急性腹痛症鉴别诊断方法探讨

Differential diagnosis methods of acute abdominal pain

目的 探讨急性腹痛症的临床鉴别和诊断方法技巧,提高急性腹痛症的分诊及诊断准确率和患者满意度.方法 通过对门诊及急诊科医生及护理人员进行6个月的急性腹痛症鉴别诊断及分诊培训,比较培训前2010年3月～2011年3月160例急性腹痛症患者（对照组）和培训后2011年9月～2012年9月160例急性腹痛患者（观察组）的鉴别诊断及分诊的准确率、平均就诊时间及患者满意度.结果 观察组160例患者均获得治疗,无严重并发症及死亡病例,鉴别诊断及分诊准确率为96.9％,与对照组（89.4％）比较差异有统计学意义（P＜0.05）.平均分诊时间（8.3±1.6）min,短于对照组（12.5±4.3）min,患者满意度为98.3％,高于对照组的90.1％.结论 急性腹痛症病情复杂,通过合理的鉴别诊断及分诊技巧,可以避免漏诊误诊引起贻误病情.

Objective To investigate the clinical syndrome of acute abdominal pain and diagnostic methods to identify skills, improve triage of acute abdominal disease and diagnostic accuracy and patient satisfaction. Methods The outpa- tient and emergency department doctors and nurses were treated for six months of the differential diagnosis of acute ab- dominal pain and triage training, from March 2010 to March 2011 before training 160 cases of acute abdominal pain （control group） and from September 2011 to 2012 September after training 160 cases of acute abdominal pain in pa- tients（observation group）, the differential diagnosis and triage accuracy rate, the average treatment time and patient sat- isfaction were compared. Results The 160 patients in observation group were received treatment, had no serious com- plications and deaths, differential diagnosis and triage accuracy was 96.9%, compared with the control group （89.4%） there was a significant the rate of difference （P 〈0.05）. Average triage time in obsenvation gronp were （8.3＋_1.6） rain shorter than control group（12.5_＋4.3） rain, patient satisfaction was 98.3%, higher than control group（90.1%）. Conclusion Acute abdominal pain syndrome disease complex, through reasonable differential diagnosis and triage skills to avoid misdiagnosis caused adversely affected by illness.