晚期血吸虫病并发上消化道出血20例临床观察及护理

晚期血吸虫病并发上消化道出血，是血吸虫病极为常见的危重症之一。1986年10月至1995年5月，我院收治晚期血吸虫病并发上消化迈出血患者20例，抢救治疗效果比较满意。1临床资料20例患者，男性19例，女性1例，最大年龄64岁，最小年龄18岁，平均41岁，均是来自血吸虫病疫区的渔民     

晚期血吸虫病上消化道出血致左眼失明1例

晚期血吸虫病食管胃底静脉曲张破裂出血在血吸虫病疫区是常见的病症，其并发症较多。但因出血致视力失明尚不多见，最近本院诊治1例。     

139例晚期血吸虫病上消化道出血临床分析

目的：探讨在不同出血量及肝功能状态下治疗食管胃底曲线静脉破裂出血（EVB）的临床效果。方法：139例轻、中、重度EVB分成2组，比较垂体后叶素与一般止血药在不同肝功能状态下的止血率及并发症发生率。结果：重度EVB中垂体后叶素止血率肝功能ChildB级为65．4％，肝功能Child C级为42．0％。并发症发生率肝功能Child B级为26．6％，肝功能Child C级为53．0％。结论：在肝功能Child B级的重度EVB，垂体后叶素仍有价值。     

134例晚期血吸虫病上消化道出血病人的心理评估与护理

为了使护理工作与治疗工作同步 ,探寻病人在患病时的心理变化 ,提出护理问题 ,再制定护理对策。1996～ 2 0 0 0年对我院 134例晚期血吸虫病上消化道出血 (下称“晚血”)的住院病人心理评估与护理 ,收到了较好的效果 ,现报告如下。1　材料与方法1.1　一般资料　本组 134例 ,男 111例 ,女 2 3例 ;年龄 15～ 6 7岁 ,平均年龄 44 .1岁 ;巨脾型 89例 ,腹水型 45例。1.2　心理评估程序设计　根据病人出现的不同心理反应与要求 ,心理评估分以下 4种心理反应 :1情绪激动不稳定型 ;2焦虑恐惧型 ;3悲观失望型 ;4心理稳定型。我们对 134例病人针对以上…     

宜兴市晚期血吸虫病情况调查

宜兴市位于江苏省南部,境内丘陵与水网并存,曾是血吸虫病流行的重疫区之一。为了解本市晚期血吸虫病（以下简称晚血）流行现状,正确评价晚血防治工作,于１９９７年在全市范围内开展了晚血调查。１对象与方法１． １调查对象全市范围内 １９８７年建册的晚血患者以及疑似“新晚血”患者。１．２调查方法１． ２．１　１９８７年在册的所有晚血患者以及各乡（镇）卫生院自查上报的疑似晚血患者,逐个调查。１． ２． ２晚血的诊断标准和临床分型标准以 １９９０年版《血吸虫病防治手册》为依据。临床分型为巨牌型、腹水型、结肠增殖型、侏…     

慢性血吸虫病首发上消化道出血36例

血吸虫病主要分为急性、慢性、晚期及异位血吸虫病几类,其中晚期血吸虫病（晚血）分巨脾型、腹水型、结肠增厚型、侏儒型。笔者接触了一些首先以上消化道出血就诊而确诊的血吸虫病患者（其中诊断为晚血者未列入）,按传统分类临床诊断为慢性血吸虫病,但此类病例的病情严重程度又必须引起高度重视,为此,收集资料完整的36例分析如下。     

应用三腔二囊管抢救晚期血吸虫病上消化道出血的护理

晚期血吸虫病肝纤维化、门脉高压症并发食管胃底静脉曲张破裂出血病情危急,病死率高。三腔二囊管压迫止血是临床抢救晚期血吸虫病上消化道出血的重要措施之一,止血效果肯定,广泛用于药物难以控制时的暂时使用,为争取抢救病人赢得时间。     

门-体分流程度评估血吸虫病肝硬化上消化道出血的应用

目的探讨门-体静脉分流程度在评估血吸虫病肝硬化上消化道出血中的应用。方法以金山医院经临床证实的33例血吸虫病肝硬化上消化道出血患者,及29例血吸虫病肝硬化非出血患者为研究对象,对其进行上腹部128层螺旋CT扫描。采用薄层块最大强度投影(TSMIP)、多平面重建(MPR)对门静脉系进行血管重建,对两组患者门-体静脉分流程度进行评分和比较,分析各侧支血管分流程度与血吸虫病肝硬化上消化道出血的关系。结果 33例上消化道出血患者中,侧支血管发生率如下:胃左静脉曲张86.4%、胃短静脉曲张68.2%、食管静脉曲张50.0%、食管旁静脉曲张50.0%、胃底静脉曲张37.9%、胃肾静脉69.7%、脾肾静脉51.5%、腹壁静脉曲张25.8%、网膜静脉曲张15.2%、脾周静脉曲张63.6%、附脐静脉曲张34.8%、腹膜后-椎旁静脉40.9%、肠系膜静脉曲张36.4%。出血组食管静脉、食管旁静脉、胃左静脉和胃底静脉的发生率和分流程度均明显大于非出血组(P值均0.05)。结论 CT门静脉系成像可精确显示各类侧支血管的部位、程度及走向。食管静脉、食管旁静脉、胃左静脉和胃底静脉能较准确地预测血吸虫病肝硬化上消化道出血的风险情况,上述侧支血管分流程度越高,上消化道出血危险性就越大。     

