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目的探讨以腹痛为主的成人铅中毒的临床表现及误诊原因。方法回顾性分析11例患者的临床资料、误诊情况及转归。结果患者均以腹痛为主要症状就诊,部分伴有贫血和肝损伤,腹部体征轻。临床易误诊为急腹症、消化道肿瘤、尿路结石及不明原因腹痛。患者血铅均高于正常,予依地酸钙钠驱铅治疗后腹痛好转。结论重视腹痛患者铅接触史询问,熟悉铅中毒容易引起腹痛等多脏器损害特点、做过细体检和铅毒化分析,就能避免成人铅中毒误诊。
Objective To investigate the clinical manifestations and causes of misdiagnosis of adult lead poisoning based on abdominal pain. Methods Retrospective analysis of 11 cases of clinical data, misdiagnosis and outcome. Results The patients were treated with abdominal pain as the main symptom, partly with anemia and liver injury, with mild abdominal symptoms. Clinically easy to misdiagnosed as acute abdomen, gastrointestinal cancer, urinary tract stones and unexplained abdominal pain. Patients with blood lead were higher than normal, according to acid calcium and lead treatment after abdominal pain improved. Conclusion Paying attention to the history of lead exposure in patients with abdominal pain, familiar with lead poisoning easily lead to abdominal pain and other multi-organ damage characteristics, do fine physical examination and lead poisoning analysis, to avoid misdiagnosis of adult lead poisoning.