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上消化道大出血、血容量减少常引起急性周围循环衰竭,因此可伴有某些特殊临床表现。晚近文献报道上消化道大出血可导致脑分水岭梗塞、垂体梗塞、空洞鞍综合征、心律失常、心肌梗塞及脑溢血等。一、神经系统的表现1.脑缺氧的临床表现上消化道大出血后血容量不足,脑组织缺氧,可出现意识障碍。尤其原有贫血或脑动脉硬化者更易出现缺氧性脑损害。虽然有时出血量并不大,伴有或不伴有休克状态,但患者常迅速进入昏迷状态,因此极易误诊,常以昏迷待查收入院。此类患者无脑膜刺激征及定位症状,经积极输血、输液、给氧后,神志常可恢复正常,可资鉴别。
Upper gastrointestinal bleeding, hypovolemia often cause acute peripheral circulatory failure, it may be associated with some special clinical manifestations. Recently reported in the literature of upper gastrointestinal bleeding can lead to brain watershed infarction, pituitary infarction, empty saddle syndrome, arrhythmia, myocardial infarction and stroke. First, the performance of the nervous system 1. Clinical manifestations of cerebral hypoxemia Bleeding after upper gastrointestinal bleeding, hypoxia, there may be disturbance of consciousness. In particular, the original anemia or cerebral arteriosclerosis are more prone to hypoxic brain damage. Although sometimes the amount of bleeding is not large, with or without shock, but patients often quickly into a coma, so easily misdiagnosed, often coma pending investigation. Such patients without meningeal irritation and location of the symptoms, the positive transfusion, infusion, oxygen, the consciousness can often return to normal, funded identification.