消化道出血小讲课课件.pptx

徐言;2008年执业医师资格考试试题： →关于上消化道出血的定义，正确的是： A.贲门以上部位出血 B.幽门以上部位出现 C.空肠以上部位出血 D.屈氏韧带以上部位出血 E.十二指肠乳头以上部位出血;Gastrointestinal hemorrhage？Gastrointestinal bleed?(GI bleed), also known as?gastrointestinal hemorrhage, is all forms of?blood?loss from the?gastrointestinal tract, from the?mouth?to the?rectum.;Annual hospital admissions for GI bleeding in the United States andUnited Kingdom have been estimated at up to 150 patients per 100000 population with a mortality rate of 5%-10%[2-5]. ;;DEFINITIONS;DEFINITIONS;;Etiology and pathophysiology;Etiology and pathophysiology;;Initial evaluation; ;Figure 1 Upper endoscopic findings in patients with suspected upper gastrointestinal bleeding. Esophageal varices(A), Dieulafoy’s lesion in the stomach (B), gastric antral vascularectasia (watermelon stomach) in the antrum of the stomach pre and post argon plasma coagulation therapy (C, D).;Colonoscopy;GI bleeding can be caused by a wide range of pathologies and they differ in onset, location, risk and clinical presentation. In patients with active GI bleeding who are unstable, acute resuscitation should precede any investigations. Accurate clinical diagnosis is crucial in determining theinvestigation of choice and specific treatment interventions. The correct diagnostic algorithm relies on a good understanding of the type of GI bleeding, risk evaluation and clinical presentation which may indicatethe nature and source of bleeding. Upper endoscopy and colonoscopy are the mainstay of initial investigations. Angiography and radionuclide imaging are best suited for acute overt GI bleeding. Capsule endoscopy and deep enteroscopy play significant roles in the diagnosis of obscure GI bleeding, usually from the small bowel.;本文章深入浅出的对消化道出血的诊断思路做出了简略的介绍，有着对以前书本知识的巩固，也有着新知识的融入。 希望本次文献阅读能够给大家一个更崭新的诊疗方向，使大家对于疾病有更深更细致的分类和理解，也能够由此展开更为针对性的治疗，并改善患者的预后。 疾病不分难易，但生命有长短。哪怕是知识的一点点更新，???是对自身的提高，更为生命的救治打下了基础。读书育人，空气养人，希望这份简单的PTT是温故知新，也能够启发大家去探索、查找更多的知识。