The artistic methods of the top divisions of the gastrointestinal tract (stomach) to say where the source of bleeding is either gastric, or stomach, or gastrointestinal bleeding (PDK) proksimalnee Treitze bundles. They can be : 1. The immediate : 1. mass; 2. moderately expressed; 3. Light. 2. Underlying (okkultnami). Evaluation criteria krovopoteri The krovopoteri determined by the clinical and laboratorno-instrume Enter Indicators : The 1-krovopotera easy. The general state of the patient was satisfactory. The heartbeat of 80 to 100 in 1 min, arterial pressure (AD) in the rules, the central ORIONE pressure (DVD), 5-15 cm waters. Art. Salt is not reduced. Hhaemoglobin not less than 100 g / l, the deficit volume of circulating blood (BCC) to 20% compared to the proper. The 2-krovopotera average. The general state of the patient moderately, tachycardia to 110 strikes in 1 min, sistolicescoe AD no lower than 90 mm Hg. Art. , a DVD less than 5 cm water. Art. Moderate decline diureza. Hhaemoglobin at least 80 g / l, the deficit BCC - 20-29%. The 3-krovopotera heavy. The general state of the patient difficult sputannoe consciousness, disorientation, with the continued hemorrhage can be a complete loss of consciousness and coma. Tachycardia more than 110 strikes in 1 min, sistolicescoe AD below 90 mm Hg. Art, un-0. Oliguria, metabolic acidosis, the content of hemoglobin less than 80 g / l deficit BCC 30% or more. Once (okkultnoe) haemorrhage, with a planned or accidental, the survey found a degree of anemia in the absence of hemodynamics disorders and respiratory violations. Subjectively the patient often had seen no deviation from the usual "normal" state. Because anemia is not significant and has been slow to develop, the patient to adjust. The initial survey can be found hidden blood in the feces. Etiology Classification, which would allow for the classification of an adequate survey of the patient at the hospital. Moreover, every age with "their" most frequent and rarely encountered causes bleeding. The most frequent causes of bleeding for adults are : * Anthrax KDP; * Erosion stomach and KDP; * varikozno-rasshirenna Neck veins in patients with hypertension gantries with liver disease and acute tromboze in gantries vena cava; * stomach ulcers; * gap eye eludern-pishchevodnyi erekhoda - Mallori-weissa syndrome; * erosivno-yazate ezofagit; * tumors oesophagus, stomach and KDP (especially top Division); * angioma (esophagus, stomach, PDK). Rarely causes bleeding can be attributed : * congenital or acquired arteriovenoznae foetal (there are a large number of different syndromes, the common is that the eye or podslizistoi clad abnormal blood vessels - Randu-osler syndrome, in patients with various diseases, such as heart disease, chronic renal failure, radiation damage, chronic liver disease, kollagenozy, etc.); * divertikula; * chronic inflammatory diseases (including tuberculosis, syphilis, fungal destruction); * acute infectious processes (including acute haemorrhagic gastritis, stomach flegmona); * heart failure (cardiovascular, hematologic, including those that lead to thrombosis, embolism); * radiation damage (often in connection with the exposure of the tumors); * foreign body and injuries; * aortopishchevodnye and gel udern-pankreaticesc e St. care; * acute mucosal damage (drugs, toxic, corrosive substances). * A special feature of bleeding, in the developing nervous defeat corrosive substances are two types of hemorrhage : early (in the acute period), and later (in 1-2 weeks, when it becomes separated necrotizing strup of granulation tissue); ankilostomidozy-parasite larvae penetrate the damaged skin, doing complex migration and KDP become sexually individuals, is fixed to the wall of the bowel and deeply penetrated podslizistuyu shell head end, corrupting receptacles and protravlivaya "a secondary infection. Under this option, a clinical picture of the ulcers, anemia complicated, acute or chronic; * Stressorne ulcer (developing in patients who are in critical situations). Morphologic substrate are erosivno-azwenne defeat nasal most erozivee that 60% compounded bleeding; * Bleeding in the early stages of the stomach POE (from 6 hours to 5 days); * Bleeding from the Pepsi ways (the main reason is the liver tumors with the dissolution of or damage to the blood vessels and discharge through jelchne road gematobilia). Bleeding in children. Until recently, as casuistry.
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