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国内名院、名科、知名专家临床诊疗思维系列丛书·呼吸内科疾病临床诊疗思维

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国内名院、名科、知名专家临床诊疗思维系列丛书·呼吸内科疾病临床诊疗思维

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对于已步入临床实践阶段的高等医学院校临床医学专业五年制、七年制和八年制高年级学生、临床型研究生及住院医师而言,如何将前期课堂教学阶段学习的基本知识和基本思维方法运用于患者的诊治,即培养自身临床诊疗主动思维能力和创造能力十分重要。临床实践中,面对无论是复杂还是简单的疾病,医生对诊治过程大多经历从感性认识到理性认识、从理论知识到实践认识的过程。该过程包括病史的询问和临床资料的收集、分析以及作出初步的诊断和治疗、对病情发展和变化的观察,并以此验证诊治正确与否或是否需要修正等阶段。临床思维贯穿于这一过程的各个阶段,呼吸系统疾病诊治的临床思维亦是如此。虽然呼吸系统疾病的主要症状仅有咳嗽、咳痰、咯血、胸痛、呼吸困难等表现,体征的辨认也不十分复杂,但如同基本音符虽仅有7个却可谱出无数乐章一样,这些临床表现的不同组合或不同方式组合常常提示不同的疾病或严重度。对此能够作出正确的判断则需要科学缜密的临床诊疗思维,这就是《呼吸内科疾病临床诊疗思维》编写的目的——通过对患者的实际诊治过程的学习,培养读者正确的临床诊疗主动思维能力。
Author Description

康健,1958年7月生,中国医科大学呼吸疾病研究所所长、附属第一医院呼吸内科主任。1982年毕业于中国医科大学医疗系(本科),1991年获博士学位。曾留学日本国立千叶大学医学部和英国牛津大学。1994年晋升为教授、主任医师,1995年被聘为博士生导师。从事临床工作24年。
主要学术兼职:国务院学位办学科评议组成员。中华医学会理事、中华医学会呼吸病学分会副主任委员、中国医师协会呼吸分会副主任委员。《中国实用内科杂志》主编,美国《Chest》杂志(中文版)副主编,《中华结核和呼吸杂志》常委编委,《国际呼吸杂志》副主编,国内其他十余种学术杂志的常务编委或编委。
近10余年来,作为课题负责人承担国家“九五”医学科技攻关课题1项,国家医学科技攻关子课题4项,部、省级课题8项;发表国际性学术杂志学术论文14篇(SCI累计IF>50点)、国家级学术杂志论文170余篇(MEDLINE收录50余篇)。主编、主译学术著作3部,参编著作20余部。培养博士研究生18名(包括1名外国留学生),硕士研究生18名。获卫生部科技进步奖2次、中华医学科技奖2次、吴阶平医学研究-保罗?杨森药学研究二等奖1次、省科技进步二等奖2次、省科技进步三等奖2次。
Catalogue

症状篇
病例1 慢性咳嗽2年
病例2 咳嗽2周
病例3 反复咳嗽、咳痰20余年,加重伴呼吸困难1个月
病例4 发作性呼吸困难6小时
病例5 呼吸困难2周
病例6 突发呼吸困难伴胸痛3天
病例7 间断咯血5个月,加重1周
病例8 胸痛,呼吸困难5天
病例9 发现杵状指3个月

