曲马多对急性非创性原因不明腹痛诊断正确率的影响

Effect of tramaclol on the accuracy of diagnosis in and ifferentiatedcl acute abolominal pain

目的 观察曲马多对诊断不明的急性非创伤性腹痛诊断正确率的影响.方法 采用可视模拟标尺法（VAS）纳入160例中-重度疼痛、诊断不明的急性非创伤性腹痛患者,随机分为对照组和曲马多组.对照组肌肉注射654-2、阿托品等对症处理药物及原发疾病处理,曲马多组除了上述处理外,肌注曲马多100 mg.观察两组疼痛评分,主要阳性体征比率,临床重要诊断正确率.结果.治疗后30 min两组VAS分别为（7.0±1.3）分和（5.8±1.5）分,差异有统计学意义（P〈0.05）;2 h VAS分别为（5.6±2.5）分和（3.3±1.8）分,差异有统计学意义（P〈0.05）.治疗后30 min两组阳性体征比率分别为70%和66%,差异无统计学意义（P〉0.05）;两组诊断正确率分别为87.5%和85.1%,差异无统计学意义（P〉0.05）.结论.曲马多镇痛治疗可以减轻患者疼痛,但不影响急性非创伤性原因不明腹痛的诊断正确率.

Objective To analyze the effect of tramadol on the accuracy of diagnosis in undifferentiated acute abdominal pain without trauma. Methods Pain was measured with a standard 0- l0 visual analog scale（VAS）. 160 patients with moderate-severe acute abdominal pain without trauma were randomized into two groups, 80 patients in the control group and the tramadol group respectively. 100 mg tramadol was administered intramuscular for the management of pain in patients in the tramadol group. VAS, the ratio of pain sign and clinically important diagnostic accuracy were compared. Results VAS decreased to （5.8 ±1.5） score in 30 minutes after treatment in tramadol group while （7.0 ±1.3 ） score in control group（ P 〈 0.05 ）. The ratio of positive pain sign were 70% in control group and 66% in tramadol group（P 〉0.05）in 30 minutes. VAS were （5.6 ± 2.5） score and （ 3.3±1.8 ） score（ P 〈 0.05 ） in 2 h after treatment. The accuracy of clinically important diagnostic was 87.5 % in the control group and 85. 1% in the tramadol group （ P 〉 0.05 ）. Conclusion Administration of tramadol to patients with acute abdominal pain provides analgesia without impairing clinically important diagnostic accuracy.