疫情反反復(fù)復(fù)，都已經(jīng)五一了，還形勢(shì)嚴(yán)峻。越是艱難的時(shí)候，越要相信人類可以戰(zhàn)勝疫情！好了，直接上干貨吧！

導(dǎo)語：摘要是對(duì)整篇文章的一個(gè)簡(jiǎn)短概述，通常也是審稿人對(duì)文章的第一印象。麻雀雖小五臟俱全，一個(gè)完整的case report摘要需包括：文章的背景及目的；病例對(duì)象的基本情況（年齡、性別、國(guó)籍等），診療過程及結(jié)果；對(duì)此罕見病例或新方法的評(píng)論；文章的臨床意義等。

一般雜志對(duì)摘要的字?jǐn)?shù)都會(huì)有要求，通常在250或300字以內(nèi)。想要在限定的字?jǐn)?shù)里將文章內(nèi)容及意義完美的體現(xiàn)出來并非難事，關(guān)鍵就是要抓住“重點(diǎn)”和“簡(jiǎn)潔”這兩個(gè)詞。

現(xiàn)在很多雜志都要求寫結(jié)構(gòu)式摘要，其優(yōu)點(diǎn)就是信息量大，能較全面地展示文章的主要內(nèi)容；結(jié)構(gòu)層次清楚并有其特定格式；便于同行專家評(píng)審和讀者獲取信息。這種結(jié)構(gòu)式摘要所包含的引導(dǎo)語也不盡相同，通?！癐ntroduction”或“Background”，“Presentationof case”或者“Casereport”,“Discussion”和“Conclusion”。

例1：出自Sjogren PP, Banerji N, Batts KP, Graczyk MJ, Dunn DH (2013) Rare presentation of a gastrointestinal stromal tumor with spontaneous esophageal perforation: A case report. International journal of surgery case reports 4 (7): 636-639.

Introduction:?Gastrointestinal stromal tumors (GISTs) of the alimentary canal are malignant tumors with?< 1% of cases diagnosed in esophagus?(指出胃腸道間質(zhì)瘤在食管中的診斷率很低). These cases?require special consideration?given their close proximity to vital structures and propensity to be?highly?aggressive (由于食管與許多器官極為貼近，因而易侵襲). Management of patients with GISTs has been transformed since the introduction of tyrosine kinase inhibitors (指出目前GISTs的治療正關(guān)注于酪氨酸激酶抑制劑).?In this report, we present an unusual case of GIST with spontaneous esophageal perforation (本研究的所介紹的疾病即不常見的GISTs并發(fā)的自發(fā)性食管穿孔).

???解析：本段主要介紹胃腸道間質(zhì)瘤背景知識(shí)及本文的研究?jī)?nèi)容，指出其診斷不易，易侵襲等特點(diǎn)，引出本文病例的特殊性，即胃腸道間質(zhì)瘤伴隨著自發(fā)性食管穿孔。背景不需要太長(zhǎng)，重點(diǎn)體現(xiàn)病例的罕見性及本研究的必要性即可。

Presentation of case:?A 39-year-old (年齡) Caucasian (國(guó)籍) male (性別) presented to our hospital?with complaints of severe chest and abdominal pain?(主訴，即嚴(yán)重的胸腹部疼痛). A diagnostic?chest radiograph?(首先胸片診斷) revealed a moderate right-sided pleural effusion (有中度的右側(cè)胸腔積液). Subsequently, an?esophagram (食管X線片)?demonstrated a perforation proximal to an elongated stricture in the distal esophagus (食管遠(yuǎn)端有穿孔). A?left thoracotomy (左側(cè)胸廓切開術(shù))?was performed whereby a large mediastinal mass firmly attached to the esophagus and gastroesophageal junction was encountered (發(fā)現(xiàn)在食道和胃食管連接處有很多縱膈腫瘤). The neoplasm involved proximal one-third of the stomach and perforated into the right hemithorax (介紹腫瘤的具體部位).?Histopathological?(組織病理學(xué)檢測(cè)) evaluation of the tumor led to a diagnosis of GIST (做出最終的診斷，即GIST).

????解析：病例介紹的第一句，需指出病例對(duì)象的基本情況，即年齡、性別、種族、主訴。若有必要，還需簡(jiǎn)單描述病人的既往病史。然后介紹疾病的診療過程，首先是胸片，食管X線片檢查，隨后通過胸廓切開術(shù)更直觀了解病情，最終通過組織病理學(xué)檢查確診疾病。本段介紹其實(shí)與普通論文的方法部分類似，指出關(guān)鍵的診斷過程即可。

Discussion:?GISTs of the gastroesophageal junction are uncommon and may rarely present with esophageal perforation (第一句首先就是要強(qiáng)調(diào)病例的罕見性). The standard of care for treating GIST at present includes tyrosine kinase inhibitors (指出治療此疾病需關(guān)注酪氨酸激酶抑制劑). This pharmacologic agent, along with improved surgical techniques and understanding of molecular markers for accurate diagnosis, will assuredly continue to improve overall survival of patients with GISTs (對(duì)藥理學(xué)試劑未來的期望).

????解析：討論本研究所用治療方法及可能的治療效果，簡(jiǎn)單說明即可。摘要中呈現(xiàn)討論部分是病例報(bào)告的一個(gè)特殊之處，但這部分并不是必須的，需看具體的雜志要求而定。

Conclusion:?When?stricture or achalasia?is detected on imaging,?GIST?should be?considered?in the differential diagnosis for individual patients (指出若出現(xiàn)食道狹窄或松弛，應(yīng)考慮是否為GIST). Additionally, chest and abdomen CT scans of may be performed to confirm presence of a tumor mass, thereby ruling out achalasia (胸腹部CT的必要性).

????解析：總結(jié)此病例得出的經(jīng)驗(yàn)及結(jié)論，提示在出現(xiàn)某些癥狀時(shí)需考慮是否為GIST，并作進(jìn)一步診斷，表明本研究對(duì)臨床醫(yī)生的指導(dǎo)意義。

這是比較完整的結(jié)構(gòu)式摘要，所有必要的內(nèi)容都有介紹，但不羅嗦，可以作為寫作的參考。

看完這么多期的case report的寫作技巧，是不是自己已經(jīng)完全掌握了它的寫作要領(lǐng)了？那么建議你通過一個(gè)完整的課程學(xué)習(xí)鞏固下，可能就把之前的零散知識(shí)給串聯(lián)起來了，歡迎大家訂閱我們的在線指導(dǎo)！