![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=1739228208-Nnq87zr4hb9ZQRICZc28I0zS71Sr6kMl-0-edce599afceb433f0b8766cb7c25e9c9)
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=1739228208-hgrFXux9xmyj6bwYFQNtek5tLkSdGdWx-0-ad0aa3d9fde411990c9218df27002c96)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.1_1_59948.jpg?sign=1739228208-b6hL1LNpDzdg5WyUrK4TptW9AqQTGT50-0-750899e0e69414d0088f8e152cd5e21d)
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=1739228208-adNUQCdBDkOLezH7ouwJ0z20NcAISAOd-0-fb3f4d466785e7193412a6b34997260e)
表5.3 急性呕吐的病因
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.3_59620.jpg?sign=1739228208-AXMORfiKtoEZp4qY8mVzBwiF4hRvZXUN-0-8c9566d4bc394cbc312432bd0fcf6691)
表5.4 液体复苏
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.4_5200.jpg?sign=1739228208-wnzjT3v1lWy0r2fBFPng5kho5kh44vBg-0-7fe18ca362aead50c6abd8b0d6e33f16)
表5.5 初始抗生素治疗
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.5_59949.jpg?sign=1739228208-fO5FawAG4SxPkM9nBAGv6uOFUMaVSBvV-0-2a197a05ef687fd642d03f86fad1d165)
表5.6 青霉素过敏
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.6_5240.jpg?sign=1739228208-axAVXpZHDhq8e81JKGTnhnc1dbxXNAxK-0-53254a23b0812716f4e5396f3bcebd00)