HematemesisandHematochezia嘔血和便血TheprofessionalstaffroomRainnyLinHematemesis嘔血Definition定義

Hematemesisisthevomitingofblood.血液從口腔嘔出。

※3、Hepatobiliarydiseases肝膽疾病Livercirrhosisandportalhypertension肝硬化門(mén)脈高壓、Livercancer肝癌、Liverabscess肝膿腫、Gallbladderandbileductstones膽囊與膽管結(jié)石等。4、Pancreaticdiseases胰腺疾病Pancreaticcancer胰腺癌、Acutepancreatitiscomplicatedwithabscess急性胰腺炎合并膿腫等。5、Acuteinfectiousdisease急性傳染病Severehepatitis重癥肝炎等。6、Blooddisease血液病白血病Leukemia、血小板減少性紫癜、過(guò)敏性紫癜、血友病等7、Others：Uremia尿毒癥、Pulmonaryheartdisease肺源性心臟病Clinicalmanifestation臨床表現(xiàn)1、Hematemesisandmelena嘔血與黑便2、Hemorrhagicshock失血性休克※Accompanyingsymptoms伴隨癥狀1、withabdominalpain嘔血伴上腹痛Pepticulcer消化性潰瘍；Gastriccancer胃癌。2、withhepatosplenomegaly嘔血伴肝脾腫大Livercancer肝癌；食管胃底靜脈曲張破裂出血?！?、withmucocutaneousbleeding嘔血伴皮膚黏膜出血血液病、敗血癥、Severehepatitis重癥肝炎等。4、withjaundice嘔血伴黃疸5、withenlargementofleftpraclavicularlymphnodes嘔血伴左鎖骨上淋巴結(jié)腫大Gastriccancer胃癌、胰腺癌等Interrogationpoints問(wèn)診要點(diǎn)1、Eliminatetheoralcavity,nasopharyngealbleedingandhemoptysis.2、Therelationshipbetweenthecauseofhematemesisanddiet.Drinking,poison,specialdrugintakehistory?3、Theamountandcolorofhematemesis.4、Thegeneralconditionofthepatient.※

Definitionhematocheziaisgastrointestinal(Gl)bleedingexcretedfromthebodyviaanus.消化道出血經(jīng)肛門(mén)排出體外?！鵓athogeny1.RectumandAnalcanaldiseases直腸與肛管疾病

Rectalcancer直腸癌、Rectalpolyps直腸息肉、hemorrhoids痔瘡、Analfissure肛裂等。2.Colonicdiseases結(jié)腸疾病

Coloncancer結(jié)腸癌、Colonicpolyps結(jié)腸息肉。3.Smallintestinaldiseases小腸疾病

Intestinaltuberculosis腸結(jié)核、Tumor腫瘤?！鵆linicalmanifestation

Thebleedingsite出血部位;

Theamountofbleeding出血量多少;

Thelengthofbloodstayintheintestinalcavity血液在腸腔內(nèi)停留時(shí)間長(zhǎng)短.※2.freshbloodystool鮮血便brightredormaroonbloodfromtherectum來(lái)在直腸的鮮紅色或褐紅色血Pureblood純血bloodintermixedwithformedstool血與糞便混合形成bloodydiarrhea血性腹瀉3、Occult隱血

detectedonlybytestingthestoolwithamonoclonalantibodyforhumanhemoglobin只有與人的血紅蛋白單克隆抗體檢測(cè)糞便EstimateamountofbleedingfromupperGItract5~10ml/dOB+50~70ml/dMelena

250~300mlinshorttimeHematemesis

Interrogationpoints

1.Isthereuncleanfood,medicationhistoryandthecollectivedisease?2.Theamountandcolourofhematochezia.Andtherelationshiptostool.3.Thegeneralcon