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全科常见未分化疾病诊疗手册(第3版)
$49.30
1.由浙江大学医学院附属第一医院任菁菁主任和复旦大学中山医院江孙芳主任和复旦大学中山医院江孙芳主任主编,联合全国全科医学领域专家禀秉着以细心、专业的态度,将精湛的专业知识和丰富的临床经验进行整合,思第1、2版的短缺,集第1、2版的优势,孜孜不倦,群策群力,终汇编成第3版。2.《全科常见未分化疾病诊疗手册》(第3版)的出版对于医学教育中全科医生的培养和教育如逢甘霖,实用性和广适性并举,不仅可以作为临床医生日常工作指导...
1.由浙江大学医学院附属第一医院任菁菁主任和复旦大学中山医院江孙芳主任和复旦大学中山医院江孙芳主任主编,联合全国全科医学领域专家禀秉着以细心、专业的态度,将精湛的专业知识和丰富的临床经验进行整合,思第1、2版的短缺,集第1、2版的优势,孜孜不倦,群策群力,终汇编成第3版。2.《全科常见未分化疾病诊疗手册》(第3版)的出版对于医学教育中全科医生的培养和教育如逢甘霖,实用性和广适性并举,不仅可以作为临床医生日常工作指导用书,还可以作为全科师资的教学辅助用书,助力各基地培养全科人才,具有较高的学术价值及社会意义。
本版概述 本选题包括多系统相关未分化疾病,再版将参考国内外最新进展对原版内容进行更新,更正第2版中的错误,同时扩充相关未分化疾病病种如腹胀、疼痛、肺部结节等,并将SOAP病例结合RICE问诊和莫塔思维等内容进一步深化使其更贴合全科医师实际工作。在编写内容上既注重疾病的深度和广度,又注重知识的系统性和实用性,可作为全科师资的教学辅助用书,除供医学生、全科医生研读,亦可供其它医学专业相关人员阅览,具有较高的实用价值。
现任全科医学科主任,良渚门诊部副主任,全科医师规范化培训基地负责人,全科医学教研室主任,全科健康管理研究中心副主任。
第一章 总论/001第一节 未分化疾病概述 /001第二节 未分化疾病的接诊模式 /004第三节 未分化疾病诊治现状和研究展望 /009第二章 未分化疾病常见症状/019第一节 发热 /019第二节 咳嗽 /025第三节 胸痛 /033第四节 呼吸困难 /043第五节 打喷嚏 /049第六节 打鼾 /055第七节 咽痛 /060第八节 胸闷 /068第九节 心悸 /074第十节 恶心与呕吐 /081第十一节 嗳气与呃逆 /088第十二节 吞咽困难 /094第十三节 口臭 /100第十四节 咯血 /107第十五节 食欲缺乏 / 113第十六节 腹痛 / 119第十七节 腹泻 /126第十八节 腹胀 /134第十九节 便秘 /140第二十节 呕血 /148第二十一节 黑便与便血 /157第二十二节 排尿困难 /163第二十三节 尿频、尿急、尿痛 /168第二十四节 泡沫尿 /174第二十五节 血尿 /178第二十六节 口干 /184第二十七节 头晕/ 眩晕 /191第二十八节 头痛 /198第二十九节 晕厥 /205第三十节 声音嘶哑 /212第三十一节 乏力 /218第三十二节 麻木 /225第三十三节 焦虑与抑郁 /230第三十四节 肢体酸胀 /237第三十五节 颈肩痛 /243第三十六节 腰背痛 /249第三十七节 关节痛 /256第三十八节 肌痛 /263第三十九节 周身疼痛 /269第四十节 潮热与盗汗 /276第四十一节 月经异常 /281第四十二节 阴道出血 /287第四十三节 白带异常 /292第四十四节 小儿惊厥 /297第四十五节 小儿喂养困难 /303第四十六节 儿童生长发育异常 /310第四十七节 皮肤瘙痒 /318第四十八节 皮肤感觉异常 /324第四十九节 眼睛干涩 /330第五十节 耳鸣 /335第五十一节 牙痛 /342第五十二节 牙龈出血 /348第五十三节 味觉异常 /353第五十四节 嗅觉异常 /359第三章 未分化疾病常见体征/369第一节 胸腔积液 /369第二节 指/ 趾甲异常 /378第三节 发绀 /383第四节 血压升高 /389第五节 血压降低 /398第六节 四肢厥冷 /403第七节 黄疸 /409第八节 腹腔积液 /416第九节 腹部肿块 /423第十节 贫血 /428第十一节 瘀点与瘀斑 /435第十二节 甲状腺肿大 /441第十三节 消瘦 /448第十四节 肥胖 /454第十五节 水肿 /460第十六节 震颤 /466第十七节 抽搐 /474第十八节 意识障碍 /480第十九节 认知功能障碍 /487第二十节 淋巴结肿大 /495第二十一节 乳腺肿块 /500第二十二节 乳头溢液 /506第二十三节 皮肤局部肿物 / 511第二十四节 皮疹 /516第二十五节 脱发 /523第四章 常见辅助检查异常的未分化疾病/531第一节 血常规异常 /531第二节 尿常规异常 /537第三节 肝功能异常 /543第四节 肾功能异常 /551第五节 血脂异常 /556第六节 血尿酸异常 /562第七节 血糖与糖化血红蛋白异常 /567第八节 肌酸激酶升高 /574第九节 甲状腺功能异常 /579第十节 甲状腺结节 /585第十一节 肺部结节 /592索引/598附录/600附录1 Bristol 粪便分型 /600附录2 便秘患者症状自评量表(PAC-SYM) /601附录3 便秘患者生存质量量表(PAC-QOL) /602附录4 抑郁自评量表(SDS)使用与结果判读 /604附录5 抑郁症状的简易筛查—“90 秒4 问题询问法” /607附录6 焦虑自评量表(SAS)使用与结果判读 /607附录7 焦虑症状的简易筛查—“90 秒4 问题询问法” /610附录8 患者健康问卷抑郁量表(PHQ-9) /610附录9 疲劳严重程度量表(FSS)/ 611附录10 疲劳评定量表(FAS) /612附录11 衰弱(FRAIL)量表 /613附录12 神经系统症状评分(NSS) /614附录13 简易精神状态评价量表(MMSE) /616附录14 临床痴呆评定量表(CDR) /620附录15 蒙特利尔认知评估量表(MoCA) /622附录16 阿尔茨海默病评定量表—认知部分(ADAS-Cog) /624附录17 12 项目瘙痒严重程度量表 /629附录18 疼痛评估 /630附录19 Glasgow 昏迷量表(GCS) /631附录20 耳鸣致残量表(THI)/632附录21 眼表疾病指数(OSDI)量表 /633附录22 中毒严重度评分PSS 系统 /634附录23 主动脉夹层危险评分 /637附录24 失眠严重程度指数(ISI) /638附录25 Epworth 嗜睡量表 /639附录26 匹兹堡睡眠质量指数(PSQI)量表 /640附录27 国际不宁腿综合征研究组评估量表(IRLS)/641附录28 阻塞性睡眠呼吸暂停病情严重程度分度 /643附录29 睡眠信念和态度量表(DBAS-16) /643附录30 STOP-Bang 问卷中文版 /644附录31 嗓音障碍指数(VHI)量表 /645附录32 声音嘶哑评估GRBAS 评分 /646附录33 0~18 岁儿童青少年身高、体重百分位数值表(男) /647附录34 0~18 岁儿童青少年身高、体重百分位数值表(女) /650
全科医疗的服务模式已被世界医学界公认为是基层医疗保健的最佳服务模式。我国于20 世纪80 年代后期引入全科医学,历经30 多年不断探索和实践,我国全科医生队伍建设取得了一定的进展。《“健康中国2030”规划纲要》中提出,建设“健康中国”,要健全基层医疗卫生服务体系和加快全科医生队伍建设。因此,培养合格的全科医生已成为目前建设健康中国的关键环节和重要任务。全科医生具有连续性管理及持续性照顾未分化疾病患者的天然优势,因此,如何科学处理未分化疾病是全科诊疗工作开展的基石。1985 年Slavney 和Teitelbaum 医生提出了“医学难以解释的症状”的概念,即medically unexplained symptoms,着重关注心身疾病症状,2014 年《全科医学与社区卫生名词》一书发布名词“未分化性疾患(undifferentiated illness)”,笔者在前二者基础之上,于2015 年在《中国全科医学》杂志发表《常见未分化疾病的全科处理探讨》一文,文中首次提出全科医学中的“未分化疾病”。并于2016 年出版《全科常见未分化疾病诊疗手册》(第1 版),历经2020 年的再版,此书收获了众多读者的肯定。我们累积了编写经验,也汇集了各位读者的建议,从第1 版的区域性,扩展到第2 版的代表性和全覆盖性。在此基础上,第3 版明确了未分化疾病的定义,进一步完善了未分化疾病病种,也更加注重编者的教学经验和带教能力,以更为完善、更为规范、更为全面的面貌与大家见面。在征求前两版读者及各省市全科专家意见的基础上,第3 版在目录及体例格式上进行全新改版,本书共分为四章九十三节,内容包括“总论”“未分化疾病常见症状”“未分化疾病常见体征”“常见辅助检查异常的未分化疾病”,从问诊、疾病评估、诊断与鉴别诊断、常见诊疗手段,到识别红旗征及转诊指征等方面进行深入浅出的解析。文末放入常见未分化疾病的病例分析部分,便于指导读者进行实践应用,兼具系统性和实用性,助力全科医生在临床实践中查阅参考。本书由来自全国32 位全科医学领域专家共同撰写完成,各位编者在紧张繁忙的临床工作之余,精益求精,务实高效地完成编写任务。借此,我们谨对参与本书编写工作的各位同道表达真挚的感谢。承蒙读者厚爱,虽然竭尽全力,但因水平和能力有限,书中难免有一些疏漏和不妥之处,敬请广大读者不吝指正,如有修订建议,可发至邮箱:zyqk1999@163.com。任菁菁 江孙芳2023 年8 月6 日
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