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内科治疗指南

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内科治疗指南

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《内科治疗指南》是临床治疗指南丛书中的一个分册。
由著名的呼吸病学家、中华医学会呼吸病学分会常委殷凯生教授领队主编,汇集近百十来位内科领域学科带头人和中年骨干医师撰写而成。
内容涉及内科临床最常见的约360种(类)疾病,包括疾病概述、治疗程序、治疗方案、疗效观察与随访、治疗经验与解析等五个部分。
尤其是【治疗程序】表的设置,可以说是该书的一大亮点,可使读者对疾病的治疗一目了然且了然于心,【疗效观察与随访】,对疾病治疗疗效的评估以及随访,依据卫生部以及相关管理部门的行业规范进行了细化和量化,也是该书的又一大亮点。符合近年来医学发展的要求,更贴近临床实际诊病、治病的需要——对初、中级临床医生,对有关教学、护理、科研和医院管理人员来说,是非常有益的。
新颖、权威、实用和简明是本书的特点。
《内科治疗指南》是临床治疗指南丛书中的一个分册。

Author Description

殷凯生,男,1946年4月生,江苏镇江人,南京医科大学第一附属医院二级教授、主任医师、博士研究生导师,是享受国务院特殊津贴的著名呼吸病学家。
兼任中华医学会呼吸病学分会常委和江苏省呼吸病学分会名誉主任委员,中国中西医结合学会呼吸专业委员会常委和江苏省中西医结合学会呼吸专业委员会主任委员,中国哮喘联盟总负责人(之一)。
主持国家和部省级课题25项,获国家图书奖特别奖1项、国家科技进步二等奖1项、江苏省科技进步一等奖1项、二等奖1项、三等奖5项,江苏省中医药科技一等奖和三等奖各1项,发表了医学论文548篇,主编《哮喘病学》和《实用抗感染药物治疗学》等专著与《双语内科学》等全国统编教材26部。2003年获“江苏省五一劳动奖章”、“全国防治非典工作优秀共产党员”和“全国卫生系统抗击非典先进个人”,2006年获“首届中国呼吸医师奖”,2007年获“中国医师奖”,2009年获“江苏省突出医学成就奖”,2010年被评为“全国优秀科技工作者”,2011年获得“第二届全国中西医结合贡献奖”。

Catalogue

第一章 呼吸系统疾病

第二章 第一节 急性上呼吸道感染

第二节 急性气管-支气管炎

第三节 慢性支气管炎

第四节 慢性阻塞性肺疾病

第五节 慢性肺源性心脏病

第六节 支气管哮喘

第七节 咳嗽

第八节 肺炎

一、 社区获得性肺炎

二、 医院获得性肺炎

三、 免疫损害宿主肺炎

四、 按病原学分类的常见肺炎

第九节 肺脓肿

第十节 肺血栓栓塞症

第十一节 肺结核病

第十二节 支气管扩张症

第十三节 原发性支气管肺癌

第十四节 弥漫性间质性肺病

一、 特发性肺纤维化

二、 隐源性机化性肺炎

三、 结节病

四、 过敏性肺炎

五、 弥漫性泛细支气管炎

六、 肺泡蛋白沉积症

七、 肺朗格汉斯细胞组织细胞增多症

八、 矽肺

九、 药物性肺部疾病

第十五节 胸膜疾病

一、 胸腔积液

二、 自发性气胸

第十六节 睡眠呼吸暂停综合征

第十七节 呼吸衰竭

一、 急性肺损伤与急性呼吸窘迫综合征

二、 慢性呼吸衰竭

第三章 心血管系统疾病

第一节 心力衰竭

一、 慢性心力衰竭

二、 急性心力衰竭

第二节 心律失常

一、 窦性心律失常

二、 房性心律失常

三、 房室交界区心律失常

四、 室性心律失常

五、 心脏传导阻滞

第三节 心脏骤停和心源性猝死

第四节 动脉粥样硬化

第五节 冠状动脉粥样硬化性心脏病

一、 隐匿性冠状动脉粥样硬化性心脏病

二、 心绞痛

三、 心肌梗死

四、 缺血性心肌病

第六节 晕厥

第七节 高血压

一、 高血压病

二、 症状性高血压

第八节 心脏瓣膜病

一、 风湿热

二、 二尖瓣疾病

三、 主动脉疾病

四、 三尖瓣瓣疾病

五、 肺动脉瓣疾病

六、 多瓣膜病

第九节 先天性心脏病

一、 无分流的先天性心脏病

二、 有左至右的先天性心脏病

三、 有右至左分流的先天性心脏病

第十节 感染性心内膜炎

第十一节 心包炎

一、 急性心包炎

二、 缩窄性心包炎

第十二节 病毒性心肌炎

第十三节 心肌病

一、 扩张型心肌病

二、 肥厚型心肌病

Book Abstract

第一章 呼吸系统疾病
第一节 急性上呼吸道感染
急性上呼吸道感染(upper respiratory tract infection,简称上感)是鼻腔、咽或咽喉部急性炎症的概称。大多由病毒引起,少数为细菌所致,是最常见的一种传染性疾病,传染性强,有时可引起较重的并发症,如中耳炎、支气管炎、肺炎、心肌炎等。本病全年皆可发病,多数为散发,亦可流行。根据病因不同,其临床表现可多样。
【治疗方案】
(一)一般治疗
注意休息,发热、病情较重或年老体弱的患者应卧床休息。戒烟,多饮水,清淡饮食,保持室内空气流通,保持鼻、咽及口腔卫生。
(二)药物治疗
1.对症治疗
(1)解热镇痛:有头痛、发热、周身肌肉酸痛症状者,可酌情应用解热镇痛药如对乙酰氨基酚、阿司匹林、布洛芬等,如必要时予阿司匹林0.3口服。
(2)减充血:有鼻塞、鼻黏膜充血、水肿、咽痛等症状者,可应用盐酸伪麻黄碱等可选择性收缩上呼吸道黏膜血管的药物,也可用1%麻黄素滴鼻,如1%麻黄素每次1滴~2滴滴鼻,每日3次。
(3)抗过敏:有频繁喷嚏、多量流涕等症状的患者,可酌情选用马来酸氯苯那敏或苯海拉明等抗组胺药,如马来酸氯苯那敏4mg口服,每晚1次。为了减轻这类药物引起头晕、嗜睡等不良反应,宜在临睡前服用。
(4)镇咳:对于咳嗽症状较为明显者,可给予右美沙芬、咳必清等镇咳药,如咳必清25mg口服,每日3次。
(5)祛痰:伴咳痰者,给予氨溴索、溴乙新、乙酰半胱氨酸等药,如氨溴索30mg口服,每日3次。
2.抗病毒感染 吗啉胍对流感病毒、腺病毒和鼻病毒等有一定的疗效;广谱抗病毒药利巴韦林和奥司他韦对流感病毒、副流感病毒、呼吸道合胞病毒均有较强的抑制作用,主张早期使用,可缩短病程(普通感冒无需使用)。如利巴韦林含片50mg含服,每日4~6次。
3.抗细菌感染 如有细菌感染,可酌情选用适当的抗感染药物,如青霉素类、大环内酯类、氟喹诺酮类(环丙沙星、左氧氟沙星)等。如乙酰螺旋霉素0.2口服,每日3次。对于单纯病毒感染者不应用抗菌药物。
4.中医治疗 根据中医辨证施治的原则,应用中药治疗本病有一定疗效。正柴胡饮冲剂、小柴胡冲剂和板蓝根冲剂等在临床应用较为广泛。如正柴胡饮冲剂5g口服,每日3次。
……

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