Clinical Research On The Diagnosis Model Of Acute Abdominal Pain Based On Procedural Thinking

Objective: To explore the role and clinical value of procedural thinking in the diagnosis of acute abdominal pain.Methods: This retrospective study included acute abdominal pain patients whose were diagnosed by 6 physicians in the emergency department of our hospital since July 1,2018 to December 31,2018 based on the procedural thinking diagnostic mode,and the acute abdominal pain patients whose were diagnosed based on traditional thinking(Hypothesis deductive)in the same period in 2017.The differences in length of stay in the emergency room,days in hospital,hospital costs,diagnostic accuracy and clinical outcome were compared between the two diagnostic modes.At the same time,the differences in length of stay in the emergency room and diagnostic accuracy between six physicians were compared before and after establishing a procedural thinking diagnostic mode.These results help us know the role and clinical value of procedural thinking diagnostic mode in the diagnosis of acute abdominal pain.Result: 1.Overall situation: a total of 2662 patients were enrolled in the traditional group,including 1394 males and 1268 females.A total of 2741 patients were included in the procedural thinking group,including 1403 males and 1338 females;The average age of the traditional group was(42.42±18.38)years,while that of the procedural thinking group was(41.73±18.49)years.The average time of onset in the traditional group was(21.12±29.71)hours,while that in the procedural thinking group was(22.15±31.00)hours.There was no statistical difference between the two groups in the time of onset,male and female ratio,age and other general data(P > 0.05),indicating that the two groups were comparable.2.Patients with level two or above: the average length of stay in the emergency room of the procedural thinking group was shorter than that of the traditional group,and there was a statistical difference between the two groups(P < 0.05).3.Patients with level three: the average length of stay in the emergency room of the procedural thinking group was longer than the traditional group,and the difference was statistically significant(P < 0.05).4.Patients admitted to hospital with level two or above: the diagnostic accuracy of the procedural thinking group was higher than that of the traditional group,while the average length of stay was shorter in the procedural thinking group.And the procedural thinking group was better than the traditional group in terms of the average days in hospital,hospital costs and clinical outcome.The differences between the two groups were statistically significant(P < 0.05).5.Patients admitted to hospital with level three: the diagnostic accuracy of the procedural thinking group was higher than that of the traditional group.The average length of stay was longer in the procedural thinking group,but the average days in hospital,hospital costs and clinical outcome were better.The above results were statistically significant(P < 0.05).6.There was a statistical difference in the average emergency stay time and diagnostic accuracy among the 6 doctors in the traditional diagnostic mode(P < 0.05),while there was no statistical difference in the same terms among the 6 doctors in procedural thinking diagnostic mode(P>0.05).Conclusions: The diagnosis mode based on procedural thinking shortens the average length of stay of patients with level two or above in the emergency room.The accuracy of emergency diagnosis in patients with level two or above and level three and the outcome of patients admitted to hospital were improved,while the average days in hospital and hospital costs were shortened.At the same time,the mode of procedural thinking is conducive to the initial homogenization of the diagnosis process and results of acute abdominal pain by emergency physicians,which maybe ultimately conducive to the realization of the homogenization of the initial diagnosis and treatment of acute abdominal pain.