嘔血與便血中英文-PPT課件

1、Hematemesis and Hematochezia嘔血和便血The professional staff room Rainny LinHematemesis 嘔血 Definition定義 Hematemesis is the vomiting of blood. 血液從口腔嘔出。 Pathogeny病因1.Esophageal diseases食管疾病Esophagitis食管炎 、Esophageal cancer食管癌、Esophageal varices食管靜脈曲張破裂。2.Gastric and duodenal diseases胃與十二指腸疾病Peptic消化性潰瘍、Gas

2、tric mucosal lesions胃黏膜病變、Chronic gastritis慢性胃炎、Gastric cancer胃癌等。3、Hepatobiliary diseases肝膽疾病Liver cirrhosis and portal hypertension肝硬化門脈高壓 、Liver cancer肝癌、Liver abscess肝膿腫、Gallbladder and bile duct stones膽囊與膽管結(jié)石 等。4、Pancreatic diseases胰腺疾病Pancreatic cancer胰腺癌、Acute pancreatitiscomplicated with abs

3、cess 急性胰腺炎合并膿腫等。5、Acute infectious disease急性傳染病Severe hepatitis重癥肝炎等。6、Blood disease血液病白血病Leukemia 、血小板減少性紫癜、過敏性紫癜、血友病等7、Others：Uremia尿毒癥 、Pulmonary heart disease肺源性心臟病 Clinical manifestation臨床表現(xiàn)1、Hematemesis and melena嘔血與黑便 2、Hemorrhagic shock失血性休克3、Fever發(fā)熱4、Hematological changes血液學(xué)改變5、Azotemia氮質(zhì)血癥

4、Accompanying symptoms伴隨癥狀1、with abdominalpain嘔血伴上腹痛Peptic ulcer消化性潰瘍；Gastric cancer胃癌。2、 with hepatosplenomegaly嘔血伴肝脾腫大Liver cancer肝癌；食管胃底靜脈曲張破裂出血。3、with mucocutaneous bleeding嘔血伴皮膚黏膜出血血液病、敗血癥、Severe hepatitis重癥肝炎等。4、with jaundice 嘔血伴黃疸5、with enlargement of left praclavicular lymph nodes 嘔血伴左鎖骨上淋巴結(jié)腫

5、大Gastric cancer胃癌、胰腺癌等Interrogation points問診要點(diǎn)1、Eliminate the oral cavity , nasopharyngeal bleeding and hemoptysis.2、The relationship between the cause of hematemesis and diet . Drinking, poison, special drug intake history?3、The amount and color of hematemesis.4、The general condition of the patient

6、.Hematochezia便血 Definitionhematochezia is gastrointestinal (Gl) bleeding excreted from the body via anus.消化道出血經(jīng)肛門排出體外。Pathogeny1.Rectum and Anal canal diseases直腸與肛管疾病 Rectal cancer直腸癌、Rectal polyps 直腸息肉、hemorrhoids痔瘡、Anal fissure肛裂等。2.Colonic diseases結(jié)腸疾病 Colon cancer結(jié)腸癌、Colonic polyps結(jié)腸息肉。3.Small i

7、ntestinal diseases小腸疾病 Intestinal tuberculosis腸結(jié)核 、Tumor腫瘤。Clinical manifestationThe bleeding site出血部位;The amount of bleeding出血量多少;The length of blood stay in the intestinal cavity血液在腸腔內(nèi)停留時(shí)間長短.1、Melena 黑 便 Shiny, black, sticky, foul-smelling stool有光澤，黑色，黏稠，惡臭的糞便 （1）degradation of blood 退化的血 （2）exoge

8、nous stool darkeners外源性黑便 Iron鐵劑 bismuth (鉍劑) 2.fresh bloody stool鮮血便 bright red or maroon blood from the rectum來在直腸的鮮紅色或褐紅色血 Pure blood 純血 blood intermixed with formed stool血與糞便混合形成 bloody diarrhea 血性腹瀉3、Occult 隱 血 detected only by testing the stool with a monoclonal antibody for human hemoglobin 只

9、有與人的血紅蛋白單克隆抗體檢測(cè)糞便Estimate amount of bleeding from upper GI tract 510 ml/d OB + 5070 ml/d Melena 250300 ml in short time Hematemesis Accompanying symptoms1、with abdominal pain便血伴腹痛2、With tenesmus hematochezia便血伴里急后重3、with abdominal mass 便血伴腹部腫塊4、 with fever便血伴發(fā)熱5、with mucocutaneous bleeding便血伴皮膚黏膜出血Interrogation points1.Is there unclean food, medication history and the collective disease?2.The amount and colour of hematochezia.And the relationship to sto