嘔血與便血ppt課件(編輯修改稿)
2025-01-04 03:43 本頁面
【文章內(nèi)容簡介】 nding on speed and volume of blood loss ＜ 1000mL: Weakness, giddiness (眩暈 ), tachycardia(心動過速 ) , cold extremity, sweating Shock: hypotention (低血壓 ), oliguria, (少尿 ) 2. Anemia and hemogram changing If blood loss is acute, the hematocrit (紅細(xì)胞比容 )dose not change during the first few hours after hemorrhage About 24 to 72 hours later, plasma volume is larger than normal and the hematocrit is at its lowest point bleeding slowly hypochromic (血紅蛋白過少 ) microcytic (小細(xì)胞 ) red blood cells mean corpuscular volume (MCV， 平均血球壓積 ) of the cells may be low 7 6 5 4 3 2 1 Volume (Liters) 45% 45% 27% A B C Hematocrit changes A Before bleeding B Immediately after bleeding C 24~72 hours after bleeding low grade fever in 24 hours after bleeding 4. Azotemia(氮質(zhì)血癥 ) Degradation of protein in intestinal tract BUN ↗ in several hours after bleeding up to the peak in about 2448 hours ↘ normal after 34days 5. Bowel sound Active bowel sound usually be presented in acute bleeding from GI tract Where is the source of bleeding? Localization Upper GI bleeding: bleeding from a source proximal to the ligament of Treitz Lower GI bleeding: bleeding from a site distal to the ligament of Treitz Localization Differentiating features of upper GI and lower GI bleeding Upper GI Lower GI M
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