![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=1738976014-SMC93hZfrD2w65MCeB3dONBFaDmwxG5G-0-c967e1a4a2c02ee21c86d36db05d3738)
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=1738976014-FdCf2dYM4fVaElvGHse3gqfEHpchUVXh-0-4dd32969b72d1dd1c38fde712b5b837a)
续表
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.1_1_59948.jpg?sign=1738976014-xYI3qA4VneobMLb7tRSz4ukIR6GQs3h8-0-07a40f98d041b5f916325a3932db024d)
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=1738976014-b3uv1RCYgc3bX4BdNGFmDy8sAa9eRtrc-0-5d21aa67c0ef6bb4819cff25a153826d)
表5.3 急性呕吐的病因
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.3_59620.jpg?sign=1738976014-GiFqw9EOiJNrE73u8j3uBfVVZ1dN9AYt-0-ecc38df20c878c7ec454b1b7c3b307ec)
表5.4 液体复苏
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.4_5200.jpg?sign=1738976014-2YjYmdw3Kqss7huEgoq5vrtgOGhDidG4-0-58a3b331e023f9dac7e0f6ded357e660)
表5.5 初始抗生素治疗
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.5_59949.jpg?sign=1738976014-nIG46hu1YefUIs5iO8QIWnhvbU2Erq9V-0-1014654e90910edbcd61bcb88f8e5456)
表5.6 青霉素过敏
![](https://epubservercos.yuewen.com/1C1403/19400084308706906/epubprivate/OEBPS/Images/T5.6_5240.jpg?sign=1738976014-MvRMy6amsdmCmWHJoUwNXXWfiuVrqTBA-0-7b7407faed6a2650b4026aded7265dae)