病理生理学 (77)病理生理学.pdfVIP

The patient, male, 32 years old, was admitted to the emergency department for burns. After debridement, fluid replacement and other treatments, the patients consciousness was clear after 4 hours and the vital signs were stable. 2 days later, the patient developed watery diarrhea and tarry stools 3 times with abdominal distension. Blood test routine RBC 2.81 × 1012/ L, Hb 71g/ L. Stool occult blood test (OB) (++++). Endoscopy There are multiple ulcer bleeding sites on the front and back walls of the stomach fundus and the duodenal bulb, which are spot-shaped and of varying sizes, with active bleeding on the surface. Hemostasis, blood transfusion and other treatments are given. The patient basically recovered after 4 days, and abdominal distension disappeared 7 days after inj ury. The patient denied any history of stomach problems. u What kind of gastrointestinal disease does this patient have? u What are the causes and mechanisms of this gastrointestinal disease? u How should the patient be prevented? Definition Stress ulcers refer to multiple small, shallow ulcers t ha t f o r m i n t he m u c o sa of t he st o ma c h o r, occa sio na lly, i n t he d uode nu m i n re s po nse t o extreme physiological stressors which is one of the common causes of death in patients of ICU. Risk factors Severe burn area 30% Severe Severe trauma, craniocerebral maj or surgery inj ury