上消化道出血消化内科专家讲座.pptx

定义(Definition)病因(Etiology)常见上消化道出血病因临床表现(ClinicalManifestation)呕血(Hematemesis)与黑便(Melena)失血性周围循环衰竭(Circulatoryfailureduetobloodloss)发烧(fever)氮质血症血象改变诊疗(Diagnosis)上消化道出血诊疗出血部位出血量预计怎样判断活动性出血或再出血上消化道出血诊疗方法esophagealvaricesbloodingulcerblooding判别诊疗上、下消化道出血判别______________________________________________________________________上消化道出血下消化道出血_____________________________________________________________________既往史多有溃疡病、肝胆疾病曾有下腹疼痛、包块及排便或呕血史异常(腹泻、便秘)史或便血史出血先兆上腹胀、疼痛或绞痛中下腹不适或下坠、欲排大便恶心、反胃出血方式呕血伴柏油便便血、无呕血便血特点柏油样便、稠或成形暗红或鲜红、稀多不成形无血块量大时可有血块______________________________________________________________________呕血与咯血判别_____________________________________________________________________咯血呕血____________________________________________________________________病史肺结核、支扩、心脏病溃疡病、肝硬化出血方式咳出呕出出血前症状常有喉痒、咳嗽、胸闷恶心、呕吐、上腹不适或痛血内混有物气泡及痰食物及胃液颜色鲜红暗红或咖啡色血液反应碱性酸性黑便无(咽下后有)有除外进食所致黑便治疗标准普通治疗禁食Fasting补充血容量补液量是否充分判断药品止血治疗药品止血治疗非外科手术止血治疗三腔二囊管压迫止血其它治疗