![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=1738928260-5oFCr7CS6D894atS286mLMjwXGgK8n8N-0-d174932bece265b431770bca10248a51)
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=1738928260-GYptgiIbDxTiBkzjwYI9uXRqbgc6yraT-0-d2fdad7cd03600bb8564da6dfe945d32)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.1_1_59948.jpg?sign=1738928260-XXPZYydPjXFaNXc8rtnBgQCzJgoctpSh-0-4f522a2fe95eeb0956032efdf7278846)
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=1738928260-Kba10unub7eMmNoqilXR1R6b3bQE96aT-0-4d27c61ae20ee9bde5c1872de4dee8e0)
表5.3 急性呕吐的病因
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.3_59620.jpg?sign=1738928260-XCMvm6Q2QCBK3DusDwc6KfyEHHX97OIv-0-8590d9efee5c161f74672f4bbc7d26d1)
表5.4 液体复苏
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.4_5200.jpg?sign=1738928260-cI5v6nXFV1PVwl7GQvSRxrpxffJxFmoS-0-2dae4ee243be1bcc03ec002ee902dc53)
表5.5 初始抗生素治疗
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.5_59949.jpg?sign=1738928260-SmZ1ATPIc8rl5xNBaShShVkIGDM0bUzt-0-e75f726d4c1848750c5f10252c6864f6)
表5.6 青霉素过敏
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.6_5240.jpg?sign=1738928260-nC45Wd5eCZ8KwFRIhndyOEWFAg19Hub9-0-4340983aed869da2664d3cffb05cc196)