Borczuk Pierre
Harvard Medical School; Associate in Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
Emerg Med Pract. 2013 Jul;15(7):1-23; Quiz 23-4. Epub 2013 Jun 10.
Low back pain is the most common musculoskeletal complaint that results in a visit to the emergency department, and it is 1 of the top 5 most common complaints in emergency medicine. Estimates of annual healthcare expenditures for low back pain in the United States exceed $90 billion annually, not even taking lost productivity and business costs into account. This review explores an evidence-based rationale for the evaluation of the patient with low back pain, and it provides guidance on risk stratification pertaining to laboratory assessment and radiologic imaging in the emergency department. Published guidelines from the American College of Physicians and American Pain Society are reviewed, with emphasis on best evidence for pharmacologic treatments, self-care interventions, and more invasive procedures and surgery in management of low back pain. Utilizing effective and proven strategies will avoid medical errors, provide better care for patients, and help manage healthcare resources and costs.
腰痛是导致患者前往急诊科就诊的最常见肌肉骨骼疾病，也是急诊医学中最常见的五大疾病之一。美国每年用于腰痛的医疗保健支出估计超过900亿美元，这还未将生产力损失和商业成本计算在内。本综述探讨了对腰痛患者进行评估的循证依据，并为急诊科实验室评估和放射影像学的风险分层提供指导。回顾了美国医师学会和美国疼痛协会发布的指南，重点关注腰痛管理中药物治疗、自我护理干预以及更具侵入性的程序和手术的最佳证据。采用有效且经过验证的策略将避免医疗差错，为患者提供更好的护理，并有助于管理医疗资源和成本。
