呕血与便血(中英文).ppt

Hematemesis and Hematochezia呕血和便血;Hematemesis 呕血; Definition定义; Pathogeny病因;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 and diet . Drinking, poison, special drug intake history? 3、The amount and color of hematemesis. 4、The general condition of the patient.; Hematochezia 便血; Definition;Pathogeny;Clinical manifestation;1、Melena 黑 便 Shiny, black, sticky, foul-smelling stool有光泽，黑色，黏稠，恶臭的粪便 （1）degradation of blood 退化的血 （2）exogenous stool darkeners外源性黑便 Iron铁剂 bismuth (铋剂) ;2.fresh bloody stool鲜血便 bright red or maroon blood from the rectum来在直肠的鲜红色或褐红色血 Pure blood 纯血 blood intermixed with formed stool血与粪便混合形成 bloody diarrhea 血性腹泻;3、Occult 隐 血 detected only by testing the stool with a monoclonal antibody for human hemoglobin 只有与人的血红蛋白单克隆抗体检测粪便 ;Estimate amount of bleeding from upper GI tract; 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