嘔血與便血ppt課件(已修改)
2024-12-20 03:43 本頁面
【正文】 嘔血與便血 Hematemesis and Hematochezia Definition Hematemesis :Bloody vomitus from the upper gastrointestinal(GI) tract（ before the ligament of Treitz) Hematochezia: bright red , maroon or black blood from the rectum Treitz: The ligament of Treitz is an anatomic landmark for the duodenaljejunal junction Clinical Manifestation 1 Manner of bleeding presentation 2 Hypovolemia (低血容量 ) or shock 3 Anemia (貧血 ) Patients manifest blood loss (A) Hematemesis 嘔 血 Character Bloody vomitus, either fresh and bright red or older and “coffee ground” (hematin 酸化正鐵血紅素 ) Manner of bleeding presentation from the GI tract in five ways: cause of disease 90% upper GI bleeding is due to four lesions: 1) peptic ulcer (消化性潰瘍 ) 2) esophageal or gastric varices (食管胃底靜脈曲張破裂 ) 3) hemorrhagic gastritis (急性糜爛性出血性胃炎 ) 4) gastric cancer peptic ulcer hemorrhagic gastritis esophageal varices gastric cancer Other causes of upper GI bleeding MalloryWeiss tear 食道 賁門撕裂傷 Foreign body in esophagus 食管異物 Ancylostomiasis 鉤蟲病 Postsphincterotomy 括約肌切開術(shù)后 Differentiation Nosebleeding? Hemoptysis? Differntiating hemoptysis and hematemesis Hemoptysis Hematemesis Cause of disease TB, bronchiectasis, pneumonia, lung cancer,heart disease PU, liver cirrhosis, a
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