论文部分内容阅读
女患,43岁。半年来时有餐后上腹隐痛,10小时前突感上腹不适、恶心,进而呕吐咖啡色液体约800ml,解柏油样大例300g。心悸、口干、乏力,于1986年9月10日17时急诊入院。否认肝病史。体检:血压16/8.8kPa。贫血貌。心率90次。上腹部轻度压痛,肝脾未扪及。Hb40g/L。RBC2.19×10~(12)/L。大便潜血试验强阳性。拟诊“消化性溃疡出血”,即按上消化道出血常规处理。21时又呕血200ml,内混血凝块,并解柏油样大便200g。血压13.5/8kPa,心率100次。急诊胃镜检查:胃内沉积大量咖啡色液体,幽门管前壁见一卵圆形、黄豆大小、根部略细之赘生物,鲜血不断自根部外渗,余无特殊。经胃镜局部反复喷洒去甲肾上腺素,渗血停止。次日13时,心
Female, 43 years old. Six months after a meal pressure abdominal pain, sudden sensation 10 hours ago abdominal discomfort, nausea, and vomit brown liquid about 800ml, solution-like large sample 300g. Palpitations, dry mouth, fatigue, at 17 o’clock on the September 10, 1986 emergency admission. Denied the history of liver disease. Physical examination: blood pressure 16 / 8.8kPa. Anemia look. Heart rate 90 times. Mild tenderness on the abdomen, liver and spleen not palpable. Hb40g / L. RBC2.19 × 10 ~ (12) / L. Strong fecal occult blood test. The proposed diagnosis of “peptic ulcer bleeding”, that is, according to the upper gastrointestinal bleeding routine treatment. 21:00 and hematemesis 200ml, mixed blood clots, and relieve tarry stool 200g. Blood pressure 13.5 / 8kPa, heart rate 100 times. Emergency gastroscopy: a large number of brown liquid deposited in the stomach, pyloric anterior wall see an oval, soy size, root slightly thin neoplasms, blood continuously from the root of extravasation, I no special. Repeatedly by endoscopy spraying norepinephrine, bleeding stopped. 13 o’clock the next day, heart