上消化道出血（Upper gastrointestinal bleeding）.doc

上消化道出血（Upper gastrointestinal bleeding） define Hemorrhage: the upper gastrointestinal tract of the Treitz ligament: Esophagus, stomach, duodenum, pancreatic bile, Gastric jejunal anastomosis of jejunal lesions Clinical manifestation: haematemesis, black Acute hemorrhagic peripheral circulatory failure. Cause: (1) upper gastrointestinal disease 1. Esophageal disease 2. Gastroduodenal disease (2) cirrhosis portal hypertension (3) diseases of the upper digestive tract adjacent to organs or tissues (iv) systemic disease (2) cirrhosis portal hypertension The esophageal gastric varices rupture Portal hypertension Portal hypertension gastropathy (3) adjacent to the gastrointestinal tract Organs or tissues disease 1. Biliary bleeding 2. Pancreatic disease 3. Aneurysms break into the esophagus, Stomach or duodenum 4. Mediastinal tumor or abscess To break into the esophagus Total body disease: 1. Vascular disease 2. Hematopathy: leukemia, Hemophilia etc. 3. Acute infectious diseases: Epidemic hemorrhagic fever, Hook disease etc. uremia Stress ulcers Connective tissue disease Now: 1. Hematemesis and black dung: Generally: nausea, hematemesis, black manure The hematemesis is much brown (heme was formed by the action of the acid in the stomach.) But if the amount of blood is large, in the stomach stop Short, red or dark red Black manure is tar, thick and shiny (the iron of the hemoglobin is formed by sulphide in the intestine.) But if the amount of blood is large, the speed is fast, can also Red or scarlet blood. 2. Hemorrhagic peripheral circulation failure Dizziness, fatigue, sweating, heart palpitation, mouth Thirst, increased heart rate, low blood pressure, syncope, etc Shock status: restlessness, confusion, pallor, cyanosis, shortness of breath, decrease of blood pressure, rapid pulse, and low urine. Note: after bleeding, it often means to go to the toilet Fainting occurs frequently. 3. Blood changes (1) Hb, RBC (2) the number of red blood cells in the net is up (3) WBC cou