nyanzvi, zvakare.

Chiremba wevana

Vanachiremba vane hanya nehutano hwepanyama, hwepfungwa, uye hwehutano hwevana uye vanorapa varwere kuburikidza nekukura kwevanhu vakuru. Vanoonawo uye vanorapa zvirwere zvakanyanya uye zvisingaperi uye pamwe nekubatana mukuchengetedza kwehutano hwekuchengetedza (funga kutungamirirwa kwezvirwere uye kurapa kwehutano). Saizvozvowo kumudzidzisi mukuru, vanachiremba vanogona kuva nyanzvi yepamusoro yevana . Uyezve, pane vanachiremba vezvechiremba vepachikoro vanonyanya kushandiswa mumasango akasiyana-siyana zvakadai semudzidzi wekambani anokwanisa nechinopesana chikuru sekuti internists anotarisira vanhu vakuru nevana vana vanotarisira vana. Vanachiremba vanopedza makore matatu ekugara pamwe nemamwe makore e subspecialty training. Mamiriro ezvinhu akajairika anoitwa navanachiremba anowanzobatanidza zvirwere zvekufema, zvirwere zvekunzwa, chirwere, uye zvimwewo.

Chirwere chezvipembenene-Gynecologist

Zvipembenene-gynecologists (OBGYNs) kutarisira zvinodiwa zvekubereka zvevakadzi. Vanotarisirawo vakadzi panguva yekuzvitakura uye kubereka. Muitiro wekudzivirira uye gynecology ndeyekurapa uye kuporesa nemaBGGN anoita zvirongwa zvakasiyana-siyana zvekuvhiya se hysterectomy , kana kubviswa kwechibereko. Obstetrics-gynecology inogara makore mana. Uyezve, OBGYN inogona kuramba ichinyanya kushandiswa mundima dzakadai sekuguma kwekubereka vana, mishonga yekuberekwa kwemucheche uye kubereka kwechibereko chekubereka uye kubereka.

Tsamba pamusoro pekushandiswa kweshoko: Kunyora OB-GYN seB OB / GYN (ine solidus kana slash) inodzwa nevakawanda vevashandi vezvechiremba. Izvo zvinokonzera kushandiswa uye zvinogona kuratidza "kana ... kana" kuvaka, izvo zviri pachena zvisakarurama nokuti vazhinji ve-OB-GYN vanoita zvose zvinopesana uye zvirwere zvemadzimai.

Vanachiremba

Kushandiswa kwevakawanda chirongwa chekugara kwemakore mashanu chinodzidzisa vanachiremba kuti vaongorore uye vabate zvirwere zvakasiyana-siyana vachishanda. Mushure mekuvhiyiwa kwekugara, vanachiremba vanovhiya (vanovhiya vanoita zvakananga kunze kwekuwedzera dzidzo yekugara) vanowanzoita chirwere chinotevera:

chirwere chekenza yekoloni (funga bowel resection kana kubviswa)
chirwere chinoputika
varicose veins
cholecystectomy kana kubviswa kwe gallbladder

Nenzira, vanachiremba vanowanzorovedzwa kuita zvose maharaparusomi , kana kuzarurirwa kwemazamu emimba, kana kuti laparoscopy , iyo inosanganisira kushandiswa kweparoscope, kana kuti tube inogadziriswa ine chiedza pamagumo ayo. Laparoscopy inzira inopedzisira isingaiti ne laparoscope uye chirongwa chekuvhiya chakaiswa mumuviri kuburikidza nekambani kadiki uye kutengesa kwemuviri mudumbu.

Pashure pokupedzisa kugara, vanachiremba vazhinji vanovhiya vanoenderera mberi. Heano humwe hukama huripo vanovhiya vanogona kutevera:

kurapwa kwevana
cardiothoracic surgery (funga kuvhiya mwoyo)
kuvhiyiwa kwemapurisa (kuvhiyiwa mumidziyo yeropa, yakadai sezvisikwa zvepistulas arteriovenous for dialysis nezvimwe zvakadaro)
chimiro chakasimba chekushandiswa
chirongwa chebhaatric
ruoko rwokuvhiya

Kunyanya kakawanda, tsika yekurapa inogona kuparadzaniswa zvikaita maviri foci: mushonga uye kuvhiyiwa. Mishonga inoreva nezvemishonga yemukati yechipfuva iyo isingabatsiri. Ndapota cherechedza kuti dzimwe nzvimbo dzokugadzirisa dzokugadzirisa uye kushamwaridzana zvakasiyana nekuvhiyiwa kukuru kwakafanana neurosurgery uye urology.