疾病篇
病例10 反复发作性喘息20年
病例11 喘息、呼吸困难20天
病例12 反复发作性喘息、发绀、嗜睡
病例13 反复发作性呼吸困难2年
病例14 咳嗽、咳痰20余年,气短5年,加重4天
病例15 慢性咳嗽咳痰10余年,气短2年
病例16 慢性咳嗽、咳痰伴活动后气促、心悸
病例17 心悸、气短2年,加重2周
病例18 反复咳嗽、咳痰,活动后气短
病例19 发热、咳嗽10天
病例20 咳嗽咳痰、高热伴气短,双肺片影
病例21 术后高热、咳脓痰,双肺弥漫浸润影
病例22 术后发热、咳嗽咳痰1天
病例23 发热、咳痰、咯血,双肺脓气胸
病例24 咯血2个月
病例25 发热、咳嗽、咳痰带血、多发肺球形空洞影1个月
病例26 咳嗽、咳痰3周,伴发热、呼吸困难2周
病例27 咳嗽、呼吸困难、多发肺浸润影2周
病例28 呼吸困难伴咳嗽、发热1个月,双肺间质改变
病例29 血糖高20年,高热伴咳嗽1个月
病例30 发热7天,活动后气短3天,双肺多发磨玻璃影
病例31 咳嗽、咯血,伴胸痛1周
病例32 发热、胸痛1个月,咳嗽咳脓痰20天,皮肤多发脓肿
病例33 发热2个月,咳嗽20余天
病例34 间断发热4个月
病例35 反复咳嗽、咳痰6个月
病例36 咳嗽、咳黄痰2周,痰中带血3天
病例37 发热伴咳嗽、大量脓痰7天
病例38 咳嗽、咳脓臭痰、发热10天
病例39 发热,咳嗽,咳痰10余天
病例40 突发左胸痛、气促伴发热3天
病例41 胸痛1个月,发热、咳痰带血10天
病例42 发热、咳嗽2周
病例43 胸闷、乏力3个月,咳嗽半个月
病例44 发热、咳嗽1个月
病例45 咳嗽、发热、呼吸困难1个月,双肺多发小结节影
病例46 咳嗽、发热2周,弥漫肺结节影
病例47 咳嗽、咳痰带血、胸痛3个月
病例48 胸痛、气短2个月,声音嘶哑1周
病例49 咳嗽、咳痰、进行性气短4个月
病例50 咳嗽、咯血6个月,右肺上叶后段空洞
病例51 间断痰中带血2年
病例52 咳嗽、间断咯血2个月
病例53 间断咳嗽、发热3年余
病例54 低热1个月,左胸痛、气短半个月
病例55 胸痛2月余,恶心、呕吐3天
病例56 间断咳嗽伴发热1年余,痰中带血丝1周
病例57 进行性气短伴咳嗽半年,加重1个月
病例58 长期活动后气短、气短加重伴双肺间质性改变
病例59 胸痛、胸闷、咳嗽伴气短半年
病例60 咳嗽、咳痰、发热、气短,双肺多发阴影
病例61 进行性气短4个月
病例62 干咳伴活动后气短半年,加重1个月
病例63 咳嗽、进行性呼吸困难3个月,双肺多发结节影
病例64 慢性咳嗽咳痰5年,伴胸闷气短进行性加重6个月
病例65 发热、咳嗽伴气短3个月
病例66 发热、咳嗽2周
病例67 咳嗽、痰中带血、胸闷1周
病例68 腹痛、发热、恶心呕吐、双肺多发斑片影2个月
病例69 突发性呼吸困难1天
病例70 左侧胸痛伴气短20天
病例71 咳嗽、发热1个月
病例72 牙痛1周、发热伴呼吸困难3天
病例73 咳嗽、咳痰1周,发热、呼吸困难3天
病例74 鼾声响亮、白日困倦3个月
病例75 打鼾3年,白日嗜睡、头晕2个月
病例76 咳嗽、咳痰伴活动后气短6年,加重1个月
病例77 发热、咳嗽1月余,气短1周
病例78 反复发作性呼吸困难3年,加重伴腹痛、腹泻4天
病例79 低热、乏力、盗汗2个月,气短1周
病例80 咽痛、咳嗽2个月,加重10天
病例81 咳嗽、呼吸困难3个月,肺门及纵隔淋巴结肿大
病例82 胸痛1个月、咯血1周
病例83 咳嗽、咳痰、发热1个月,伴肺部阴影
病例84 阵发性呼吸困难2个月
病例85 呼吸困难伴胸痛,胸腔积液合并肺门纵隔淋巴结肿大
病例86 气短、胸痛2个月,进行性贫血
病例87 心源性肺水肿患者无创正压机械通气治疗
病例88 严重营养不良患者机械通气困难撤机病例
病例89 慢性阻塞性肺疾病呼吸衰竭患者无创机械通气治疗
病例90 慢性阻塞性肺疾病呼吸衰竭患者有创机械通气治疗
病例91 重症哮喘呼吸衰竭患者机械通气治疗病例
附病例诊断结果
Book Abstract

