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急性胃粘膜病变(AGML)包括糜烂性胃炎、Cushing氏溃疡、Cufling氏溃疡、应激性溃疡等多种疾患,统称为AGML。有人将其分为出血性胃炎和应激性溃疡两类。其病因主要为严重的创伤、烧伤或感染,中枢神经系统损伤,休克,药物刺激等,就连日常生活中的饮酒或喝浓茶也可诱发之。发病机理尚不清楚,学说繁多,但正常胃粘膜屏障的破坏和H~+逆向弥散是其关键。诊断首先应询问病史,了解有无易患因素,其次应注意有无间歇性出血的特点(AGML常有之)。紧急内窥镜检查(emergencyendosopy)不能确诊时再行动脉造影,x线双重造影排在最后做。①紧急镜检:国外七十年代初已盛行,国内报道24小时内镜检的诊断率为94％,24～48小时内为74.1％,两者差别显著(P<0.05),故强调紧急镜检应及早进行,因为病变可在48小时内完全修复。其并发症并不比常规镜检多。活动性出血的判断
Acute gastric mucosal lesions (AGML) include erosive gastritis, Cushing’s ulcer, Cufling’s ulcer, stress ulcer and many other diseases, collectively referred to as AGML. Some people will be divided into two types of hemorrhagic gastritis and stress ulcer. The main causes of severe trauma, burns or infections, damage to the central nervous system, shock, drug stimulation, even daily drinking or drinking tea can also be induced. The pathogenesis is not clear, the theory is numerous, but the destruction of normal gastric mucosal barrier and H ~ + reverse diffusion is the key. Diagnosis should first ask the medical history, to understand whether there is a risk factor, and secondly, should pay attention to the characteristics of intermittent bleeding (AGML common). Emergency endoscopy (emergencyendosopy) can not be confirmed when the re-arterial angiography, x-ray double contrast ranked last done. ① emergency microscopy: foreign countries have already prevailed in the early seventies, the domestic coverage of 24 hours of microscopic examination was 94%, 24 ~ 48 hours 74.1%, the difference was significant (P <0.05), it stressed the emergency mirror The test takes place early because the lesion can be completely repaired within 48 hours. Its complications are not more than conventional microscopic examination. Determination of active bleeding