![急诊临床路径](https://wfqqreader-1252317822.image.myqcloud.com/cover/11/36535011/b_36535011.jpg)
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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=1739588855-7uQebRslI7hb141coDJGkUrr0zC7eLp5-0-f5d47c88243cbf039de91800160402c0)
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=1739588855-vizZUuQVbGH4k7Hl8CHybWGefUa8TDuZ-0-2cc8f72028a33a8651a2cf96fc3d5df3)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.1_1_59948.jpg?sign=1739588855-1nn7wcaH6RUu44MNRyUd1Eg7idhbLcoF-0-f864dc2f12ca0e3f202c8e83219dd8c7)
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=1739588855-YzxH2fA7jkoOx3ZXYKUMJ9B4WwxavQjN-0-378d4ffec88860735485416132438d9a)
表5.3 急性呕吐的病因
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.3_59620.jpg?sign=1739588855-gKbRtXvAmHFJzUUKihRY6HHYJ0KdmChG-0-f4d32e26ae594ec40b59fab9fe3728bd)
表5.4 液体复苏
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.4_5200.jpg?sign=1739588855-aBravpCGuC6Uj0CqP69oUdJyrKqYkCdB-0-d1482e8279e9137d3f625ef402c062be)
表5.5 初始抗生素治疗
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.5_59949.jpg?sign=1739588855-PykBn3IdNbisAS5P4pIA6mjy01hVIYoW-0-0ac9e2928b7dfdaac9112ef6914437d7)
表5.6 青霉素过敏
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.6_5240.jpg?sign=1739588855-yymnX0ozv0ubHCdtjUwaLrrq7IKCJJQZ-0-1c0274596cdd19e1e2a955fac33a5e98)