消化性溃疡病

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最后审阅: 9 Nov 2024
最后更新: 03 Nov 2023

小结

定义

病史和体格检查

关键诊断因素

  • 腹痛
  • 存在的危险因素
  • 指点征
完整详情

其他诊断因素

  • 上腹部压痛
  • 恶心或呕吐
  • 早饱感
  • 体重减轻或厌食
  • 腹泻
  • 贫血的症状
  • 胃肠道出血
  • 低血压或脓毒性休克
  • 振水音
完整详情

危险因素

  • 幽门螺杆菌感染
  • 使用非甾体抗炎药 (NSAID)
  • 吸烟
  • 年龄增长
  • 消化性溃疡病患者的个人史
  • 消化性溃疡病患者的家族史
  • 重症监护病房患者
完整详情

诊断性检查

首要检查

  • 上消化道内镜检查
  • 幽门螺杆菌碳-13 尿素呼气试验或粪便抗原检测
  • 全血细胞计数 (FBC)
完整详情

需考虑的检查

  • 空腹血清胃泌素水平
  • 尿液 NSAID 筛查
完整详情

治疗流程

急症处理

活动性出血性溃疡

非活动性出血:幽门螺杆菌阴性

非活动性出血:幽门螺杆菌阳性

持续性治疗

复发性或难治性溃疡

撰稿人

专家顾问

Ian Beales, BSc, MD, FRCP, FEBG

Consultant Gastroenterologist

Clinical Associate Professor

Norwich Medical School

Department of Gastroenterology

Norfolk and Norwich University Hospital

Norwich

UK

利益声明

IB declares that he has no competing interests.

Kristle Lee Lynch, MD

Assistant Professor of Clinical Medicine

Division of Gastroenterology

Department of Medicine

Hospital of the University of Pennsylvania

University of Pennsylvania

Perelman School of Medicine

Philadelphia

PA

利益声明

KLL declares that she has no competing interests.

鸣谢

Dr Kristle Lynch would like to gratefully acknowledge Dr Marty M Meyer and Dr Steven Moss, previous contributors to this topic.

同行评议者

Alexander C Ford, MBChB, MD, FRCP

Professor of Gastroenterology

Honorary Consultant Gastroenterologist

Leeds Institute of Medical Research at St. James's

University of Leeds

Leeds Gastroenterology Institute

Leeds Teaching Hospitals Trust

Leeds

UK

简介

ACF served on the National Institute for Health and Care Excellence (NICE) guideline committee for clinical guideline CG184: Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management.

利益声明

ACF declares that he has no competing interests. ACF is an author of a Cochrane systematic review cited in this topic.

编辑

Celia Pincus

Section Editor, BMJ Best Practice

利益声明

CP declares that she has no competing interests.

Jo Haynes

Head of Editorial, BMJ Knowledge Centre

利益声明

JH declares that she has no competing interests.

Adam Mitchell

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

Julie Costello

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

  • 消化性溃疡病 images
  • 鉴别诊断

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    • 胃癌
    • 胃食管反流病 (GORD)
    更多 鉴别诊断
  • 指南

    • 成人胃食管反流病和消化不良:检查与管理
    • 16 岁以上人群急性上消化道出血:管理
    更多 指南
  • 医学计算器

    胃肠道出血的 Blatchford 评分

    上消化道出血的 Rockall 评分

    更多 医学计算器
  • 患者教育信息

    消化性溃疡

    更多 患者教育信息
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