文档介绍：健康快乐每一天!
临床诊断学
上海第二医科大学仁济临床医学院
费R
巴
Nausea and Vomiting
As the symptoms
症状学:恶心与呕吐
Goals
Briefly define
Outline the prominent disease states
associated with nausea and vomiting
Characterize Nausea and vomiting caused by
the prominent disorders
Discriminate the accompanying symptoms.
Suggest diagnostic strategies of the symptoms
Definition of Nausea and Vomiting
Nausea: the inclination or
恶心:紧迫欲吐,
feeling of imminent desire to
通常伴有上腹不适
vomit, usually felt in the throat
和迷走兴奋的临床
or epi-gastrum. Associated with
decreased activity of the
征候群。
stomach
呕吐:胃和/或小肠
Vomiting: the forceful oral
内容物经食管和口
expulsion of gastric contents via
retro-peristalsis.
腔排除体外
Nausea-Vomiting: simultaneity
恶心和呕吐常伴随
or separateness
存在,也可单独出
现!
Nausea and Vomiting
Definition of emesis (Three phases)
呕吐反射过程(三个阶段)
1. Nausea- the inclination or feeling1、恶心:咽部及
of imminent desire to vomit, usually上腹部不适,胃张
felt in the throat or epigastrum
力和蠕动减弱,幽
Associated with decreased activit
of the stomach
门和贲门开放
2. Retching-the labored rhythmic
2、干呕:胃窦部
contraction of respiratory and
和腹壁肌肉收缩,
abdominal musculature that
腹压增加,食管及
frequently precedes or accompanies咽部开放
vomiting
3. Vomiting-the forceful oral
3、呕吐:胃和/或
expulsion of gastric contents via
小肠内容物经食管
retroperistalsis(Abdominal effects)
和口腔排除体外
发生机制
迷走兴奋表现
恶心
干呕
呕吐
呕吐区别于反食
呕吐:多数情反食:无恶心
况有恶心的感的感觉和呕吐
觉和呕吐反射反射的协调动
的协调动作。
作。(儿童、
饱餐)
Mechanisms of emesis