推荐回答(5个)
消化道分为上消化道和下消化道,以十二指肠为界分为上、下消化道。消化道的任何一个部位发生出血都可称之为消化道出血。但是,消化道出血量的多少不同,其临床表现也不同。如果出血量较小,在5-10ml,肉眼看不见明显出血,但在镜下可看见,其大便潜血呈阳性;如果出血量在50-100ml,大便可呈柏油样;如果出血量在250-300左右,那往往就会有呕血的表现;若出血量再大超过1000ml可能就会出现休克,而出现心慌、头晕、出冷汗等循环衰竭表现。引起消化道出血的原因很多,但是常见的就是消化道溃疡出血、食管胃底静脉曲张破裂出血、结肠一些粘膜病变等,还有一次性大量饮酒等也会引起急性上消化道出血。有些患者出血症状不明显,可能仅有些腹部不适,或仅有大便异常,但是查粪便常规显示潜血阳性,这种情况下应该再多查几次潜血,如果都是阳性,应进一步检查,不要忽视。
1.呕血与黑粪
是上消化道出血的特征性表现。上消化道大量出血之后,均有黑粪。出血部位在幽门以上者常伴有呕血。呕血多棕褐色呈咖啡渣样;如出血量大,未与胃酸充分混合即呕出,则为鲜红或有血块。黑粪呈柏油样,黏稠而发亮。高位小肠出血乃至右半结肠出血,如血在肠腔停留较久亦可呈柏油样。
2.失血性周围循环衰竭
急性大量失血由于循环血容量迅速减少而导致周围循环衰竭。表现为头昏、心慌、乏力,突然起立发生晕厥、肢体冷感、心率加快、血压偏低等。严重者呈休克状态。
3.贫血和血象变化
急性大量出血后均有失血性贫血,但在出血的早期,血红蛋白浓度、红细胞计数与血细胞比容可无明显变化。
急性出血患者为正细胞正色素性贫血,在出血后骨髓有明显代偿性增生,可暂时出现大细胞性贫血,慢性失血则呈小细胞低色素性贫血。出血24小时内网织红细胞即见增高,出血停止后逐渐降至正常。
4.发热
消化道大量出血后,部分患者在24小时内出现低热,持续3~5天后降至正常。引起发热原因尚不清楚,可能与周围循环衰竭导致体温调节中枢的功能障碍等因素有关。
5.氮质血症
由子大量血液蛋白质的消化产物在肠道被吸收,血中尿素氮浓度可暂时增高,称为肠源性氮质血症
消化道出血是指十二指肠屈氏韧带以上的出血,最常见的病因学包括消化性溃疡、急性胃黏膜病变、食管胃底静脉曲张破裂以及胃癌;
症状有包括第一是黑便或呕吐咖啡色样物,如出血量比较大会是柏油样的大便;第二个是休克或休克前的症状,如短时间内大量出血会出现低血压、脉搏弱、心慌乏力、头晕等休克前或休克症状;第三个是发热,是出完血后体温调节中枢的上调;第四个是肠源性的氮质血症,这时大生化检查发现肌酐正常,而尿素氮升高;第五个是贫血,如短时间内大量失血,最直接观察是血红蛋白的降低;第六其他的症状要根据患者相关的原发疾病的不同,而有不同的表现,比如消化性溃疡,会有腹痛症状。
病情分析:消化道出血的表现有:1、有可能会导致呕血的症状。2、会导致黑便的症状。3、现在严重的情况下会导致血液循环衰竭,严重的情况下还会引起生命危险。当消化道出血的时候要积极的配合医生使用些药物或者是手术的方法来进行治疗,也做到早发现早治疗。如果严重最好到医院做检查,明确原因再针对病因进行治疗,平时注意少吃辛辣刺激等不易消化的食物,可以口服吗丁啉,奥美拉唑,鸡内金片等治疗,多锻炼身体。
消化道出血表现为呕血、黑便和便血。临床上上消化道出血较为常见,主要表现为:
1、呕血、黑便;
2、失血性周围循环衰竭:出现头晕、乏力、心率加快、血压下降等周围循环衰竭表现;
3、贫血和血象变化:失血量较大时可出现贫血;
4、发热:周围循环衰竭对体温中枢产生影响,出现障碍导致发热;
5、肠源性氮质血症:肠道蛋白物质在肠道大量吸收,导致血中尿素氮增加,出现肠源性氮质血症。
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