作为确立并不久的重症医学的一部分，神经重症医学，更是一个新兴的亚专科。其研究对象主要包括重症脑血管病、颅脑外伤、脑肿瘤及其他神经系统相关重症患者。其理论体系尚不完善，很多大型随机对照研究结论存在相悖的现象。这使得初入该领域的年轻医生有时在临床实践中无所适从。为解决这一问题，笔者希望通过对近年流行的循证医学理念进行反思，强化科学精神，并通过引入证据链概念，帮助神经重症专业的年轻医生解读纷繁复杂的循证医学证据，并最终建立正确的临床思维方法。%As an emerging subspecialty, the theoretical system of neuro-critical care is incomplete. The main study subjects include severe cerebral vascular diseases, craniocerebral trauma, cerebral tumor and other neuro-system related critical patients. Consequently, there are numerous inconsistent conclusions among different studies. In view of this, the authors analyzed the fundamental conceptions of Evidence Based Medicine (EBM) based on traditional philosophy and introduced the conception of evidence chain. Hopefully, this paper will help the junior neuro-intensive physicians to better understand those complex evidences from EBM, and assist them in the establishment of the effective mode of clinical thinking.
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