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患者 女性,24岁,农民.因频繁呕吐、呕血伴胸骨后疼痛7天,于1996年10月8日急诊入院.7天前患者因进食过硬食物后咽部不适,上腹部胀满感,继而恶心呕吐,呕吐物初为胃内容物及粘液,后为鲜红色血液约50ml及咖啡样物200ml,内含血凝块.呕吐剧烈时吐出一条完整的管形膜状物,长约10cm.同时伴胸骨后疼痛,排糊状黑便,每日1～2次,每次50g左右.曾在当地县医院按“上消化道出血、食道炎”止血对症治疗,因呕吐不止,每小时多达10余次,并有小块片状物吐出转入我院.查体:神清,轻度脱水,血压16/10kPa(120/75mmHg),脉搏80次/分.心肺正常.腹软,无压痛,子宫底剑下3指.大便潜血阳性,血红蛋白110g/L,红细胞3.33 x 12~12/L.呕吐膜状物病理报告为鳞状上皮组织(病理号9608338).诊断:表皮剥脱性食道炎,妊娠8个月.入院后给予禁食、输液、止血、止吐、解痉,思密达保护粘膜以及抗生素预防感染等治疗,3天后呕吐消失.由于宫缩频繁转入产科分娩.
Female, 24 years old, farmer. Due to frequent vomiting, hematemesis with sternum pain for 7 days, was admitted to the emergency department on October 8, 1996. 7 days ago, the patient developed discomfort in the throat, a feeling of fullness in his upper abdomen, Nausea and vomiting, vomit early gastric content and mucus, after the bright red blood of about 50ml and 200ml of coffee samples, containing blood clots vomiting spit out a complete tubular film, about 10cm. At the same time With chest pain, paste paste black, 1 to 2 times a day, each about 50g. In the local county hospital according to “upper gastrointestinal bleeding, esophagitis,” hemostasis symptomatic treatment, due to vomiting more than an hour up to More than 10 times, and a small piece of spit into our hospital. Physical examination: Shen Qing, mild dehydration, blood pressure 16 / 10kPa (120 / 75mmHg), pulse 80 beats / min. Tenderness, under the sword at the bottom of the uterus 3. Stool occult positive, hemoglobin 110g / L, erythrocytes 3.33 x 12 ~ 12 / L. Vomit membrane-like pathology reported squamous epithelium (pathology No. 9608338). Diagnosis: Exfoliative esophagus Inflammation, pregnancy for 8 months after admission to give fasting, infusion, hemostasis, antiemetic, antispasmodic, Smecta protective mucosal and antibiotics to prevent infection and other treatment , Vomiting disappeared after 3 days due to frequent contractions into obstetric childbirth.