Psychiatrists

Psychiatry inyanzvi yezvokurapa inotarisa kuongororwa, kurapwa, nekudzivirira kwehutano hwetsika, kukanganisika kwepfungwa uye kushungurudzika mupfungwa.

Ndapota cherechedza kuti kunyange zvazvo kune kuwirirana pakati pemaitiro maviri, masayendisiti uye masayendisiti ezvepfungwa vanoita zvakasiyana zvakasiyana nezvehutano. Kunyanya, masayendisiti ndivo vanachiremba uye vane MD kana DO DO.

Psychiatry yekugara inotora makore mana. Pano pane mamwe masayendisiti epspecialties:

addiction psychiatry
mwana uye wechidiki chepfungwa dzepfungwa
geriatric psychiatry
kunonoka-kutarisira

Ndapota cherechedza kuti nyanzvi yezveuropiyo chiremba anonyanya kugadziriswa uye kurapwa kwematambudziko ehurumende yenheyo. Kunyangwe pane kuwirirana pakati peminda mbiri, nyanzvi yezveuroyoyoti inotarisa zvirwere zvehupenyu. Semuenzaniso, nyanzvi yezveuropiyo inokwanisa kupa kurapwa kwehutachiwana hwehutachiona hwakadai sechirwere kana chirwere chisingaperi chisingakanganisiki se multiple sclerosis kana dementia.

Zvinofadza kuti minda yeuroyology neyepfungwa dzepfungwa inobatanidza zvakare kare uye yakaparadzaniswa kwenguva yakareba. Zvirwere zvizhinji zvehupfungwa zvinokonzera zvirwere zvepfungwa. Uyezve, zvirwere zvepfungwa zvinogona kuratidza sechirwere chinokonzerwa neurological. Mhedzisiro inowanikwa yezvikamu izvi inoratidzika mumhando dzose dzekugara kwekudzidzisa, zvirwere zvepfungwa zvinogamuchira zvakawanda zvekutsvaga neurology, uye nyanzvi dzezvehutano dzichiwana kuzarurirwa kwepfungwa dzepfungwa, zvakare. Ichokwadi, masayendisiti anogamuchira chiziviso kuburikidza nokutora American Board of Psychiatry neNeurology.

Mhedziso

Mashoko aya ari munyaya ino anotsanangura zvido zvakasiyana-siyana zvezvehutano hazvirevi zvakazara. Zviitiko zvakasiyana-siyana uye subspecialties hazvina kuziviswa pano, kusanganisira radiology, kurapa kwepanyama uye kugadzirisa (PM & R), hematology, zvirwere zvinotapukira, nezvimwe zvakadaro. Uyezve, urefu chaihwo hwehumwe hwekugara uye zvirongwa zvekuyanana dzimwe nguva hunosiyana. Pakupedzisira, pane zvimwe zvirevo uye kuwirirana kwekudzidziswa kwepamusoro-soro kwandisingafungi pano. Semuenzaniso, vamwe vanachiremba vanoita kusanganiswa kwekugarisa mukati mese mushonga wepakati uye nevana (Med-Peds).

Kana iwe uine mibvunzo pamusoro pebasa rechiremba wako, tapota tsvaga sangano rinobatanidza mawebsite uye unzwe wakasununguka kubvunza chiremba wako panguva yekushanya. Nguva dzose inokurudzirwa kuziviswa pamusoro pezvinhu zvose zvekutarisira kwako kusanganisira izvo chaizvo chiremba wako anoita uye anobata.

_Sources:

_{Tsanangudzo yechiremba wevana.} _{2015 chirevo chematongerwo enyika kubva kuAmerican Academy of Pediatrics.} _{Inowanikwa kubva: URL: http://pediatrics.aappublications.org/content/135/4/780.}

_{Primary Care.} _{Inowanikwa kubva: URL: AAFP: http://www.aafp.org/about/policies/all/primary-care.html}

_{Specialty of General Surgery Kunotsanangurwa.} _{Inowanikwa kubva: URL: American Board of Surgery: http://www.absurgery.org/default.jsp?aboutsurgerydefined}

_{Mutengo BH, Adams RD, uye Coyle JT.} _{Neurology uye Psychiatry: Kuvhara Great Divide.} _{Neurology 2000;} _{54: 8-14.}

_{Chii chinonzi Psychiatry.} _{Inowanikwa kubva: URL: American Psychiatric Association: https://www.psychiatry.org/patients-families/what-is-psychiatry.}