重视全科医师风湿病的病史采集和体检方法

Emphasis on history taking and physical examination in patients with rheumatic diseases for general practitioners

目的推进全科医师风湿病和关节炎的普及教育。方法当接诊风湿病和关节炎患者时,应首先了解患者发病前的健康状况,发病年龄、性别、诱因,发病方式,前驱表现,首发部位,演变过程,病变范围,伴随现象,加重或缓解的因素,接受过的检查和治疗以及对治疗的反应等。注意关节受累的特点,将患侧与健侧对比或与检查者的健康关节对比检查。结果完整的病史和体格检查资料是关节炎和风湿病临床诊断和治疗最基本和重要的方法。结论加强风湿病基本技能的教育,对普及风湿病的医疗服务,提高风湿病的诊治水平具有重要意义。

Objective To promote the universal education of rheumatism and arthritis for general practitioner. Meth- ods At interview with patients with rheumatism and arthritis, general practitioner should first understand the health status of pre - onset, age, sex, incentives, onset ways, precursor performance, starting position, evolution process, extent of the lesion, accompanied phenomenon,factors influencing disease severity,received examination and therapies as well as the response to the treatment. To note the characteristics of joint involvement,and compare affected side with the eontralateral or the health con- trast joints. Results Complete medical history and physical examination data are the most basic and important methods for diagnosis and treatment of arthritis and rheumatism. Conclusion The education enhancement of basic skills is significant for rheumatic health care services and the diagnosis and treatment of rheumatism and arthritis.