铅绞痛误诊分析  

AN ANALYSIS ON MISDIAGNOSIS FOR PATIENT WITH LEAD COLIC.

作　　者：程崇泉[1] 安绪淑[1] 

机构地区：[1]华西医科大学附属职业病防治院

出　　处：《现代预防医学》1999年第1期34-35,共2页Modern Preventive Medicine

摘　　要：本文对在院外被误诊的３６例铅绞痛分析表明，生活性急性、亚急性铅绞痛２４例，毒物常为黄丹、铅白，中毒原因主要是误服，其次为服中药或偏方，少数为自杀。职业性慢性铅中毒１２例，均吸入铅烟、铅尘所致。误诊原因是临床医生未询问职业史及服药史，对铅中毒的知识认识不足，重视不够。为了正确及时诊断铅绞痛，凡遇到急性腹痛的病人，一时诊断困难时，应详细询问病人的职业史及服药史，熟悉铅绞痛的临床表现。疑为铅绞痛，应作铅中毒方面的化验检查，必要时可作诊断性治疗，２０％ＣａＮａ２—ＥＤＴＡ１０ｍｌ＋５～１０％ＧＳ５００ｍｌ静脉滴注，每日一次，１０％葡萄糖酸钙１０ｍｌ静脉注射，每日两次，２～３天铅绞痛缓解。Analysis of 36 cases with lead colic missed in other hospitals indicated that in 24 acute and sub acute lead colic cases,the common poisons are Pb 2O 3 and PbCO 3·2Pb(OH) 2.The main cause of poisoning is to take the poisons accidentally,and the second is to take Chinese traditional medicine or folk prescription,self suicide is rare.In 12 occupational chronic lead poisoning cases,all of them have history inhaling lead smog or lead dust.The reason of misdiagnosis is ignorance about the occupational and medicine taken history,leak of knowledge on lead poisoning and leak of recognition for importance.For diagnosing lead colic correctly and in time,all of colic cases with difficulty to diagnose should be asked occupation and medicine taken history carefully.The doctors should know symptoms of lead colic.If the patient was suspected as lead colic,the lab test of lead poisoning has to be done.If necessary,the diagnostic treatment can be given that is 20% CaNa 2-EDTA 10ml+5￣10%GS500ml given by intravenous fusion once a day,10% calcium glucose 10ml given by IV twice a day,the colic will be released in 2 or 3 days.

关 键 词：铅绞痛 误诊 腹痛 铅中毒 诊断 

分 类 号：R595.204[医药卫生—内科学]