1、消化系统疾病的症状与病史采集A good eater must be a good man; for a good eater must have good digestion, and good digestion depends upon a good conscience.Benjamin Disraeli(1804-1881)Diseases of the abdomen are common.In the United States, in 2000.Approximately 10% of the adule male population is affected peptic u
2、lcer disease.Five percent of the population older than the age of 40 years has diverticular disease.The probability of developing colorectal cancer between birth and age 80 years is approximately 5.5%.2003年我国居民前十种慢性病患病率 ()Morbidity Rate of 10 Main Chronic Diseases排 序 疾病名 合计 城市 农村2 胃肠炎 10.3 9.8 10.5G
3、astroenteritis6 胆结石胆囊炎 5.7 8.5 4.7Cholelith 直肠癌 68例 ; 肝癌 47例 ; 胰腺癌 40例 ; 胆囊癌 17例 ;结肠癌 10例。The most common symptoms of abdominal disease are as tollows: Pain Nausea and vomiting Change in bowel movements Rectal bleeding Jaudice (icterus) Abdominal distention Mass Pruritus (itching)我国最常见的消化疾病症状:吞咽困难 (
4、dysphagia)呕 吐 (vomiting)呕血与黑粪 (hematemesis and melena)便 血 (hematochezia)低血容量休克 (hypovolemic shock)腹 痛 (pain)腹 泻 (diarrhea)便 秘 (constipation)黄 疸 (jaudice)腹 水 (ascites)肝肿大 (hepatomegaly)腹腔肿块 (mass)Emergency interventionwGeneral exam:facial features (面容 )facies of fever (热病容 )pallor (贫血面容 )Hippocrates
5、(垂危面容 )Consciousness (意识 )somnolence (嗜睡 )confusion (意识模糊 )stupor (昏睡 , 木僵 )coma (昏迷 )Emergency interventionwVital sign.Blood pressure and pulse.Hypovolemia: pallor diaphoresis hypotension tachycardia decreased urine outputMedical or surgical: 全身中毒反应 ,例 :发热 (fever) 腹膜刺激征 (peritoneal irritation sign) 类似急腹症的 “ 内科病变 ” 心血管损害:心肌梗塞;脾梗塞;肾梗塞;急性心包炎等。 胸部损伤:肺炎;肺梗塞;肺大疱破裂;急性纵膈炎等。 其他:糖尿病酸中毒;脊髓痨;紫癜;带状疱疹;急性铅中毒等。