急诊科使用高乌甲素对急腹症诊断正确率的影响

Effect of Emergency Department Use of Lappaconitine on the Accuracy of Diagnosis in Acute Abdomen

目的：观察高乌甲素对诊断不明的急腹症患者诊断正确率的影响。方法：采用视觉模拟评分法（VAS）纳入180例中~重度疼痛、诊断不明的急腹症患者,随机分为对照组和高乌甲素组,每组90例。对照组肌注阿托品等对症处理和原发病处理,高乌甲素组除了上述处理外,肌注高乌甲素8 mg,观察两组疼痛评分、主要阳性体征比率和临床诊断正确率。结果：治疗后30 min,对照组VAS为（7.0±1.2）分,高乌甲素组为（5.7±1.4）分,两组比较差异有统计学意义（P〈0.05）;治疗后2 h,对照组VAS为（5.4±2.3）分,高乌甲素组为（3.2±1.6）分,两组比较差异有统计学意义（P〈0.05）。治疗后30 min两组阳性体征比率分别为69%和64%,两组比较差异无统计学意义（P〉0.05）;治疗后2 h两组阳性体征比率分别为67%和62%,两组比较差异无统计学意义（P〉0.05）。两组诊断正确率分别为86.7%和84.4%,比较差异无统计学意义（P〉0.05）。结论：高乌甲素镇痛治疗可以减轻患者疼痛,但不影响急腹症的诊断正确率。

Objective：To analyze the effect of lappaconitine on the accuracy of diagnosis in unexplained acute abdomen.Method：Pain was measured with a standard visual analog scale（VAS）.180 patients with moderate-severe diagnosis in unexplained acute abdomen were randomized into two groups,the control group and the lappaconitine group respectively,each of 90 patients.8 mg lappaconitine was administered intramuscular for the management of pain in patients in the lappaconitine group.VAS,the ratio of pain sign and clinically diagnostic accuracy were compared.Result：After 30 minutes treatment,VAS were（5.7±1.4）scores in lappaconitine group,while（7.0±1.2）scores in control group, the difference was statistically significant（P〈0.05）;the ratio of positive pain sign was 69% in control group and 64% in lappaconitine group,the difference was no statistically significant（P〉0.05）.After 2 h treatment,VAS were（5.4±2.3） scores in control group and（3.2±1.6） scores in lappaconitine group,the difference was statistically significant（P〈0.05）; the accuracy of clinically important diagnostic was 86.7% in the control group and 84.4% in the lappaconitine group, the difference was no statistically significant（P〈0.05）.Conclusion：Administration of lappaconitine to patients with acute abdominal pain provides analgesia without impairing clinically important diagnostic accuracy.