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本文用胃镜观察了99例重型病毒性肝炎患者的上消化道粘膜变化。急重型、亚重型肝炎患者83.3%有急性胃粘膜病变,表现为胃壁粘膜抓痕样条状充血、水肿、散在新鲜出血点等。慢性重型肝炎患者以肝硬化伴门脉高压者胃粘膜病变较多,发生率也高。急重型肝炎和亚急重型肝炎的机理可能与肿瘤坏死因子的作用、凝血因子合成障碍、患者的低氧血症及酸碱失衡有关。慢性重型肝炎患者除上述因素外,可能还存在内毒素的作用,门脉的高压作用和高胃泌素血症等。
In this paper, 99 cases of severe viral hepatitis observed in patients with upper gastrointestinal mucosal changes. 83.3% of patients with acute and severe hepatitis have acute gastric mucosal lesions, which are characterized by gastric mucosal scratching spline congestion, edema and scattered fresh bleeding spots. Patients with chronic severe hepatitis liver cirrhosis with portal hypertension more lesions, the incidence is also high. The mechanism of severe hepatitis and subacute severe hepatitis may be related to the role of tumor necrosis factor, coagulation factor synthesis disorders, patients with hypoxemia and acid-base imbalance. Chronic severe hepatitis patients in addition to the above factors, there may be the role of endotoxin, portal hypertension and high blood gastrin disease.