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href="http://thedailypurge.net" title="醫(yī)學(xué)教育網(wǎng)" class="a1">醫(yī)學(xué)教育網(wǎng)</a> </div> <a href="javascript:void(0)" onclick="window.external.AddFavorite(location.href,document.title);" target="_self" class="collection ico fr"></a>  <div id="0cg8yai" class="fen fr">|</div> <div id="88igem8" class="font_size fr ico"><a href="javascript:void(0);" target="_self" class="big lan ico">大</a><a href="javascript:void(0);" target="_self" class="small ico">小</a></div> </div> </div> </div>   <div id="gwmckom" class="news_con"> <div id="m8uomy8" class="jxbox clearfix"> <p><strong></strong></p> <p>嘔血的病因是全科主治醫(yī)師考試需要掌握的內(nèi)容，醫(yī)學(xué)教育網(wǎng)小編為大家整理匯總?cè)缦?，希望可以幫助大家?fù)習(xí)掌握。 </p> <p><strong></strong></p> <p><strong>1.急性<a href="http://thedailypurge.net/jibing/weiyan/" target="_blank" title="胃炎" class="hotLink" >胃炎</a> </strong></p> <p><strong></strong></p> <p>最常見(jiàn)的表現(xiàn)為嘔血和黑便。盡管有上腹部不適、惡心、發(fā)熱，但它們也可是<font style="BACKGROUND-COLOR: #ffd700">唯一</font>表現(xiàn)。大量血液丟失可引起休殼。典型的患者有酗酒史、應(yīng)用阿司匹林或其他非甾體類藥物史。胃炎也可以因幽門(mén)螺桿菌感染引起。 </p> <p><strong></strong></p> <p><strong>2.胃食管反流病 </strong></p> <p><strong></strong></p> <p>該病嘔血少見(jiàn)，常伴有胃部灼熱感、腹脹，消化不良和反流，躺下或前屈時(shí)加重。重度食管炎時(shí)可出現(xiàn)吞咽困難、胸骨后絞痛、體重降低和誤吸表現(xiàn)如嗆咳、呼吸困難和反復(fù)肺部感染。 </p> <p><strong></strong></p> <p>3.Mallory-Weiss綜合征即賁門(mén)黏膜撕裂 </p> <p><strong></strong></p> <p>該病特征是胃和食管連接部黏膜撕裂，導(dǎo)致嘔血和黑便。通常因嚴(yán)重的嘔吐、干嘔或是<a href="http://thedailypurge.net/jibing/kesou/" target="_blank" title="咳嗽" class="hotLink" >咳嗽</a>加重，尤其在酗酒者或幽門(mén)梗阻的患者中易發(fā)生。嚴(yán)重的出血之后可有休克表現(xiàn)，如心動(dòng)過(guò)速、低血壓、呼吸困難和皮膚濕冷。 </p> <p><strong></strong></p> <p><strong>4.消化性潰瘍 </strong></p> <p><strong></strong></p> <p>當(dāng)消化性潰瘍穿透動(dòng)脈、靜脈或富含血管的組織，可引起嘔血。當(dāng)動(dòng)脈被穿透時(shí)可引起威脅生命的大出血。伴有黑便、便血、寒戰(zhàn)、發(fā)熱和休克、脫水的表現(xiàn)（如心動(dòng)過(guò)速、低血壓、皮膚血管充盈差以及口渴）。多數(shù)患者有惡心、嘔吐、上腹部疼痛等病史，進(jìn)食或服用抗酸藥物后緩解。部分患者有飲用咖啡、酗酒或應(yīng)用非甾體類藥物史。 </p> <p><strong></strong></p> <p><strong>5.急性憩室炎及繼發(fā)性梅毒 </strong></p> <p><strong></strong></p> <p>當(dāng)急性憩室炎累及十二指腸可發(fā)生消化道出血和反復(fù)的嘔血，可伴有腹痛和發(fā)熱。繼發(fā)性梅毒累及消化道也可引起嘔血，常見(jiàn)的表現(xiàn)有原發(fā)性軟下疳、皮疹、發(fā)熱、厭食、體重降低和<a href="http://thedailypurge.net/jibing/toutong/" target="_blank" title="頭痛" class="hotLink" >頭痛</a>。 </p> <p><strong></strong></p> <p><strong>6.瘧疾及黃熱病 </strong></p> <p><strong></strong></p> <p>瘧疾可引起嘔血和其他消化系統(tǒng)表現(xiàn)，但典型的表現(xiàn)為寒戰(zhàn)、發(fā)熱、頭痛、肌痛、脾大。黃熱病也可引起嘔血和突然發(fā)熱、心動(dòng)過(guò)緩，黃疸以及虛脫。 </p> <p><strong></strong></p> <p><strong>7.其他病因 </strong></p> <p><strong></strong></p> <p>留置鼻管或氣管插管可引起與吞咽血液有關(guān)的嘔血。鼻或咽部手術(shù)也可引起相同表現(xiàn)。 </p> <p><strong></strong></p> <p>想要了解更多2020年全科主治醫(yī)師考試相關(guān)資訊歡迎關(guān)注醫(yī)學(xué)教育網(wǎng)2020年全科主治醫(yī)師考試欄目！這里有2020年全科主治醫(yī)師考試政策動(dòng)態(tài)、資料及備考技巧，助力你的2020年全科主治醫(yī)師考試備考！</p> <p>相關(guān)推薦：<a href="http://thedailypurge.net/quankezhuzhi/ziliao/sh1908168390.shtml" target="_blank"><font color="#0000ff">嘔血的病因與常見(jiàn)疾病（一）</font></a></p><div 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