呕血与便血中英文课件.pptVIP

Accompanying symptoms 1、with abdominal pain便血伴腹痛 2、With tenesmus hematochezia便血伴里急后重 3、with abdominal mass 便血伴腹部肿块 4、 with fever便血伴发热 5、with mucocutaneous bleeding便血伴皮肤黏膜出血 ※ Interrogation points 1.Is there unclean food, medication history and the collective disease? 2.The amount and colour of hematochezia.And the relationship to stool. 3.The general condition of the patient. 4.Is there a history of diarrhea, abdominal pain, hemorrhoids, anal fissure history or abdominal operation? ※ Hematemesis and Hematochezia呕血和便血 The professional staff room Rainny Lin Hematemesis 呕血 Definition定义 Hematemesis is the vomiting of blood. 血液从口腔呕出。 ※ Pathogeny病因 1.Esophageal diseases食管疾病 Esophagitis食管炎 、Esophageal cancer食管癌、Esophageal varices食管静脉曲张破裂。 2.Gastric and duodenal diseases胃与十二指肠疾病 Peptic消化性溃疡、Gastric mucosal lesions胃黏膜病变、Chronic gastritis慢性胃炎、Gastric cancer胃癌等。 ※ 3、Hepatobiliary diseases肝胆疾病 Liver cirrhosis and portal hypertension肝硬化门脉高压 、Liver cancer肝癌、Liver abscess肝脓肿、Gallbladder and bile duct stones胆囊与胆管结石 等。 4、Pancreatic diseases胰腺疾病 Pancreatic cancer胰腺癌、Acute pancreatitiscomplicated with abscess 急性胰腺炎合并脓肿等。 5、Acute infectious disease急性传染病 Severe hepatitis重症肝炎等。 6、Blood disease血液病 白血病Leukemia 、血小板减少性紫癜、过敏性紫癜、血友病等 7、Others： Uremia尿毒症 、Pulmonary heart disease肺源性心脏病 Clinical manifestation临床表现 1、Hematemesis and melena呕血与黑便 2、Hemorrhagic shock失血性休克 ※ 3、Fever发热 4、Hematological changes血液学改变 5、Azotemia氮质血症 Accompanying symptoms伴随症状 1、with abdominalpain呕血伴上腹痛 Peptic ulcer消化性溃疡； Gastric cancer胃癌。 2、 with hepatosplenomegaly呕血伴肝脾肿大 Liver cancer肝癌；食管胃底静脉曲张破裂出血。 ※ 3、with mucocutaneous bleeding呕血伴皮肤黏膜出血 血液病、败血症、Severe hepatitis重症肝炎等。 4、with jaundice 呕血伴黄疸 5、with enlargement of left praclavicular lymph nodes 呕血伴左锁骨上淋巴结肿大 Gastric cancer胃癌、胰腺癌等 Interrogation points问诊要点 1、Eliminate the oral cavity , nasopharyngeal bleeding and hemoptysis. 2、The relationship between the cause of hematemesis