消化性溃疡课件.pptVIP

體征上腹部固定而局限的壓痛點。胃區振水音上腹部包塊ExaminationThepatientcharacteristicallyputshishandovertheupperabdomenormaypointtotheepigastriumwithaforefingerwhenaskedwherethepainisandthisisthepointofmaximumtenderness.Thepresenceofanepigastricmasssuggestsagastriccarcinoma.Agastricsplash(orsuccussion)indicatespyloricobstructionduetobenignduodenalstrictureortocarcinomaofthepyloricantrum.特殊類型的消化性潰瘍一、複合性潰瘍二、幽門管潰瘍三、球後潰瘍≠球後壁潰瘍四、巨大潰瘍五、老年性消化性潰瘍：位於胃體上部的高位潰瘍較多見。六、無症狀性潰瘍：老年人多見（約15％）實驗室檢查一、胃鏡檢查及胃粘膜活組織檢查二、X線鋇餐檢查三、幽門螺桿菌檢測四、胃液分析和血清胃泌素測定診斷病史體征輔助檢查