急诊内科急性腹痛常见病因构成及诊治体会

Common etiology and diagnosis and treatment of acute abdominal pain in emergency department

目的探讨内科急腹痛的病因及诊治体会。方法选择2016年1月—2019年12月我院急诊内科诊治的51例急性腹痛作为观察对象,通过询问病史、体检、辅助检查,必要时实施有创检查进行病因诊断,并依据检查结果实施相应的治疗措施。结果51例患者中因腹腔器官急性炎症致急性腹痛者22例,占43.14%(22/51);空腔脏器阻塞或扩张16例,占31.37%(16/51);因腹腔外疾病牵涉性急性腹痛者9例,占17.65%(9/51);全身性疾病引起腹痛2例,占3.92%(2/51);2例误诊(3.92%)。实施相应诊疗后50例(98.04%)腹痛基本消失,1例(1.96%)胰腺炎住院后死亡。结论腹痛发生多与腹腔内器官疾病相关,原因较为复杂,且会对患者造成较大的影响。临床须对患者其进行主诉、体征、辅助检查等综合评估,以便于诊疗工作的开展。

Objective Discuss experience of pathogenesis,clinical diagnosis.,and treatment in patients with acute abdominal pain.Methods From January 2016 to December 2019,51 cases of acute abdominal pain diagnosed and treated in the Department of emergency medicine of Nantong maternal and child health care hospital in Jiangsu Province were selected as the objects of observation.Medical history and abdominal pain were inquired,physical examination and related examination were carried out.If necessary,invasive operation examination was also carried out for etiological diagnosis,and corresponding treatment measures were implemented according to the results of clinical examination.Results Among the 51 patients,22(43.14%)suffered from acute abdominal pain caused by acute inflammation of abdominal organs.16 cases(31.37%)suffered from acute abdominal pain due to the obstruction or expansion of empty organs.9 cases(17.65%)were involved in acute abdominal pain due to extraperitoneal diseases.systemic diseases 2 cases(3.92%),Misdiagnosis 2 cases(3.92%).After the corresponding diagnosis and treatment,50 cases(98.04%)abdominal pain basically disappeared,and 1 case(1.96%)of pancreatitis died after hospitalization.Conclusion The incidence of abdominal pain is more related to internal organs diseases such as abdominal internal medicine,and the causes are more complex,which will have a greater impact on patients.It is necessary to evaluate the main complaint,physical signs,auxiliary examination and other comprehensive factors to facilitate the development of diagnosis and treatment.