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Jingdong book

消化系统急难重症病情评估与处理

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Jingdong book

消化系统急难重症病情评估与处理

Name: 消化系统急难重症病情评估与处理
Brand: Jingdong book
SKU: 3117007411
Price: 43.80 USD
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Content Description

《消化系统急难重症病情评估与处理》注重介绍临床资料的收集与分析要点，按照程序思维进行诊断和病情评估。特别强调对患者全面情况进行评估，包括对病情轻重、急缓等做出正确的评估与诊断，参照疾病诊治标准，制定出经济、合理、有效的治疗方案。考虑到有些观点还存在争议，有些学术思想还不成熟，《消化系统急难重症病情评估与处理》在每个章节最后提出诊治的难点与对策，希望能帮助临床医生和研究生了解和掌握新的研究动态，提高对消化系统急难重症的诊治水平。

Catalogue

上篇消化系统急性症状的分析与处理及其诊治技术
第一章恶心呕吐的病情评估及其诊治策略
第二章急性腹痛危重征象的早期识别与初步处理
第三章急性腹泻的病情评估与处理
第四章黄疸鉴别诊断及相关急重征象识别
第五章急性消化道出血的接诊处理与病情评估
第六章消化系统急危重症疾病复苏技术与监测处理
第七章消化道急症用药的要点和评价
第八章消化系统疾病急症化验检查与分析
第九章急症消化疾病影像学检查与结果解读
第十章急诊消化系统疾病的介入治疗
第十一章急诊消化内镜的临床应用
第十二章消化内镜诊治的并发症及处理

下篇消化系统急性重病的病情评估与处理
第十三章食管异物损伤的识别与处理
第十四章急性胃肠道穿孔的识别与处理
第十五章肠梗阻的内科诊治方法与病情评估
第十六章非静脉曲张性上消化道出血病情评估与处理
第十七章食管静脉曲张出血病情评估与防治
第十八章急性肠系膜缺血的早期诊断及临床处理
第十九章未明原因消化道出血诊治技术及其个体化抉择
第二十章重症急性胰腺炎的病情评估与处理
第二十一章急性肝衰竭病情评估与处理
第二十二章肝性脑病病情评估与处理
第二十三章肝硬化腹水和自发性细菌性腹膜炎处理的难点与争议
第二十四章肝肾综合征鉴别诊断和防治对策
第二十五章急性胆道系统感染的病情评估与处理
第二十六章重症溃疡性结肠炎并发症的识别与处理
第二十七章克罗恩病的临床判别与处理

Book Abstract

5.腹痛的性质与强度突发的疼痛，疼痛呈阵发性绞痛，疼痛持续时间长短不一，常提示机械性原因，如空腔脏器梗阻或痉挛、穿孔或急性缺血等；起病相对缓慢的腹痛，疼痛呈持续性钝痛或隐痛，多提示腹内炎症或出血性病变，如阑尾炎、急性胰腺炎或者胆囊炎等；持续性腹痛伴阵发性加重提示炎症和梗阻并存，如肠梗阻发生绞窄，胆结石合并胆道感染等。当然，上述不同规律的腹痛可以出现在同一疾病的不同病程中，可以互相转化。
6.加重或减轻的因素十二指肠溃疡疼痛在进食或服用抑酸剂后可好转，胃溃疡疼痛进食后加重。呕吐后缓解提示幽门或者近端小肠病变。与此相反，复发性或进行性呕吐往往提示机械性肠梗阻。结肠疼痛可在排便后减轻。腹膜后疾病，如胰腺炎，在特定的体位，如坐位或前屈位时，腹膜的空间增大疼痛可以减轻。急性腹膜炎疼痛静卧时减轻，腹壁加压或改变体位时加剧，患者拒按，而铅绞痛时患者喜按。
7.伴随症状
（1）厌食：厌食几乎伴随所有急性腹痛，但是并不具有特异性。泌尿系统及生殖系统病变时很少出现厌食。
（2）恶心呕吐：可以由胃肠道本身的疾病引起，也可以由胃肠外的疾病引起。恶心呕吐先于腹痛者，多见于内科疾病；恶心呕吐发生于腹痛之后，多见于腹内炎症和梗阻性疾病。急性胃肠炎早期即频繁呕吐；急性阑尾炎常在腹痛3-4小时后出现。高位小肠梗阻呕吐出现早且频繁；低位小肠或结肠梗阻出现晚或不出现。呕吐物为宿食，不含胆汁见于幽门梗阻，呕吐物混有胆汁提示梗阻部位在十二指肠乳头以下。呕吐物为粪水样，常为低位肠梗阻。
（3）排便情况：便秘可能是既往健康习惯的征象，或者为疾病进展的表现，如肠梗阻或者穿孔等疾病发展的并发症；顽固性便秘伴有机械性梗阻；水样腹泻提示急性胃肠炎；血性腹泻提示肠道炎症性病变的加重，肠系膜缺血或者肠系膜血栓形成。
（4）寒战高热：提示感染性疾病，如：急性化脓性胆道炎、腹腔脏器脓肿、大叶性肺炎等。
（5）腹胀：常见于肠梗阻，尤其是麻痹性肠梗阻患者。
（6）尿频尿急尿痛、血尿、排尿困难：提示泌尿系感染或结石。
（7）休克：见于急性腹腔出血、急性化脓性胆道炎症、绞窄性肠梗阻、消化性溃疡穿孔、急性胰腺炎、急性心肌梗死等。
……

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