资源描述：
《呕血便血(诊断学9版-2学时-)ppt课件.ppt》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。
1、石国庆主任医师《诊断学》消化系统疾病诊断学第9版呕血与便血Hematemesisandhematochezia第十二节呕血（P31）Haematemesis呕血：是上消化道疾病或全身性疾病所致的上消化道出血，血液经口腔呕出。Hematemesisisuppergastrointestinalbleedingcausedbyuppergastrointestinaldiseases(digestiveorgansabovetheflexor'sligament,includingesophageal,gastric,
2、duodenal,hepatic,biliary,pancreaticdiseases)orsystemicdiseases.Bloodisvomitedthroughthemouth.定义Definition指Treitz韧带以上的消化器官,包归食管、胃、十二指肠、肝、胆、胰疾病。病因pathogeny一、上消化道疾病Upperdigestivetractdiseases1、食管疾病：食管炎、食管癌、Mallory-Weiss综合征等。Esophagealdiseases:esophagitis,esophage
3、alcancer,Mallory-Weisssyndromeandsoon.2、胃、十二指肠疾病：消化性溃疡、急性糜烂出血性胃炎、胃癌等。Gastroduodenaldiseases:pepticulcer,acuteerosivehemorrhagicgastritis,gastriccancerandsoon.3、门脉高压:食管胃底静脉曲张破裂或门脉高压性胃病。Portalhypertension:bleedingfromesophagogastricvaricesorportalhypertensivegas
4、tropathy.二、上消化道邻近器官疾病：肝胆、胰腺疾病。Upperdigestivetractadjacentorgandiseases:hepatobiliaryandpancreaticdiseases.病因pathogeny三、全身性疾病Systemicdisease（1）血液病：过敏性紫癜、白血病、凝血机制障碍性疾病等。Hematologicaldiseases:allergicpurpura,leukemia,coagulationdisorders,andsoon.（2）感染性疾病：流行性出血热、钩
5、体病、败血症、爆发性肝炎等。Infectiousdiseases:epidemichemorrhagicfever,leptospirosis,septicemia,fulminanthepatitisandsoon.病因pathogeny（3）结缔组织病等：系统性红斑狼疮（SLE）、皮肌炎、结节性多动脉炎累及上消化道。Connectivetissuedisease,suchassystemiclupuserythematosus(SLE),dermatomyositis,nodularpolyarteritisi
6、nvolvingtheuppergastrointestinaltract.（4）其他：尿毒症、肺心病等。Others:uremia,pulmonaryheartdiseaseandsoon.病因pathogeny常见病因commonetiology消化性溃疡Pepticulcer食管胃底静脉曲张破裂Esophagealandgastricvaricesbleeding急性糜烂出血性胃炎Acuteerosivehemorrhagicgastritis胃癌gastriccancer消化性溃疡EGVB急性糜烂出血性胃炎
7、胃癌常见病因commonetiology食管贲门粘膜撕裂Mallory-Weisssyndrome食管溃疡Esophagealulcers其他病因Othercauses恒径动脉破裂Dieulafoydisease胃肠间质瘤Gastrointestinalstromaltumor（GIST）其他病因Othercauses毕II式术后出血BillrothIIpostoperativebleeding门脉高压性胃病Portalhypertensivegastropathy其他病因Othercauses胆道出血Biliar
8、ytracthemorrhageEST术后出血BleedingafterEST其他病因Othercauses临床表现Clinicalmanifestation1.呕血与黑便Hematemesisandmelena:特征性表现。呕血：可为鲜红色、暗红色或咖啡色（棕褐色）Hematemesis:brightred,darkredorbrown.黑便：血液经肠道排