症状篇
病例1慢性咳嗽2年
患者女性,42岁,2008年5月门诊就诊。
一、主诉
反复咳嗽2年。
二、病史询问
(一)初步诊断思路及问诊目的
患者为中年女性,以反复咳嗽2年为主诉就诊。咳嗽是患者就诊的主要症状,同时也是很多疾病可能出现的临床症状之一。问诊的主要目的是围绕着咳嗽的鉴别诊断,寻找咳嗽的病因,为诊断和治疗提供依据。临床上通常将咳嗽时间≥8周,以咳嗽为主要表现,胸部x线检查无明显病变者称为不明原因的慢性咳嗽。慢性咳嗽的病因很多,可能有上气道疾病(如鼻炎、鼻窦炎等)、呼吸系统疾病(如咳嗽变异型哮喘、嗜酸细胞性支气管炎、支气管内膜结核等)、消化系统疾病(如反流性食管炎)等等。因此在病史询问中,要深入细致,按照咳嗽的诊断程序,循序渐进,注意鉴别诊断的病史询问。
(二)问诊主要内容及目的
1. 现病史询问 重点询问咳嗽的特点,如是干性咳嗽、湿性咳嗽还是刺激性咳嗽;是白天咳嗽、夜间咳嗽还是凌晨咳嗽;哪些因素诱发咳嗽;咳嗽有无季节性;咳嗽的缓解方式是自行缓解还是用药物缓解,用何种药物缓解;还要询问咳嗽的伴随症状,如是否伴随流涕、咳痰、气短、喘息、呼吸困难、咯血、发热、胸痛等;患者慢性咳嗽的病史较长,达2年,要询问其间是否曾到医院就诊,是否行胸部x线检查,检查结果如何。还要询问药物治疗的情况及治疗的反应。
2. 既往史询问 按照咳嗽的诊断程序,首先应当询问有无高血压病史,有无服用血管紧张素转换酶抑制剂(ACEI)类药物史,以除外ACEI类药物引起的咳嗽。要注意询问是否有过敏史、过敏性鼻炎史、肺结核病史、心血管疾病史、胃炎或胃溃疡病史,以便与引起咳嗽症状的其他疾病鉴别。
3. 个人史询问 吸烟史;有何种爱好,如饲养宠物等;居住环境是否潮湿,是否居住在新装修的房屋;个人职业史,是否有职业性过敏物质接触史。
Introduction

对于已步入临床实践阶段的高等医学院校临床医学专业五年制、七年制和八年制高年级学生、临床型研究生及住院医师而言,如何将前期课堂教学阶段学习的基本知识和基本思维方法运用于患者的诊治,即培养自身临床诊疗主动思维能力和创造能力十分重要。临床实践中,面对无论是复杂还是简单的疾病,医生对诊治过程大多经历从感性认识到理性认识、从理论知识到实践认识的过程。该过程包括病史的询问和临床资料的收集、分析以及作出初步的诊断和治疗、对病情发展和变化的观察,并以此验证诊治正确与否或是否需要修正等阶段。临床思维贯穿于这一过程的各个阶段,呼吸系统疾病诊治的临床思维亦是如此。虽然呼吸系统疾病的主要症状仅有咳嗽、咳痰、咯血、胸痛、呼吸困难等表现,体征的辨认也不十分复杂,但如同基本音符虽仅有7个却可谱出无数乐章一样,这些临床表现的不同组合或不同方式组合常常提示不同的疾病或严重度。对此能够作出正确的判断则需要科学缜密的临床诊疗思维,这就是本书编写的目的——通过对患者的实际诊治过程的学习,培养读者正确的临床诊疗主动思维能力。
本书所选病例均为中国医科大学附属第一医院呼吸疾病研究所的真实病例,诊治过程也忠实原态。参加本书编写者皆是本研究所的医生,病例多为他们本人亲自诊治的患者。绝大多数编写者具有高级技术职称并从事呼吸内科临床工作多年。病例选择时,我们力求覆盖呼吸疾病的主要病种、难易兼顾,但由于诊治时条件或业务水平所限,有的病例可能不尽完善,敬候读者批评指正。

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Yami has a consolidation warehouse in China which collects multiple sellers’ packages and combines to one order. Our Yami consolidation warehouse will directly ship the packages to your door. Cross-store free shipping over $69.

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You may return products within 30 days upon receiving the products. Sellers take responsibilities for any wrong shipment or missing items. Packing needs to be unopened for any other than quality issues return. We promise to pack carefully, but because goods are taking long journey to destinations, simple damages to packaging may occur. Any damages not causing internal goods quality problems are not allowed to return. If you open the package and any quality problem is found, please contact customer service within three days after receipt of goods.

Shipping Information

Yami Consolidation Service Shipping Fee $9.99(Free shipping over $69)

Sellers in China will ship their orders within 1-2 business days once the order is placed. Packages are sent to our consolidation warehouse in China and combined there. Our Yami consolidation warehouse will directly ship the packages to you via UPS. The average time for UPS to ship from China to the United States is about 10 working days and it can be traced using the tracking number. Due to the pandemic, the delivery time may be delayed by about 5 days. The package needs to be signed by the guest. If the receipt is not signed, the customer shall bear the risk of loss of the package.

Sold by JD@CHINA

Service Guarantee

Free shipping over 69
Genuine guarantee

Shipping

Yami Consolidated Shipping $9.99(Free shipping over $69)


Seller will ship the orders within 1-2 business days. The logistics time limit is expected to be 7-15 working days. In case of customs clearance, the delivery time will be extended by 3-7 days. The final receipt date is subject to the information of the postal company.

Yami Points information

All items are excluding from any promotion or points events on Yamibuy.com

Return Policy

You may return product within 30 days upon receiving the product. Items returned must be new in it's original packing, including the original invoice for the purchase. Customer return product at their own expense.

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About the brand

Jingdong book

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About the brand

Jingdong book