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流动患者

The Traveling Patient

作者信息

Shulman Jonas A., Morrison Allan

PMID:21250180
Abstract

Developments of the post–World War II era including the advent of diverse modes of rapid transportation, enhanced complexity of relations between nations, and significant population mobility have contributed to greatly increased international travel. With this phenomenon, the role of the clinician has come to include the practice of emporiatrics (from the Greek , "one who goes on shipboard as a passenger" and , "medicine"). Because travelers are at risk for acquiring certain illnesses, the modern physician's responsibilities now encompass pretravel assessment of baseline medical health risk (preferably 1 to 2 months before planned departure), recommendations for the prevention of diseases that may be endemic or epidemic in the area to be visited, and therapy for symptoms that develop during travel. Posttravel follow-up is also indicated to diagnose and treat clinically evident or occult infection. Continuity of health care delivery is the cornerstone to effective management of the traveling patient. Particularly important components of the history in a patient requesting travel health counseling include the exact travel itinerary and duration of stay in each country. Previous illnesses, allergies, medications, pregnancy, and detailed vaccination history must be carefully documented.

摘要

第二次世界大战后的发展,包括多种快速交通方式的出现、国家间关系日益复杂以及人口的大量流动,都极大地促进了国际旅行。随着这一现象的出现,临床医生的职责范围已扩展至旅行医学(源自希腊语,“乘船旅行的乘客”和“医学”)。由于旅行者有感染某些疾病的风险,现代医生的职责现在包括旅行前对基线医疗健康风险的评估(最好在计划出发前1至2个月)、针对可能在所前往地区流行或爆发的疾病的预防建议,以及对旅行期间出现的症状的治疗。旅行后随访也有助于诊断和治疗临床明显或隐匿的感染。提供持续的医疗服务是有效管理旅行患者的基石。在寻求旅行健康咨询的患者中,病史的特别重要组成部分包括确切的旅行行程以及在每个国家的停留时间。必须仔细记录既往疾病、过敏史、用药情况、妊娠情况以及详细的疫苗接种史。