内科急腹症88例诊断分析

Diagnostic analysis of internal medicine acute abdomen in 88 cases

目的:分析内科急腹症流行病学特点,探讨延迟诊断、误诊、漏诊主要原因,总结诊断经验。方法:回顾性分析延迟诊断内科急腹症患者临床资料,描述性分析延迟诊断原因。结果:常见疾病为急性胃炎、急性肠炎、消化性溃疡、胃肠感染,延迟诊断主要原因为临床表现不典型、无明显诱因、无病史,经影像学检查、内镜、疗效验证及后期典型表现确诊。同一时间段内科急腹症收治患者4 322例,延迟诊断老年患者比重55.68%高于内科急腹症合计比重8.31%,差异具有统计学意义(P<0.05)。结论:疼痛部位、发作时间分布、疼痛水平不典型、病史不明是致内科急腹症延迟诊断主要原因;老年人易致延迟诊断;内科急腹症延迟诊断患者病情相对较轻,急、慢性界限不清,诊断难度较大,但预后相对较好。

Objective:To analyze the epidemiological characteristics of internal medicine acute abdomen,to explore the main reasons of delayed diagnosis,misdiagnose and missed diagnosis,to summarize the diagnostic experience.Methods:The clinical data of internal medicine acute abdome patients with delayed diagnosis were retrospectively analyzed.The delayed diagnosis reasons were descriptively analyzed.Results:Common diseases: acute gastritis,acute enteritis,peptic ulcer,gastrointestinal infection,the main reasons of the delayed diagnosis were not typical clinical manifestations,without apparent cause,without history,they were verified by imaging examination,endoscopy,efficacy,and confirmed by late typical performance.4 322 cases of internal medicine acute abdomen patients were selected at the same time;the proportion 55.68% of elderly patients with delayed diagnosis was higher than the proportion 8.31% of internal medicine acute abdomen;the difference was statistically significant(P<0.05). Conclusion:The pain position,onset time distribution,not typical pain level and unknown medical history are the major causes of delayed diagnosis of internal medicine acute abdomen.The elderly may cause delayed diagnosis.The internal medicine acute abdomen patients with delayed diagnosis is relatively light,acute and chronic boundary is not clear, the diagnosis is difficult,but the prognosis is good.