1、 上消化道大出血Massive Upper Gastrointestinal Bleeding上海交通大学医学院瑞金临床医学院2009Introduce OurselvesDr. Yang&Dr. LiBasic ConceptsWhat Is Massive Bleeding 20% (800ml) blood loss Hemodynamic instability血流动力学不稳 Clinical signs of poor perfusion组织灌注差What Is UGI Esophagus食道 Stomach胃 Duodenum十二指肠 Jejunum空肠 Ileum回肠 Ascen
2、ding Colon升结肠 Transverse Colon横结肠 Descending Colon降结肠 Sigmoid Colon乙结肠 Rectum直肠 Anus肛门Please Remember UGIB is not uncommon in the emergency room Mortality rate is about 10% UGIB is a series of diseases mainly treated by internal medicine. 3-15% require a surgical procedureLets have a problem!Patient Come 45-yr female first episode of hematemesis呕血 transferred from a small hospital 2 units of packed erythrocyte红细胞 tranfused nasogastric tube胃管 introduced with active bleeding pulse 120 bpm, BP 80/40 mmHg