消化道出血介绍PPT学习教案

1、会计学1 消化道出血介绍消化道出血介绍 第1页/共59页 第2页/共59页 第3页/共59页 第4页/共59页 最常见 第5页/共59页 Esophageal Diseases Duodenal and Gastric Diseases Portal Hypertension-Related Causes Hemobilia Hemosuccus Pancreaticus Systemic Diseases 第6页/共59页 第7页/共59页 第8页/共59页 第9页/共59页 第10页/共59页 第11页/共59页 第12页/共59页 第13页/共59页 第14页/共59页 第15页/共59

2、页 第16页/共59页 第17页/共59页 第18页/共59页 第19页/共59页 Be defined as the vomiting of blood and indicates an upper gastrointestinal site of bleeding blood may be either fresh, bright red, or it may be old and take on the appearance of coffee grounds bright red blood often from varices or arterial lesion; Patients

3、 with coffee ground emesis are not usually bleeding actively but have had a recent or even remote bleeding 第20页/共59页 Be defined as passage of black, tarry, and foul-smelling stool Character of melena is due to degradation of blood to hematin or other hemochromes by bacteria Instillation of 50 to 100

4、 mL of blood into the stomach is required to produce melena consistently, tests for fecal occult blood become positive when about 5 mL is lost per day 第21页/共59页 Refers to passage of bright red blood from the rectum that may or may not be mixed with stool It is happen when patients have gastro- intes

5、tinal lesions that bleed massively 第22页/共59页 Including lightheadedness; tachycardia; angina pectoris; postural hypotension (the blood pressure is maintained on recumbency but falls more than 15 to 20 mmHg when the patient sits up) or even shock (pale to ashen, dyspnea, sweating and distressed, synco

6、pe) 第23页/共59页 Patients who bleed small amounts of blood over long periods of time develop iron deficiency anemia, a low mean corpuscular volume (MCV), hypochromic, microcytic red blood cell and detection of occult blood in the stool with standard fecal occult blood tests If blood loss is acute, hema

7、tocrit value may not reflect blood loss accurately and the MCV, hemoglobin concentration is normal, Because equilibration with extra-vascular fluid and subsequent hemodilution requires several hours 第24页/共59页 The blood urea nitrogen (BUN) level may be mildly elevated in patients with upper GI bleedi

8、ng Due to breakdown of blood proteins to urea by intestinal bacteria and its absorption, as well as from a mild reduction in glomerular filtration rate BUN less than 14.3 mmol/L 第25页/共59页 道出血 第26页/共59页 第27页/共59页 第28页/共59页 第29页/共59页 第30页/共59页 第31页/共59页 第32页/共59页 第33页/共59页 第34页/共59页 L o w e r digestive hemorrhage refers to bleeding (hemorrhage) that arises in the digestive t r a c t b e l o w t h e ligament of Treitz 第35页/共59页 第36页/共59页 第37页/共59页 第38页/共59页 第39页/共59页 第40页/共59页 第41页/共59页 第42页/共59页 第43页/共59页 第44页/共59页 第45