基层医院急诊外科成人非外伤性腹痛220例剖析.docVIP

基层医院急诊外科成人非外伤性腹痛220例剖析 　　摘要： 目的 探讨基层医院急诊外科成人急性非外伤性腹痛构成特点及诊治思维。方法 回顾性分析我院2013年10月1日～2015年2月1日急诊外科接诊的220例成人急性非外伤性腹痛患者的临床资料。结果：我院急诊外科腹痛种类按科别分为外科腹痛162例（73.6%），内科腹痛30例（13.6%），妇科腹痛15例（6.8%）及其他类型腹痛13例（6.0%）。按病因发病率较高的前四位腹痛分别为急性阑尾炎、泌尿系结石、胆道疾病及急性胃肠炎，分别为62例、49例、35例、18例，占总例数的74.5%。疾病早期误诊2例，误诊率为0.9%。全组死亡0例，常用辅助检查包括：血常规及血型检查、尿常规检查、便常规检查、生化检查、凝血机能检查、腹部超声检查、X线检查，心电图检查、腹部CT检查。结论 基层外科医生要具备严谨的诊治思维及扎实的诊治技术，善于改变传统腹痛诊断思维方式为循证思维思考，早期及时对急性腹痛患者做出疾病严重程度的预判断，给予合理诊疗，避免耽误病情。 　　关键词：基层医院；急性非外伤性；腹痛；诊断思维；治疗 　　Abstract：Objective To explore the characteristics and diagnosis thinking of treating patients of acute non traumatic abdominal pain in emergency surgery department of primary hospital. Methods Retrospectively analyze the clinical data of 220 cases of acute non traumatic abdominal pain diagnosed in our hospital from October 1， 2013 to February 1， 2015 in emergency surgery department. Results The patients according subject were divided into 162 cases （73.6%） of surgical abdominal pain， 30 cases （13.6%） of internal medicine abdominal pain， 15 cases （6.8%） of gynecologic abdominal pain and 13 cases （6%） of other types of abdominal pain . According to the cause of disease， the front four high incidence rate of abdominal pain was acute appendicitis， urinary calculus， biliary diseases and acute gastroenteritis， respectively 62 cases， 49 cases， 35 cases， 18 cases， accounting for 74.5% of the total numbers. 2 cases were misdiagnosed， misdiagnosis rate was 0.9%. There were 0 deaths. The common auxiliary examination included blood examination， routine urine examination， stool routine examination， biochemical examination and blood coagulation function examination， abdominal ultrasound， X-ray examination， electrocardiogram， abdominal CT examination. Conclusion Primary surgeon must have rigorous thought in diagnosis of diseases and solid treatment technology， be good at changing the traditional thinking way of pain for evidence-based thinking， make the serious patients with acute abdominal pain prejudge