![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=1734455907-WmZwJYn9M4i2iFfcExlMLQJjCVdMX9VJ-0-55640c57ff0d08568c0693092308ca05)
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=1734455907-5nuMd2KSB0fn7FiaMF1bBXexwU2em7Yd-0-a5ca4b9ca098ba8af6a6f9b1ba0a29d1)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.1_1_59948.jpg?sign=1734455907-uH0k9UWra6HjY7uylzSYpCal2VbaK7lk-0-0c756ca7107220c0d5f9dbd6be1767e4)
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=1734455907-ah7H1wmdg485edBvGtD4jyGpEbNGFR61-0-4be6ca82016ab3f8adf0b86c86fa2da2)
表5.3 急性呕吐的病因
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.3_59620.jpg?sign=1734455907-ZnN8G81kvyGdTgGycPxlCqnjeyTX7f5a-0-74694076330624df16a869b33d95c830)
表5.4 液体复苏
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.4_5200.jpg?sign=1734455907-HsAOK6FqRMkNyynPBrn4ydnw1ENgRUCd-0-c89e5f30c5771fa0e28f5771bec2781c)
表5.5 初始抗生素治疗
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.5_59949.jpg?sign=1734455907-TVEMfnLDbibBpnOTJMDnoog6grzG0vwy-0-f36207d8aa1ecdfc4aec585fba20ed0c)
表5.6 青霉素过敏
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.6_5240.jpg?sign=1734455907-JAzvS4uM2JiP8OBzedUXdh3fk3clLOlR-0-28c729154271ba8619626741599c8b3d)