Pediatrics is the study of growth and
development of the child from the genetic
background and moment of conception
through adolescence,
It is the science and art of prevention,
diagnosis,and treatment of the diseases of
children from birth through adolescence,
whether these disturbances be physical,
mental,or emotional,
The most characteristic feature of
pediatrics is that it deals with the
growth and development of the child,
comprising all those changes in size and
form and in complexity of function that
constitute growing up,
儿科学 ( pediatrics )是研究小儿各年
龄阶段的生长发育和疾病防治，提高小儿
身心健康水平的医学科学
fetal period
intrauterine life,embryonic and fetal period
first trimester first 12 wk
second trimester 13 ～ 28wk
third trimester 29 ～ 40wk
Stage of children by age
neonatal period after birth～ 4wk
perinatal period 28wk of gestation ～ 1wk after birth
infancy 4wk～ 1yr
Todlerhood 2nd yr ～ 3rd yr
Stage of children by age
preschool age 3 yr～ 6(7) yr
school age 6（ 7） yr～ 11(12)yr
adolescence 11 ～ 12yr--17 ～ 18yr(femal)
13 ～ 15yr---19 ～ 21yr(male)
Stage of children by age
? <18yr in total population of children
and adult
developed countries 22.4%
developing countries 35.7%
china 30%
( UNCF 1999 )
? <18yr 400 million( china)
Disparity in occurrence and progression of disease
between children and adult
? disparity in anatomy,physiology,and
immunologic function between children
and adult,
? the younger,the more different
生后 1小时
2岁
nervous system
Kernig sign,Babinski sign
signs of meningeal irriatation
neonatal period Kernig sign,Babinski sign(+)
within 3～ 4m Kernig sign (+)
within 2yr Babinski sign (+)
neonatal period rooting reflex,Moro reflex
infancy abdominal reflex (－ ) possible
tendon reflex ( ↑)
nervous system
reflex
Disparity in occurrence and progression of
disease between children and adult
? age-dependent lab data,physical exam
Disparity in occurrence and progression of
disease between children and adult
? ? congenital anomalies,inborn errors of metabolism
more common in children
? ? newborn,infants vulnerable to infection
? ? sinusitis rare in infancy
? ? infants vulnerable to obstruction in respiratory tract
? Disparity in spectrum of disease
Disparity in occurrence and progression of
disease between children and adult
? ? pneumonia bronchial pneumonia,
lobar pneumonia
? ? vit D difficiency rickets(佝偻病 ),
malacosteon(骨软化 )
? Disparity in type of disease
Disparity in occurrence and progression of
disease between children and adult
? ? diarrhea dehydration；
fever seizure
? Disparity in manifestation of disease
Disparity in occurrence and progression of
disease between children and adult
? ? hepatomegaly,splenomegaly common in
infancy ( anemia,infection)
Disparity in occurrence and progression of
disease between children and adult
Progression
Recovery deterioration
Infant mortality
~1949 1999 2000 2003
China city 15% 1.18% 0.55%
rural 20% 3.7%
0.4~0.7% Developed Countries
<5yr death
1991 1999 2000 2003
China city 2.1% 1.4 % 0.7 %
rural 7.1% 4.6 %
0.4~0.8% Developed
Countries
<5yr death 93% in rural
infant accounting to 80％
newborn death 65％ of total infant death
Leading death cause,pneumonia,
asphyxia,prematurity,diarrhea,
congenital anomalies,(2000)
Leading causes of death
<1yr 1,perinatal conditions
intrauterine growth retardation
respiratory distress syndrome
intrauterine hypoxia/birth asphyxia
birth trauma
2,congenital anomalies
3,sudden infant death syndrome
4,pneumonia
5,gastrointestinal disorders
1yr ～ 4yr 1,accidental injuries
2,congenital anomalies
3,malignant neoplasms
5 yr～ 14yr 1,accidental injuries
2,malignant neoplasms
Leading causes of death
The young are often among the most
vulnerable or disadvantaged in society
and their needs require special attention,
1990年首次世界儿童问题首脑会议
, 儿童生存保护和发展世界宣言, 及, 推行计划,
中国政府相继制定, 九十年代中国儿童发展规划纲要
及 （ 2001～ 2010） 中国儿童发展纲要,
Genetics,embryology,nutriology,
pshychology
Pediatrics (health care)
Child health
education Social services
1,infective disease
2,psycho-behavior problem
3,accidental injury
4,congenital anomalies
5,prevention of adult disease in
childhood
Key points
Characteristic feature of pediatrics
Stage of children by age
Tasks of pediatrics
理论课 35学时
见习课 25学时
主讲教师 8位
见习带教教师 王廉文 钱继红