Middlemore Hospital, Department of surgery, Auckland, New Zealand.
World J Emerg Surg. 2007 Sep 25;2:26. doi: 10.1186/1749-7922-2-26.
Abdominal pain is a common cause for emergency admission. While some patients have serious abdominal pathology, a significant group of those patients have no specific cause for the pain. This study was conducted to identify those who have non-specific abdominal pain who can be either admitted short term for observation or reassured and discharged for outpatient management.
A prospective documentation of clinical and laboratory data was obtained on a consecutive cohort of 286 patients who were admitted to a surgical unit over a nine month period with symptoms of abdominal pain regarded severe enough for full assessment in the casualty department and admission to a surgical ward. The patients were followed until a definite diagnosis was made or the patient's condition and abdominal pain improved and the patient discharged. The hospital where the study took place is a small peripheral general hospital draining a population of 120,000 people in a rural area in New Zealand.
There were 286 admissions to the emergency department. Logistic regression multivariate statistical analysis showed that guarding raised white cells count, tachycardia and vomiting were the only variables associated with significant pathology.
Patients with no vomiting, no guarding, who have normal pulse rates and normal white cell counts are unlikely to have significant pathology requiring further active intervention either medical or surgical.
腹痛是急诊入院的常见原因。虽然有些患者有严重的腹部病理，但相当一部分患者的疼痛没有明确的原因。本研究旨在确定那些有非特异性腹痛的患者，可以短期入院观察，或得到安抚后出院接受门诊治疗。
对 286 名连续入院的患者进行了前瞻性的临床和实验室数据记录，这些患者在九个月的时间内因腹痛症状严重，需要在急诊部门进行全面评估并收入外科病房。这些患者一直被随访到明确诊断或患者病情和腹痛改善并出院。本研究在一家小型的外围全科医院进行，该医院位于新西兰农村地区，服务人口为 12 万人。
急诊科有 286 名患者入院。逻辑回归多变量统计分析显示，腹部压痛、白细胞计数升高、心动过速和呕吐是与显著病理相关的唯一变量。
没有呕吐、没有腹部压痛、脉搏正常、白细胞计数正常的患者不太可能有需要进一步积极干预（包括药物或手术）的显著病理。
