Murtagh安全诊断策略在全科教学门诊中的应用:以风湿性多肌痛为例

Application of Murtagh Safe Diagnostic Strategy in the General Practice Teaching Clinic:an Example of Rheumatic Polymyalgia

澳大利亚著名全科医学专家约翰·莫塔(John Murtagh)提出的Murtagh安全诊断策略逐渐被全科医生用于临床诊断和治疗,多用于常见病的初步诊断、危急重症的快速识别、分析和判断是否存在导致某种症状/体征而容易被忽略的疾病,同时了解患者的担忧和期待。全科教学门诊是培养全科医生临床思维、提升全科诊疗能力的重要培训方法。本文以1例风湿性多肌痛(PMR)患者为教学案例,应用Murtagh安全诊断策略剖析诊疗思路,结合文献分析诊疗过程、总结诊治经验,指导全科医生从多维度思考疾病诊断、治疗,培训全科住院医师的全科临床思维、提高PMR诊治水平,达到教学目的。

The Murtagh safe diagnostic strategy proposed by renowned Australian general practitioner John Murtagh has been gradually used by general practitioners in clinical practice for diagnosis and treatment,mainly for initial diagnosis of common diseases,rapid identification of critical and severe diseases,analysis and judgment of the existence of diseases that can be easily overlooked,as well as to understand the patient's concerns and expectations.The general practice teaching clinic is an important training method for developing clinical thinking and enhancing diagnosis and treatment abilities of general practitioners.This article takes a patient with polymyalgia rheumatica(PMR)as a teaching case,applies the Murtagh safe diagnostic strategy to analyze the diagnosis and treatment ideas,analyzes the diagnosis and treatment process in combination with literature,summarizes diagnosis and treatment experience,guides general practitioners to think about disease diagnosis and treatment from multiple dimensions,trains general practice residents' general clinical thinking,improves the diagnosis and treatment level of PMR,so as to achieve the teaching purpose.