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诊疗学汇总腹痛消化系统腹痛(abdominalpain)腹痛(abdominalpain)病因(causes)急性腹痛(acuteabdominalpain)急性腹痛(acuteabdominalpain)急性腹痛(acuteabdominalpain)急性腹痛(acuteabdominalpain)急性腹痛(acuteabdominalpain)急性腹痛(acuteabdominalpain)急性腹痛(acuteabdominalpain)急性腹痛(acuteabdominalpain)慢性腹痛(chronicabdominalpain)慢性腹痛(chronicabdominalpain)慢性腹痛(chronicabdominalpain)慢性腹痛(chronicabdominalpain)慢性腹痛(chronicabdominalpain)慢性腹痛(chronicabdominalpain)发生机制(mechanisms)发生机制(mechanisms)发生机制(mechanisms)发生机制(mechanisms)Referredpain牵涉痛的临床意义牵涉痛与病变的内脏有一定解剖相关性,故对病变部位的判断有一定帮助。Referredpain临床举例临床表现clinicalmanifestation1.腹痛部位regionLocalisationofforegut、midgutandhindgutpain弥漫性或部位不定的疼痛见于:急性弥漫性腹膜炎(原发性或继发性)、机械性肠梗阻、急性出血性坏死性肠炎、铅中毒、腹型过敏性紫癜等。腹痛部位与各种疾病2.腹痛性质和程度(quality&severity)阵发性剑突下钻顶样疼痛是胆道蛔虫症的典型表现。持续性、广泛性剧烈腹痛伴腹壁肌紧张或板样强直,提示为急性弥漫性腹膜炎。阵发性剧烈绞痛,多见于结石症。2.腹痛性质和程度(quality&severity)3.诱发因素(provocativefactors)4.发作时间(temporalcharacteristics)5.与体位的关系(relationshipwithposture)几种常见疾病腹痛特点伴随症状simultaneousphenomenon伴随症状simultaneousphenomenon伴随症状simultaneousphenomenon伴随症状simultaneousphenomenon问诊要点思考题