中国全科医学 ›› 2022, Vol. 25 ›› Issue (36): 4577-4581.DOI: 10.12114/j.issn.1007-9572.2022.0298

• 诊疗分析 • 上一篇    下一篇

腹痛病因清单在血管性疾病鉴别诊断中的应用——附三例病例分析

王翠娅1,2, 张军娜2, 臧会铃2, 吕畅2, 郭慧2, 马志超2, 李建国2,*()   

  1. 1.050050 河北省石家庄市,河北医科大学研究生院
    2.050051 河北省石家庄市,河北医科大学附属河北省人民医院急诊科
  • 收稿日期:2022-03-05 修回日期:2022-05-15 出版日期:2022-12-20 发布日期:2022-07-21
  • 通讯作者: 李建国
  • 王翠娅,张军娜,臧会铃,等.腹痛病因清单在血管性疾病鉴别诊断中的应用——附三例病例分析[J].中国全科医学,2022,25(36):4577-4581.[www.chinagp.net]
    作者贡献:王翠娅撰写论文;张军娜、臧会铃查阅文献;吕畅、马志超进行病例的筛选、整理;郭慧进行论文最终版本修订;李建国提出研究思路,是腹痛病因清单的倡导者并对文章负责。

The Checklist of Abdominal Pain Causes Used in the Differential Diagnosis of Vascular Diseases with Abdominal Pain as a Presentation: an Analysis of Three Cases

WANG Cuiya1,2, ZHANG Junna2, ZANG Huiling2, LYU Chang2, GUO Hui2, MA Zhichao2, LI Jianguo2,*()   

  1. 1.Graduate School, Hebei Medical University, Shijiazhuang 050050, China
    2.Department of Emergency, Hebei General Hospital Affiliated to Hebei Medical University, Shijiazhuang 050051, China
  • Received:2022-03-05 Revised:2022-05-15 Published:2022-12-20 Online:2022-07-21
  • Contact: LI Jianguo
  • About author:
    WANG C Y, ZHANG J N, ZANG H L, et al. The checklist of abdominal pain causes used in the differential diagnosis of vascular diseases with abdominal pain as a presentation: an analysis of three cases [J] . Chinese General Practice, 2022, 25 (36) : 4577-4581.

摘要: 背景 急性腹痛是急诊科最常见的主诉之一,血管性疾病引起的急性腹痛临床表现不典型,临床误诊率高。 目的 探讨腹痛病因清单在血管性疾病鉴别诊断中的临床应用。 方法 按照腹痛病因清单确定的局部器官疾病、邻近器官疾病、全身性疾病、功能性疾病、妇科疾病5个鉴别诊断方向,对3例以急性腹痛为主要表现的病例进行分析,筛查腹痛病因,总结腹痛病因清单在血管性疾病诊断中的实用性。 结果 3例以不典型腹痛就诊的病例,按照腹痛病因清单筛查,分别用时1.5、1.5、1.75 h确诊为肾动脉梗死、主动脉夹层、肺动脉栓塞,患者得到了及时诊断和治疗。 结论 腹痛病因清单有助于引导血管性腹痛的鉴别诊断方向,帮助医师做出快速临床诊断,并形成系统化的思维模式。

关键词: 急腹症, 腹痛, 清单, 诊断,鉴别, 血管疾病, 肾动脉梗阻, 肺栓塞

Abstract:

Background

Acute abdominal pain is one of the most common chief complaints in medical emergencies. Due to atypical clinical manifestations, the misdiagnosis rate of acute abdominal pain caused by vascular diseases is high.

Objective

To assess the value of the checklist of abdominal pain causes in the differential diagnosis of vascular diseases with abdominal pain as a presentation.

Methods

In accordance with the five diseases (localized organic disease, heart, lung and spine diseases, systemic disease, functional disorders, gynecological disease) with abdominal pain as a manifestation in the checklist of abdominal pain causes, we analyzed the causes of abdominal pain in three patients with acute atypical abdominal pain as the main manifestation for making a proper diagnosis, then assessed the practicability of the checklist in the diagnosis of vascular diseases.

Results

With the help of the checklist, the time used for diagnosing one patient with acute renal infarction, one with aortic dissection, and the other with pulmonary embolism was 1.5, 1.5, 1.75 hours, respectively. All the patients received timely diagnosis and treatment.

Conclusion

The checklist is helpful to the differential diagnosis of vascular abdominal pain, making a rapid clinical diagnosis, and forming a systematic diagnostic thinking mode.

Key words: Abdomen, acute, Abdominal pain, Checklist, Diagnosis, differential, Vascular diseases, Renal artery obstruction, Pulmonary embolism