沈阳市某三级甲等医院MUS现状的初步调查分析.pdf

目 录 一、摘要 中文论著摘要····················································1 英文论著摘要····················································3 二、英文缩略语·····················································5 三、论文 前言····························································6日U舌。。。‘。。。‘‘。‘。。。。‘。。。。‘。‘。。。。。。。。。。。‘。。‘。‘。‘。。。。。。。。。‘‘。。‘。。‘‘b 研究对象与研究方法··············································7 研究结果与讨论··················································9 结论···························································15 四、本研究创新性的自我评价·········································16 五、参考文献·······················································17 六、附录 附件一·························································19 附件二·························································20 综述···························································26 致谢···························································46 个人简介·······················································47 ·中文论著摘要· 沈阳市某三级甲等医院MUS现状的初步调查与分析 刖 罱 医学无法解释的症状(Medically UnexplainedSymptoms，MUS)，是指在临床 中普遍存在，严重困扰患者、给他们的生活和社会功能造成损害、却又不能用任 何器质性疾病做出解释的非特异性的躯体症状，它属于生物、心理、社会因素交 互作用的健康问题范畴。MUS通常需要由全科医生或其他初级卫生保健提供者进 行综合性管理，但患者却否认自己的躯体症状与心理社会因素有关，只是一味地 担心自己患有严重躯体疾病而反复到大医院专科门诊就诊。他们接受了大量不必 要且昂贵的检查和治疗，非但没能缓解症状和消除疑虑，反而造成医疗费用增加 和医疗资源浪费，同时他们也占用了专科医生的时间，不同程度地增加了其工作 压力。由于专科医生和MUS患者对治疗结果的期望值差异较大，因此医患双方对 诊疗结果均不满意，以至医患关系紧张，医患矛盾增多，甚至对医疗体系产生不 满。 目 的 研究市级三级甲等医院MUS的流行现状、主要症状谱、并存临床症状，为今 后深入研究MUS提供依据。 方 法 选定沈阳市某三级甲等医院一个月内相关科室门诊患者作为研究对象；组织 相关领域专家，制定适合我国文化背景的MUS诊断专家共识，并依此编制患者信 息采集表；采用门诊医生直接询问患者并填写问卷的调查方式，收集相关数据； 1 运用统计分析软件SPSS3．O对数据进行统计分析。 结 果 1、沈阳市某所三级甲等医院呼吸内科、消化内科、心血管内科、神经内科四 个科室门诊一个月内所有以头痛、头晕、呼吸困难、麻木、胸痛、心悸、腹痛、 腹泻、疲劳乏力、关节痛、腰痛这11种症状为主诉的就诊患者MUS的构成比为 25．00％。