协和医学杂志

2013, (03)

[打印本页] [关闭]
本期目录(Current Issue) | 过刊浏览(Past Issue) | 高级检索(Advanced Search)

分诊与急性阑尾炎预后的关系
The relationship of triage with the outcome of acute apppenditis.

高健;高倩;黄静雅;李凡;李毅;史冬雷;徐胜勇

摘要(Abstract):

目的:探索阑尾炎患者的分诊模式。方法:分析98例阑尾炎患者的分诊情况及其相对应的手术情况、术前检查情况、病理等情况。结果:急性阑尾炎患者首诊于外科者占70.41%,不同就诊科室患者起病时间不同,差异有统计学意义(P=0.0001)。全部患者均有腹痛,41%有典型的转移性右下腹痛,33%有发热,15%有恶心呕吐,13%有腹泻;84%白细胞升高;全部患者均有右下腹压痛,41%有反跳痛。术前准备时间以外科最长,但统计学差异不显著(P=0.7233)。并发腹膜炎者28例,无腹膜炎者70例,两组患者的白细胞值没有差异(P=0.6482)。首诊科室的不同,并不会导致患者并发腹膜炎例数的不同。结论:腹痛患者分诊时,应注意将急性起病者,尤其是起病12小时以内者,分入外科就诊。对腹痛伴有右下腹压痛者,可以使用改良的阑尾炎指数。对于评分高的患者,尤其是9分以上者,应该尽快联系外科行手术治疗,从而避免导致穿孔、腹膜炎等并发症。阑尾炎患者的预后与术前时间、首诊科室及白细胞数目的关系仍有待更大样本的研究。
Objective: To investigate a suitable triage mode for aucte appenditis.. Method: analyze 98 appenditis patients, triage and their related operation information, exam result before operation and pathology. Result: 70.41% aute abdominal pain patients were triaged to the surgeon admission room. Pain onset is different among the admission rooms, and there is statistic difference among them(P=0.0001).All patients have abdominal pain, 41% have migaration right low abdominal pain,33% have fever, 15% have nausea and vomiting, 13% have diarrhea. 84% have white cell elevated. All patients have right low abdominal tenderness, 41% have reboundness pain. Patients admitted to the surgeon experience the longest pre-operation time, but there is no statistic difference(P=0.6482).the difference of the admission room can not induce difference of the peritoneal case number. Conclusion: patients with acute onset of abdominal pain, especially those within 12 hours, are suggested to triaged to the surgeon room. If the patients have right lower abdominal tenderness, modified appenditis index is helpful for the triage.If high sore, especially higher than 9, surgeon should be consulted and operation may need to avoid peritoneal complications. The outcome relationship with pre-operation time, admission room and white cell count need more sample trials.

关键词(KeyWords): |腹痛|阑尾炎|分诊|
|abdominal pain| appendititis| triage|

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 高健;高倩;黄静雅;李凡;李毅;史冬雷;徐胜勇

Email:

DOI:

参考文献(References):

扩展功能
本文信息
服务与反馈
本文关键词相关文章
本文作者相关文章
中国知网
分享