![急诊临床路径](https://wfqqreader-1252317822.image.myqcloud.com/cover/11/36535011/b_36535011.jpg)
上QQ阅读APP看书,第一时间看更新
5. 急性呕吐
概 述
呕吐原意是指恶心而吐出胃内容物。其定义是指胃内容物或部分肠内容物,通过食管逆流出口腔的一种复杂的动作,常伴有强力的腹肌收缩。呕吐按发展过程将其分为两个阶段:呕吐前期和呕吐期。呕吐前期又称前驱期,以恶心感为主要特征,主要表现为从咽部到胃部先感到一阵特有的不适感,常伴有交感神经兴奋。如进一步发展则进入呕吐期,吐出胃内容物。呕吐过程是靠众多平滑肌和躯体肌肉相互协调、持续收缩完成的。以下是急性呕吐诊治的临床路径。
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/P31_551_1161_1682_2454_4782.jpg?sign=1739290142-fGXv56c0GcEPKY71drNLaQVj5xmrz7Ye-0-c4e8e38e2c6f1911e4057cc669f09b90)
注意:如果患者在医院内发生急性呕吐,病因通常为肠梗阻或者药物
表5.1 恶心和呕吐的药物治疗
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.1_59947.jpg?sign=1739290142-NsXHSIO5itE3AMmNkGoerdY62WoeklqS-0-bcdd04daf0938dea0671402b8cd6acb7)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.1_1_59948.jpg?sign=1739290142-vJIyY9qjvxQJMUFZuW8jj6VEYMVC720u-0-5d5de1ea25455f0d62c737bbe65ffb5c)
注:如果患者在医院内发生急性呕吐,病因通常为肠梗阻或者药物
表5.2 紧急调查
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.2_5134.jpg?sign=1739290142-Ba1USls3vZtdJOa44CsWAgkuCRwXofBU-0-6dc5155f48ddcda4e46645752a7e8d11)
表5.3 急性呕吐的病因
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.3_59620.jpg?sign=1739290142-tSUmIbBNau7ahC5Uxb4OVCqRcuIRUp38-0-8deb0e9ef5c9dc5b12bc6e866a196c77)
表5.4 液体复苏
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.4_5200.jpg?sign=1739290142-0XA6eIAwDvAkSEA0dQ15Mc7S72sDmJMP-0-76998facdd3a2df0a5ddf92088a69f68)
表5.5 初始抗生素治疗
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.5_59949.jpg?sign=1739290142-c8zXMBlrG1i0KljWcDWXlRqGJPCfyiob-0-4a2d191bd9b0947187c6f895e8f32720)
表5.6 青霉素过敏
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.6_5240.jpg?sign=1739290142-uPDu5tvSisLPF5uANLuTpHe35b2jxD3u-0-54dd2bf920f7f54a2cc915687106e44a)