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患者,男,68岁,因头昏3天,解黑大便12小时,呕血3小时以上消化道出血收住消化科。入院前3天,患者因受凉,自感头昏,不伴发热,咳嗽,自服“感冒通”(北京第六制药厂产品,批号京卫药准字(88)第036号)2片/次,1日3次,连服3天。于入院前12小时,解黑色软便一次,量约100g,无腹痛、腹泻、发烧、呕吐、心悸出冷汗。入院前3小时,突然呕血4次,共约1500ml,先为鲜红色,后为咖啡色,其中混有食糜,呕血后感头昏、乏力、心悸、出冷汗。经用去甲肾上腺素8mg加生理盐水100ml分4次口服,后收住院治疗。既往身体健康,无肝炎、胃及十二指肠溃疡病史,无药物过敏史。查体:T36℃,P104次/分,R25次/分,BP8/4kPa。急性病容,失血貌,心肺(-),腹部稍丰满,无肠型及包块,上腹部有压痛,无反跳痛,肝脾(-)。辅助检查:Hb 95g/L,WBC
Patients, male, 68 years old, dizzy for 3 days, black stool for 12 hours, hematemesis for more than 3 hours to receive gastrointestinal bleeding Department of Gastroenterology. 3 days prior to admission, patients with cold, self-feeling dizzy, without fever, cough, self-service, “cold through” (Beijing Sixth Pharmaceutical Products, batch number Beijing Wei Yaozhunzi (88) No. 036) Times, 3 times on the 1st, and even served for 3 days. 12 hours before admission, solution of black soft stool once, the amount of about 100g, no abdominal pain, diarrhea, fever, vomiting, palpitation, cold sweat. 3 hours before admission, hematemesis 4 times, a total of about 1500ml, first bright red, after brown, which mixed with chyme, hematemesis after dizziness, fatigue, palpitations, a cold sweat. After using norepinephrine 8mg plus saline 100ml 4 times orally, after receiving hospital treatment. Past health, no hepatitis, stomach and duodenal ulcer history, no history of drug allergy. Physical examination: T36 ℃, P104 times / min, R25 beats / min, BP8 / 4kPa. Acute illness, blood loss, heart and lung (-), abdominal slightly full, no intestinal type and mass, upper abdominal tenderness, no rebound pain, liver and spleen (-). Auxiliary examination: Hb 95g / L, WBC