儿童急性腹痛急诊预检分诊流程的构建及应用研究

doi:10.3761/j.issn.0254-1769.2026.12.008

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (12): 1644-1650.DOI: 10.3761/j.issn.0254-1769.2026.12.008

儿童急性腹痛急诊预检分诊流程的构建及应用研究

朱淑贞¹(), 张翠平¹, 张彩娣¹, 许丹¹, 叶盛¹, 周红琴²^,^*(), 陈秀萍²

¹ 浙江大学医学院附属儿童医院急诊科杭州市 310053
² 浙江大学医学院附属儿童医院护理部杭州市 310053

收稿日期:2025-09-12 出版日期:2026-06-20 发布日期:2026-06-12
*通讯作者: 周红琴，E-mail：zhouhongqin@zju.edu.cn
作者简介:朱淑贞：女，本科，副主任护师，副护士长，E-mail：zsz727@zju.edu.cn
第一联系人：作者贡献声明
朱淑贞：研究设计、研究实施、数据收集及整理、统计学分析、论文撰写；张翠平、张彩娣、许丹：研究实施、数据收集及整理；叶盛、陈秀萍：研究指导；周红琴：研究设计、研究指导、基金支持、论文审阅与修改
基金资助:
浙江省医药卫生科技计划项目(2023KY829)

Construction and application of an emergency triage process for children with acute abdominal pain

ZHU Shuzhen¹(), ZHANG Cuiping¹, ZHANG Caidi¹, XU Dan¹, YE Sheng¹, ZHOU Hongqin²^,^*(), CHEN Xiuping²

¹ Emergency Department， Children’s Hospital Zhejiang University School of Medicine， Hangzhou 310053， China
² Department of Nursing， Children’s Hospital Zhejiang University School of Medicine， Hangzhou 310053， China

Received:2025-09-12 Online:2026-06-20 Published:2026-06-12
* Corresponding author: ZHOU Hongqin，E-mail：zhouhongqin@zju.edu.cn
Funding program:
Zhejiang Provincial Medical and Health Science and Technology Plan Project(2023KY829)

摘要/Abstract

摘要：

目的构建儿童急性腹痛急诊预检分诊流程，并评价其应用效果，为优化儿童急诊分诊提供临床实践参考。方法基于循证方法，通过开展共识会议、流程试点与优化等环节构建儿童急性腹痛急诊预检分诊流程。采用便利抽样法，选取2024年4—11月于杭州市某三级甲等儿童专科医院急诊科就诊的急性腹痛患儿作为研究对象，其中，2024年9—11月的211例为试验组，2024年4—6月的263例为对照组。试验组采用儿童急性腹痛急诊预检分诊流程进行分诊，对照组采用通用儿科急诊五级预检分诊标准进行分诊，比较两组分诊准确率、分诊耗时、急腹症漏诊及误诊率及护士满意度的差异。结果试验组分诊准确率为94.3%，高于对照组的88.2%；急腹症漏诊及误诊率为0，低于对照组的2.7%；分诊耗时为（65.69±14.87）s，短于对照组的（102.75±21.11）s；护士满意度得分为（4.86±0.25）分，高于对照组的（4.53±0.41）分，两组比较，差异均有统计学意义（均P<0.05）。结论应用基于循证方法构建的儿童急性腹痛急诊预检分诊流程能有效提升护士的分诊质量，提高工作效率和满意度。

关键词: 儿童, 急腹症, 急诊预检分诊, 循证护理学

Abstract:

Objective To establish an evidence-based emergency triage process for children with acute abdominal pain and evaluate its clinical efficacy，aiming to provide a reference for optimizing pediatric emergency triage practices. Methods Based on evidence-based methods，an emergency pre-examination and triage process for acute abdominal pain in children was constructed through consensus meetings，process pilots and optimizations. Using convenience sampling，pediatric patients with acute abdominal pain admitted to a tertiary-level children’s specialty hospital in Hangzhou from April to November 2024 were enrolled as study participants. Among them，211 cases from September to November 2024 were assigned to an experimental group，while 263 cases from April to June 2024 were in a control group. The experimental group implemented the acute abdominal pain triage process，while the control group followed the standard five-level pediatric triage process. Differences were compared between groups in triage accuracy，triage duration，missed diagnosis rates for acute abdomen，and nurse satisfaction before and after process implementation. Results The triage accuracy rate in the experimental group was 94.3%，higher than the 88.2% in the control group. The missed diagnosis rate for acute abdomen was 0，lower than the 2.7% in the control group. Triage duration was（65.69±14.87） seconds，shorter than（102.75±21.11） seconds in the control group. Nurse satisfaction scores were（4.86±0.25） points，higher than（4.53±0.41） points in the control group. Comparisons between the 2 groups showed statistically significant differences（P<0.05）. Conclusion The evidence-based emergency triage process for pediatric acute abdominal pain effectively enhances triage quality workflow efficiency，and staff satisfaction.

Key words: Children, Acute Abdomen, Emergency Triage, Evidence-Based Nursing

朱淑贞, 张翠平, 张彩娣, 许丹, 叶盛, 周红琴, 陈秀萍. 儿童急性腹痛急诊预检分诊流程的构建及应用研究[J]. 中华护理杂志, 2026, 61(12): 1644-1650.

ZHU Shuzhen, ZHANG Cuiping, ZHANG Caidi, XU Dan, YE Sheng, ZHOU Hongqin, CHEN Xiuping. Construction and application of an emergency triage process for children with acute abdominal pain[J]. Chinese Journal of Nursing, 2026, 61(12): 1644-1650.

图/表 2

图1 儿童急性腹痛急诊预检分诊流程注：采用AVPU（A为清醒、V为声音反应、P为疼痛反应、U为无反应）评分对患儿意识进行评估，且遵循意识评估优先原则。通过不同年龄段心率、呼吸频率及血压的异常阈值对患儿生命体征进行评估，2~3岁为心率每分钟>130或<90次，呼吸频率每分钟>35或<22次；4~6岁为心率每分钟>120或<80次，呼吸频率每分钟>30或<20次；7~12岁为心率每分钟>110或<70次，呼吸频率每分钟>25或<16次；≥13岁为心率每分钟>100或<60次，呼吸频率每分钟>20或<12次；血压预警值为2~10岁收缩压<（70+年龄×2） mmHg（1 mmHg=0.133 kPa），≥10岁收缩压<90 mmHg。疼痛评估工具的选择：2~6岁采用FLACC量表（F为面部表情、L为下肢动作、A为活动、C为哭闹、C为是否易安慰）；7~18岁采用面部表情量表。

Figure 1 Emergency triage process for children with acute abdominal pain

表1 两组一般资料的比较

Table 1 Comparison of general data between 2 groups

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儿童急性腹痛急诊预检分诊流程的构建及应用研究

Construction and application of an emergency triage process for children with acute abdominal pain

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