内科学课件-胃炎
55页1、1 Gastritis 2 Definition Gastritisistheinflammationofvariousfactorsstimulatethegastricmucosa CategoriesAcutegastritisChronicgastritisSpecialtypeofgastritis 3 SectionIAcuteGastritis 4 Summarizeacutegastritisalsocallederosivegastritis hemorrhagicgastritis acutegastricmucosalesion Gastroscopeexamination gastricmucosaerosion bleedingHistology acuteinflammationofthegastricmucosa 5 etiologyandpathogenesis 1 StressInthestressstate itcancausegastricmucosalerosionandbleeding suchasseveretrauma majorsurge
2、ry largeareaburnandintracraniallesion shock sepsisandmultipleorganfailure MOF 6 mechanism gastricmucosamicrocirculationdysfunction hypoxia mucussecretiondecreased locallackofprostaglandinsynthesis barrierfunctionisdamaged gastricacidsecreteincreased 7 etiologyandpathogenesis 2 Drugnon steroidanti inflammatorydrug NSAID suchasaspirin acetaminophen 对乙酰氨基酚 etc Someanti tumormedicine potassiumchlorideliquid chalybeate etc NSAIDblocksprostaglandinsynthesisbyinhibitingthecyclooxygenase COX COX 1helpto
3、epithelialcellstorepair COX 2promotesinflammationmedium 8 etiologyandpathogenesis 3 AlcoholAlcoholwithlipotropyandfatsoluble candestroythebarrierofgastricmucosadirectly 4 Traumaandphysicalfactorsplacedstomachtube vomiting stomacheyewinker 异物 polyp 息肉 excisionundergastroscope etc 9 5 DuodenogastricrefluxAbnormalgastricdynamics Pyloricsphincterdysfunction billroth operation6 Gastricmucosabloodcirculationobstacleportalhypertensivegastropathy PHG 10 clinicalfeatureMostpatientsisasymptomatic Afewpati
4、entshaveepigastricdiscomfort nauseaandvomiting Itcanoccursuddenlyhematemesisand ormelaena evenmassivehemorrhageoftheupperalimentarytract whichaccountsforabout10 25 casesofuppergastrointestinalbleeding sign slight 11 DiagnosisDiagnosisdependsonthehistoryandclinicalfeature andconfirmeddiagnosisdependsonendoscopicexamination 12 Askingmedicalhistorytodeterminethecause Manystressescausedbythestresshistory whichisthemainperformanceofuppergastrointestinalbleeding Endoscopicexaminationshowedmultipleeros
5、ions acutesuperficialulcer hemorrhageandmucosaledema etc 13 14 AcuteGastricMucosalLesions 15 Differentialdiagnosis pepticulceresophogealvaricesgastriccarcinoma 16 Treatment1 Removethecause2 Drugsinhibitinggastricacidsecretion protonpumpinhibitors PPI orH2receptorantagonist 3 Gastricmucosaprotectiveagent sucralfate misoprostol bismuthagent etc 17 Prognosis Mostofthegastricmucosalerosionandbleedingcanhealitself andafewdevelopintoulcers 18 Prevention 1 stoppingNSAID2 Ifunderthestressstateorneedlong
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