Objective To analyze the effect of tramadol on the accuracy of diagnosis in undifferentiated acute abdominal pain without trauma. Methods Pain was measured with a standard 0-10 visual analog? scale(VAS). 320 patients with moderate-severe acute abdominal pain without trauma were randomized into two groups. 160 patients in the control group and the tramadol group respectively. l00mg tramadol was administered IM for the management of pain in patients in the tramadol group. VAS. the ratio of pain sign and clinically? important diagnostic accuracy were compared. Results There were no differences between groups in demographic variables or the degree of pain initially (VAS7. 2± 1.1 vs VAS 7. 3±1. 5). VAS decreased to 5. 8±1. 5 in 30 minutes after treatment in tramadol group while 7. 0±l. 3 in control group(P<0.05). The ratio of positive pain sign were 70% in control group and 66% in tramadol group(P>0. 05)in 30 minutes. VAS were 5. 6±2. 5 and 3. 3±1. 8(P<0.05)in 2 hours after treatment. The accuracy of clinically? important diagnostic was 87. 5% in the control group and 85. l%? in the tramadol group(P>0. 05). Conclusion Administration of? tramadol to patients with acute abdominal pain provides analgesia without impairing? Clinically important diagnostic accuracy.%目的 观察曲马多对急性非创伤性腹痛患者诊断正确率的影响.方法 采用可视模拟标尺法(VAS)纳入320例中-重度疼痛、诊断不明的急性非创伤性腹痛患者,随机分为对照组和曲马多组,每组160例,曲马多组肌注曲马多100mg,观察两组疼痛评分、主要阳性体征比率和临床诊断正确率.结果 两组患者基线特征相似,就诊时对照组VAS 7.2±1.1,曲马多组VAS 7.3±1.5(P＞0.05).治疗后30分钟两组VAS分别为7.0±1.3和5.8±1.5(P＜0.05),2h VAS分别为5.6±2.5和3.3±1.8(P＜0.05),治疗后30分钟两组阳性体征比率分别为70％和66％(P＞0.05),两组诊断正确率分别为87.5％和85.1％(P＞0.05).结论 曲马多镇痛治疗可以减轻患者疼痛,但不影响急性腹痛的诊断正确率.
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