急诊内科急性腹痛的临床研究

Clinical Study of Acute Abdominal Pain in Emergency Medicine

目的探讨分析医院急诊内科急性腹痛的临床效果。方法简单随机选择2018年1月—2019年12月该院收治的100例急性腹痛的患者作为研究对象,对患者进行腹部X线检查、B超、CT检查等。腹部X线检查:在检查时需要人员帮助患者取仰卧位,具体检查部位为耻骨联合下缘、耻骨结节、第5腰椎下缘,起扫描顺序是上界至前向后,下界至前向后。腹部CT检查:在实施扫描前患者需要取仰卧位,扫描类型为平扫和增强,扫描前需要将管电压设置为120 kV,宽度调整为1 mm×16 mm。在对患者进行增强扫描前,需要在患者经肘前静脉注射海碘醇,其注射的剂量按照患者的实际情况进行注射,一般在80~100 mL,层厚控制在7 mm左右。B超检查:检测时患者需要取仰卧位、侧卧位,将探头频率控制在3.5 MHz。如果患者为外伤所致的腹部疼痛,就需要对全腹部扫描。如果患者疾病所致的腹部疼痛,就要根据患者疼痛部位进行扫描。结果急诊内科100例急性腹痛患者中,急性肠胃炎患者25例,占比25%;急性胰腺炎患者28例,占比28%;急性阑尾炎患者26例,占比26%;泌尿系统疾病15例,占比15%;肠梗阻患者6例,占比6%。急性腹痛患者发病的主要原因:冰冷食物40例,占比40%;油腻食物35例,占比35%;饮酒过量20例,占比20%;急性腹痛史5例,占比5%。结论急诊内科对急性腹痛患者进行检查,寻找病因,明确治疗方案,进行有针对性的治疗是非常重要的,有利于提升急性腹痛的治疗效果。

Objective To discuss and analyze the clinical effect of acute abdominal pain in the emergency department of hospital.Methods 100 patients with acute abdominal pain admitted to the hospital from January 2018 to December 2019 were simply randomly selected as the research objects,and abdominal X-ray examination,B-ultrasound,CT examination,etc.were performed on the patients.Abdominal X-ray examination:during the examination,personnel were required to help the patient take the supine position.The specific examination sites were the lower edge of the pubic symphysis,the pubic tubercle,and the lower edge of the fifth lumbar vertebra.The scanning sequence was from upper boundary to front to back,and lower boundary to front to back.For abdominal CT examination:the patient needs to take the supine position before performing the scan.The scan type was plain scan and enhanced.Before the scan,the tube voltage needs to be set to 120 kV,and the width was adjusted to 1 mm×16 mm.Before performing an enhanced scan on the patient,the patient needs to be injected intravenously in front of the elbow of Riiodol.The injection dose was in accordance with the actual situation of the patient,generally 80-100 mL,and the layer thickness was controlled at about 7 mm.For B-ultrasound examination:the patient needs to take the supine position and the lateral position during the test,and control the probe frequency to 3.5 MHz.If the patient suffers from abdominal pain caused by trauma,a full abdominal scan was required.If the patient has abdominal pain caused by disease,scan according to the painful part of the patient.Results Among the 100 patients with acute abdominal pain in the emergency medical department,25 were patients with acute gastroenteritis,accounting for 25%;28 patients with acute pancreatitis,accounting for 28%;26 patients with acute appendicitis,accounting for 26%;urinary system diseases 15 cases,accounting for 15%;6 cases of intestinal obstruction,accounting for 6%.The main reasons for patients with acute abdominal pain:40 cases of cold food,accounting for 40%;35 cases of greasy food,accounting for 35%;20 cases of excessive drinking,accounting for 20%;5 cases of history of acute abdominal pain,accounting for 5%.Conclusion It is very important for the emergency medical department to examine patients with acute abdominal pain,find the cause,clarify the treatment plan,and carry out targeted treatment,which is beneficial to improve the treatment effect of acute abdominal pain.