全文获取类型
收费全文 | 54695篇 |
免费 | 4059篇 |
国内免费 | 1044篇 |
专业分类
耳鼻咽喉 | 348篇 |
儿科学 | 858篇 |
妇产科学 | 1089篇 |
基础医学 | 3939篇 |
口腔科学 | 1712篇 |
临床医学 | 13276篇 |
内科学 | 4426篇 |
皮肤病学 | 376篇 |
神经病学 | 6604篇 |
特种医学 | 1759篇 |
外国民族医学 | 6篇 |
外科学 | 8488篇 |
综合类 | 4911篇 |
一般理论 | 6篇 |
预防医学 | 2930篇 |
眼科学 | 234篇 |
药学 | 4372篇 |
66篇 | |
中国医学 | 2103篇 |
肿瘤学 | 2295篇 |
出版年
2024年 | 150篇 |
2023年 | 1179篇 |
2022年 | 1847篇 |
2021年 | 2531篇 |
2020年 | 2530篇 |
2019年 | 2444篇 |
2018年 | 2381篇 |
2017年 | 2287篇 |
2016年 | 2059篇 |
2015年 | 1970篇 |
2014年 | 3950篇 |
2013年 | 4686篇 |
2012年 | 2791篇 |
2011年 | 3190篇 |
2010年 | 2528篇 |
2009年 | 2494篇 |
2008年 | 2681篇 |
2007年 | 2338篇 |
2006年 | 2184篇 |
2005年 | 1714篇 |
2004年 | 1519篇 |
2003年 | 1279篇 |
2002年 | 1052篇 |
2001年 | 955篇 |
2000年 | 756篇 |
1999年 | 753篇 |
1998年 | 623篇 |
1997年 | 604篇 |
1996年 | 494篇 |
1995年 | 454篇 |
1994年 | 398篇 |
1993年 | 317篇 |
1992年 | 322篇 |
1991年 | 263篇 |
1990年 | 207篇 |
1989年 | 194篇 |
1988年 | 195篇 |
1987年 | 187篇 |
1986年 | 184篇 |
1985年 | 202篇 |
1984年 | 166篇 |
1983年 | 120篇 |
1982年 | 145篇 |
1981年 | 106篇 |
1980年 | 85篇 |
1979年 | 70篇 |
1978年 | 43篇 |
1977年 | 46篇 |
1976年 | 41篇 |
1975年 | 25篇 |
排序方式: 共有10000条查询结果,搜索用时 0 毫秒
31.
Major progress in clinical pain assessment and management has been achieved in the last decade. More effective analgesic drugs and improved techniques for pain management have been introduced. However, medical reports published during the last few years on postoperative pain management (POPM) indicate that moderate or even severe pain is still rather commonly experienced by surgical patients in the early postoperative period and that worst-pain-episodes may occur even in the late postoperative phase. Insufficient relief of postoperative pain seems a more common problem on surgical wards than on a postanaesthesia care unit (PACU). The aims of POPM are to inhibit autonomic trauma-induced nociceptive impulses that may result in functional disturbances of vital organs and thereby affect the incidence of potentially severe complications influencing clinical outcome. Considering that recent studies continue to show sub-optimal pain management despite the availability of effective drugs and analgesic techniques it must be considered essential to identify possible barriers to effective pain management in clinical practice so that necessary improvements in POPM routines can be carried out. 相似文献
32.
John D Paulson Melissa Delgado 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2007,11(2):175-181
OBJECTIVE: This study was designed to determine the relationship between interstitial cystitis (IC), endometriosis (endo), and chronic pelvic pain (CPP) in individuals in whom nongynecological and nonurological problems had been previously ruled out. METHODS: A prospective study of 162 consecutive women with a complaint of chronic pelvic pain seen in the clinic was performed between August 2002 and December 2005. These patients underwent a workup to exclude other causes of pelvic pain, had PUF (Pain Urgency and Frequency) questionnaires filled out, and underwent a laparoscopy and a cystoscopy with hydrodistention. Pain levels were determined, and treatment was reviewed and enumerated. Results were obtained and quantified. RESULTS: In this study, 123 (76%) patients were diagnosed with active endometriosis, 133 (82%) were diagnosed with interstitial cystitis, and 107 (66%) had both disease entities simultaneously. Thirteen (8%) patients were diagnosed with pathologies unrelated to endometriosis and interstitial cystitis. Pain levels were seen to decrease at 6 months in all groups of patients with the exception of those patients with endometriosis only. CONCLUSION: CPP is a difficult, taxing, and frustrating concern for many women in the United States. These individuals have traditionally been difficult to treat. A large number of women with CPP in our patient population have been shown to have endometriosis, interstitial cystitis, or both. Therefore, a workup for premenopausal individuals with CPP involves obtaining a history that keys into possible nongynecologic causes of pain, a complete accounting of urinary problems, and a thorough history of gynecological problems. A physical examination with a comprehensive history should be performed, and the investigation may include the possibility of a simultaneous laparoscopy and cystoscopy if warranted. These procedures can serve as both a means for diagnosis and treatment of these problems when encountered. 相似文献
33.
34.
Alfred Philip James Lake BSc MBBS FFARCS ; Kathiravelpillai Puvanachandra MBBS DO FRCS FRCOphth 《Pain practice》2004,4(2):130-131
Abstract: Stellate ganglion block is commonly used to treat the sympathetically maintained pain which may occur in one‐third of patients with complex regional pain syndrome type 1. A complication that followed a single block and presented a diagnostic dilemma for the ophthalmologist is reported. 相似文献
35.
