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1、1Acute Clinical Analysis of 268 cases of gastric mucosal lesionsAcute gastric mucosal lesions is the body under stress or exposure to certain substances can cause acute gastrointestinal mucosal erosion damage of multiple, often accompanied by bleeding, and even the formation of acute superficial ulc
2、ers, healed lesions are usually not left behind in recent years to due to the widespread application of endoscopy, particularly the emergency endoscopy, the incidence rate increasing, upper gastrointestinal bleeding in patients with a endoscopy and found 268 cases of acute gastric mucosal lesions, a
3、ccounting for 35%, with domestic and international coverage of basic the same. Clinical data 1.1 General information: The group of 268 cases, male 193 cases, female 75 cases, male to female ratio 2.57:1 place, aged 15 to 17 years, mean 40.6 years of age, risk factors: alcohol abuse in 61 cases, taki
4、ng anti-inflammatory pain in 48 cases, A aspirin in 8 cases, adrenal cortex hormones in 19 cases, trauma 2in 4 cases, acute cerebral vascular accident in 16 cases, severe infection in 25 cases, eight cases of various causes of shock, fatigue tired in 12 cases, severe visceral dysfunction in 15 cases
5、, unknown cause in 52 cases. 1.2 Clinical manifestations: In addition to the primary disease other than the above performance-based gastrointestinal bleeding such as hematemesis or melena whose bleeding characterized by seizures often show gaps, few prodromal symptoms, and sometimes there may be abd
6、ominal pain, bloating, heartburn , such as nausea and vomiting hiccups, hematemesis and melena in this group 157 cases of pure black will be 111 cases, bleeding in the 300 2500ml or so. 1.3 gastroscopy: bleeding in this group of patients are 24 to 72 hours for gastroscopy. Endoscopic gastric mucosa
7、could see was a wide range of point-like, flake or spot bleeding, the end of congestion, edema, mucosal erosion or some the formation of acute superficial ulceration, were round, oval, linear, irregular-shaped, etc. often has a sporadic distribution of 3pleomorphic, some necrosis of gastric mucosa s
8、howed a large sheet, mucosal ulceration and bleeding irregular stripping wound above lesions occurred in 46% of the gastric body, gastric 13%, gastric 23%. 1.4 Pathology: In this group of cases, 184 cases of gastric mucosa live for examination, the main pathological changes of blood micro-thin tube
9、mucosal congestion, mucous membrane bleeding, lymphocytes, plasma cells, white blood cell infiltration rare. In the visible erosion and mucosal ulcers at the table epithelial cell loss and necrosis. 1.5 Treatment and prognosis: treatment of the primary disease promptly remove the incentive to improv
10、e tissue perfusion, were treated with norepinephrine, add cold water and oral thrombin, while intravenous injection of H2 receptor antagonist cimetidine or oral mine Nepalese for small or oral omeprazole. oral mucosal protective agent sucralfate, etc., to the hemorrhage and endoscopic hemostatic age
11、nts such as spraying at the norepinephrine, thrombin, etc. hemostasis with thrombin is superior, in combination 4with other integrated treatment of patients with endoscopy .67 gastric lesions did not find any left over. 2 Discussion The clinical manifestations of acute gastric mucosal lesions are ma
12、inly gastrointestinal bleeding, gastric bleeding, erosion, necrosis, or ulcer formation of acute mucosal lesions of the mechanism, though not very clear, but many studies have shown that gastric mucosal ischemia, mucus , the destruction of mucosal barrier, gastric acid hypersecretion, gastric H + an
13、ti-diffusion increases, such as bile reflux is a major factor in mucosal blood flow reduction and increase in blood lead children amine increased mucosal ischemia is the most basic conditions of acute gastric mucosal lesions can directly damage the gastric mucosal barrier and systemic stress caused
14、gastric mucosal barrier to start the cycle factors, divided into direct and systemic stress-induced damage of two types. The patients in 136 cases of direct damage and the incidence of gastric mucosal barrier. Gastroscopy and found lesions in the gastric body and 46%, gastric 31%, 5gastric 23%, no m
15、atter what factors lead to lack of gastric blood, usually the Ministry of gastric fundus and the degree of vasoconstriction is greater than the gastric antrum and gastric mucosal damage with the former Yi Yi. The diagnosis of acute gastric mucosal lesions induced acute gastric mucosal lesions accord
16、ing to the primary disease and gastrointestinal bleeding performance. Endoscopy is the main diagnostic measures the conventional X-ray barium meal examination of the lesions without positive findings, only for the exclusion of other cause stomach bleeding. The treatment of acute gastric mucosal lesions, including treatment of the primary disease remove the incentive application H2 receptor blockers or acid pump inhibitors and mucosal protective agent, as well as integra
