![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=1739219271-c4ldPlxaqBAZwx7M9I7uHnn9MeEI1ze7-0-949356e02afc04cbffd42ec1c9b3ac88)
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=1739219271-Tz92guIJjy00PdbRR4Hp9E4UEJAt7pgn-0-59bd5e3a03e1c4b2b6b054e31675c6a3)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.1_1_59948.jpg?sign=1739219271-IAeoTf331wmL81sDkw60fQnymxFTN8F2-0-561092bda109b8e1a596947301c81125)
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=1739219271-ePMTpEZeDCOO9asj8XK2dCgFG8zXcogB-0-58f7d0ce858532569390e9b865f77ec7)
表5.3 急性呕吐的病因
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.3_59620.jpg?sign=1739219271-VWpK2dGrPODzz8cKGKvHb1UPQ5S0bG0m-0-2942bdfcdfb6a9513a5d5709f9ffefa5)
表5.4 液体复苏
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.4_5200.jpg?sign=1739219271-KhurSRTMGBb7AmfQN7IttLSdPEg0SMuV-0-00d3b4ccfcc3bf8b1ac8afde962cd7f0)
表5.5 初始抗生素治疗
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.5_59949.jpg?sign=1739219271-PWI5C6og4kDRXJp7kXY8VcPh08NHFUI2-0-2845e98c65a1f19cb6ba4c7ffb32fdfe)
表5.6 青霉素过敏
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.6_5240.jpg?sign=1739219271-XMFFyfFN2dPaNLHexcOaGZ9cDovGIWuf-0-d35b762db6fb37391acc0b1183494c24)