Donna Brown 《Journal of clinical nursing》2004,13(Z2):74-90
Little research has examined the care older people receive in the acute surgical setting. Although pain assessment and management are judged to be a priority in nursing, often pain, in older people, is undermanaged for a variety of reasons. Factors such as stoicism, communication and ageism can shape both the patients’ and nurses’ attitude towards the perception of pain which subsequently affects pain management. Through a review of the literature, this paper aims to: (i) identify how healthcare professionals contribute to the assessment and control of postoperative pain in older people and (ii) explore potential barriers to achieving more advantageous pain control in this group. It is suggested that to improve pain management there is a need to individualize pain assessment for older people and to assist clinicians with enhancing their education and decision‐making abilities in this field. This may best be achieved by supporting a programme of change to develop the skills of staff and encouraging learning through reflective practice. There is however a need for further research in this area. 相似文献
36.
Birol Civelek H. İbrahim Inal Kubilay Ozdil Selim Celebioglu 《European journal of plastic surgery》2007,30(1):25-28
Skin is the most commonly used tissue for the transplantation. A meticulous care of the donor site is needed to prevent scarring,
delayed healing, and pain. Various agents and dressing materials have been reported to help healing of skin graft donor sites.
Sucralfate is an extensively used agent, which provides acute gastroprotection and acceleration of chronic ulcer healing.
In this study, we assessed the effects of topical sucralfate on the healing of the split thickness skin graft donor sites
in a prospective comparative way. The study was carried out on 32 randomly chosen patients undergoing surgery for various
causes and requiring split thickness skin graft resurfacing. The upper halves of the skin graft donor sites on the thighs
were simply covered with paraffin gauze and the lower half was covered with sucralfate-soaked paraffin gauzes. The day of
full epithelization varied from 6 to 9 days and 8–12 days on the sucralfate-applied areas and on the control sites, respectively.
The mean value of the healing was 7.01 days in the studied lower halves and 10.8 days in the upper halves. The healing rate
was strikingly faster and less painful on the sucralfate-applied areas. We were able to discharge patients earlier than usual,
and patients’ comfort increased. It seems that sucralfate is a promising topical agent to increase the healing rate and decrease
the incidence of associated problems such as pain and hypertrophic scar. 相似文献
37.
自控止痛泵在疼痛治疗中的应用 总被引:1,自引:0,他引:1
介绍了自控止痛泵在临床各种类型疼痛病人治疗中的应用 ,研究了最佳给药途径、注药模式及常见的不良反应 ,为临床正确用药提供了帮助。 相似文献
38.
目的 探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)不同压力CO2气腹对气腹存留时限及肩部疼痛的影响,探讨LC术后气腹存留时限的影响因素及肩部疼痛的原因.方法 2002年4~10月连续观察69例LC,随机分为A、B、C 3组,每组23例.气腹压力设定A组10mm Hg,B组12mm Hg,C组14mm Hg.对69例LC术后进行连续胸部X线平片观察膈下游离气体,测量术后24h两侧膈下游离气体的长、高并计算残气量.采用视觉模拟评分(vision analogue score,VAS)观察3组术后1、3、6、12、24、48、72、96、120h肩部疼痛程度.结果 LC后气腹存留时限为(1.8±1.1)d,男女组气腹存留时限分别为(1.8±1.1)d和(1.7±1.0)d,2组比较无显著意义(H=0.013,P=0.911).3组术后24h膈下残气量及术后气腹存留时限差异无显著性(P>0.05).逐步回归分析示lg(气腹存留时限)与术后24h膈下残气量呈正相关(r=0.616,P=0.006),与气腹时间呈负相关(r=-0.228,P=0.014),与年龄、体重、身高、手术时间及所用气体量无相关性.术后26例出现肩部疼痛,随着A、B、C 3组气腹压力的增高,发生肩部疼痛患者的VAS评分明显增高(F=9.635, P=0.000),术后24h肩部疼痛VAS评分与术后24 h右侧膈下残气量呈正相关(r=0.333,P=0.005),与气腹存留时限呈正相关(r=0.296,P=0.014).结论 LC术毕尽量将腹腔内CO2气体排净可缩短术后残气吸收时间.不同压力CO2气腹对LC术后残余的CO2气体量及气腹存留时限无明显影响.LC后肩部疼痛程度随气腹压增高有明显加重趋势,人工气腹引起膈肌的张力可能是造成肩部疼痛的重要原因. 相似文献
39.
40.
Studies on the effectiveness of pain management have uniformly concluded that health care providers underestimate or undertreat pain. In the emergency department (ED) in which this study was conducted, physicians receive formal didactic and bedside teaching on pain recognition and management in order to heighten the awareness of patient's need for pain control. The purpose of this study was to determine if this outpatient pain management of patients with acute, painful conditions is better than that reported in the medical literature. In this prospective study, 110 adult patients who had an acute, painful diagnosis were telephoned 48 hours after discharge from the ED and asked if they felt their pain at home was well controlled. Patient satisfaction with pain control was higher (91%) than that reported in the medical literature. Also, pain medication was provided more frequently by this study's ED (95%). Education on pain awareness and treatment is a way to improve pain management. 相似文献