Diagnosis and Treatment of Involuntary Weight Loss：a General Practice Perspective

doi:10.12114/j.issn.1007-9572.2021.00.439

Abstract

Abstract: Involuntary weight loss（IWL） is a common outpatient complaint in general practice. As IWL is an undifferentiated disease，the sufferers often seek treatment in multiple departments but could not obtain organized and standardized management，which wastes substantial healthcare resources，impairs patient health-seeking experience，and brings a lot of inconveniences to the patient's life. We reviewed the literature on IWL，discussed its diagnosis and treatment from a general practice perspective，hoping to help general practitioners with standardized diagnosis and treatment and continued management of IWL.

Key words: Emaciation, General practice, General practitioners, Diagnosis and treatment ideas

摘要： 消瘦是全科医学门诊一种常见的患者主诉。作为一种可能与多学科相关的未分化疾病，消瘦患者常徘徊于各个科室之间，并且不能得到有序规范的管理，一方面浪费了大量的医疗资源，另一方面也给患者诊疗体验及生活带来了诸多不便。本文通过对国内外相关文献的回顾，从全科医生的视角，对消瘦的诊疗思路进行论述，以期能帮助全科医生了解如何对消瘦患者进行规范的诊治和连续性管理。

关键词: 消瘦, 全科医学, 全科医生, 诊疗思路

MA Renjie,CHEN Yangyang,REN Jingjing, et al. Diagnosis and Treatment of Involuntary Weight Loss：a General Practice Perspective　[J]. Chinese General Practice, 2021, 24(23): 3009-3012. DOI: 10.12114/j.issn.1007-9572.2021.00.439.
马仁杰,陈央央,任菁菁等. 消瘦的全科诊疗思路[J]. 中国全科医学, 2021, 24(23): 3009-3012. DOI: 10.12114/j.issn.1007-9572.2021.00.439.

References

［1］ALIBHAI S M，GREENWOOD C，PAYETTE H. An approach to the management of unintentional weight loss in elderly people［J］. CMAJ，2005，172（6）：773-780. DOI：10.1503/cmaj.1031527.
［2］MARTON K I，SOX H C Jr，KRUPP J R. Involuntary weight loss：diagnostic and prognostic significance［J］. Ann Intern Med，1981，95（5）：568-574. DOI：10.7326/0003-4819-95-5-568.
［3］PAYETTE H，COULOMBE C，BOUTIER V，et al. Nutrition risk factors for institutionalization in a free-living functionally dependent elderly population［J］. J Clin Epidemiol，2000，53（6）：579-587. DOI：10.1016/s0895-4356（99）00186-9.
［4］刘娟娟，刘颖，任菁菁. 常见未分化疾病的全科处理探讨［J］. 中国全科医学，2015，18（32）：3985-3987. DOI：10.3969/j.issn.1007-9572.2015.32.021.
LIU J J，LIU Y，REN J J. Study of the treatment of common undifferentiated diseases in general practice［J］. Chinese General Practice，2015，18（32）：3985-3987. DOI：10.3969/j.issn.1007-9572.2015.32.021.
［5］刘凤奎，罗意帆，王国兴.消瘦的临床诊断思路［J］. 中国临床医生杂志，2017，45（12）：14-15. DOI：10.3969/j.issn.2095-8552.2017.12.004.
［6］BOSCH X，MONCLúS E，ESCODA O，et al. Unintentional weight loss：clinical characteristics and outcomes in a prospective cohort of 2677 patients［J］. PLoS One，2017，12（4）：e0175125. DOI：10.1371/journal.pone.0175125.
［7］STAJKOVIC S，AITKEN E M，HOLROYD-LEDUC J. Unintentional weight loss in older adults［J］. CMAJ，2011，183（4）：443-449. DOI：10.1503/cmaj.101471.
［8］GOH Y，DAN Y Y，CHUA W，et al. Diagnostic utility of whole body CT scanning in patients with unexplained weight loss［J］. PLoS One，2018，13（7）：e0200686. DOI：10.1371/journal.pone.0200686.
［9］MCMINN J，STEEL C，BOWMAN A. Investigation and management of unintentional weight loss in older adults［J］. BMJ，2011，342：d1732. DOI：10.1136/bmj.d1732.
［10］HERNáNDEZ J L，RIANCHO J A，MATORRAS P，et al. Clinical evaluation for cancer in patients with involuntary weight loss without specific symptoms［J］. Am J Med，2003，114（8）：631-637. DOI：10.1016/s0002-9343（03）00115-3.
［11］METALIDIS C，KNOCKAERT D C，BOBBAERS H，et al. Involuntary weight loss. Does a negative baseline evaluation provide adequate reassurance?［J］. Eur J Intern Med，2008，19（5）：345-349. DOI：10.1016/j.ejim.2007.09.019.
［12］DEHESTANI B，LE ROUX C W. The role of the small bowel in unintentional weight loss after treatment of upper gastrointestinal cancers［J］. J Clin Med，2019，8（7）：E942. DOI：10.3390/jcm8070942.

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