Pantoprazole-induced thrombocytopenia in patients with upper gastrointestinal bleeding

Proton pump inhibitors (PPIs) are highly effective drugs for patients suffering from peptic ulcer and gastro-esophageal reflux diseases, but recent studies have indicated possible risks with the long-term use of PPIs, such as osteoporosis, fractures, increased risk of pneumonia, diarrhea, iron and vitamin B12 deficiencies. There are publications written as a case study that indicate thrombocytopenia as side effects of PPIs, but there is no study on this subject. This study aimed to investigate the development of thrombocytopenia in patients with short-term use of PPI-infusion therapy. In this study, the records of the patients were evaluated retrospectively, for the period between January 2012 and January 2013. Thirty-five patients with upper gastrointestinal bleeding were enrolled. Platelet counts were analyzed before treatment, and on the first, second and third day of treatment, respectively. All patients were treated with intravenous pantoprazole. Hemogram values of patients were analyzed before and after PPI infusion treatment. Platelet counts were found to decrease from the first day to the third day of treatment (249?714.29/µl, 197?314.29/µl, 193?941.18/µl, 183?500/µl, respectively). The platelet count decrease was statistically significant (p?<?0.001). After cessation of infusion therapy, platelet counts began to rise on the fourth day. Three patients had severe thrombocytopenia on the third day of the treatment. (69?000/µl, 97?000/µl and 49?000/µl respectively). Platelet counts recovered after discontinuation of treatment. In conclusion, this study demonstrates that PPIs may cause thrombocytopenia, and this result should not be ignored. In particular, patients with PPI infusion therapy should be monitored more closely.     

门奇断流术救治晚期血吸虫病合并上消化道大出血

食管胃底曲张静脉破裂致上消化道大出血是晚期血吸虫病常见的并发症之一,其发病急骤,来势凶猛,死亡率高,第一次大出血死亡率即可高达25％,再出血者死亡率更高。本症是晚期血吸虫病患者死亡的主要原因之一。急诊手术死亡率可高达50％,因其手术风险高,手术难度相对较大,致使实施手术的病例数较少。本院实施急诊门奇断流术救治24例晚期血吸虫病合并食管胃底曲张静脉破裂大出血患者,报告如下。     

Aortic stenosis associated with gastrointestinal bleeding. A survey of 612 patients

A retrospective study was done in order to examine the association between aortic stenosis (AS) and gastrointestinal tract (GIT) bleeding. Four groups of patients included a group of 152 patients with AS, a control group of 152 patients with MS, and another two groups of 154 patients each with and without GIT bleeding. GIT bleeding of known and of idiopathic sources was significantly more prevalent among patients with AS (three and four patients, respectively) than among those with MS (none). Moreover, AS was significantly more prevalent in association with idiopathic GIT bleeding (seven out of 24, 29.1%), in comparison to its association with bleeding from a known source (two out of 130, 1.5%), and its incidence in routinely admitted patients without GIT bleeding (three out of 154, 1.9%). This study supports the assumption that GIT bleeding may be associated with AS.     

奥曲肽与垂体后叶素联合治疗血吸虫性肝硬化上消化道出血

奥曲肽与垂体后叶素联合治疗血吸虫性肝硬化上消化道出血疗效显著,不良反应较少。     

泮托拉唑钠粉针剂治疗上消化道出血疗效观察

目的　评价泮托拉唑钠 (诺森 )粉针剂对消化性溃疡所致的上消化道出血的疗效和安全性 ,并与奥美拉唑 (洛赛克 )粉针剂作对照。方法　选择消化性溃疡出血患者 90例 ,泮托拉唑治疗组 60例 ,其中胃溃疡 (GU) 2 4例 ,十二指肠球部溃疡 (DU) 33例 ,糜烂性胃炎 3例。奥美拉唑对照组 30例 ,其中GU 9例 ,DU 1 6例 ,糜烂性胃炎 5例。治疗方法 :分别用泮托拉唑或奥美拉唑 80mg加入 5 %葡萄糖液 2 50ml内 ,静脉滴注 (30～ 60min) ,1次 /d ,共 5d。观察生命体征与出血情况的改变。结果　两组出血情况差异无显著性 (P >0 .0 5)。治疗后 3d内泮托拉唑组有 51例止血 (85 % ) ,奥美拉唑组有 2 4例止血 (80 % ) ;4～ 5d内止血分别为 7例 (1 1 .7% )和 5例 (1 6 .7% )。止血显效率 ,泮托拉唑组为 85 % ,奥美拉唑组为 80 % ,治疗总有效率两组均为 96 .7%。两组各有 1例出现恶心症状 ,不良反应发生率分别为1 .7%和 3 .4%。结论　泮托拉唑钠粉针剂是治疗消化性溃疡出血安全、有效的药物