《消化内科笔记》word版.doc

1. (Chronic Gastritis). (B)90%Hp. (A)20%AddisonHpAHpAB12B12 NULLHpHpBH+AB12 (also called )E,N A.B()B(Paneth) (also called ) 0.51.0cm,0.2cm,2. (Gastroesophageal reflex disease, GERD)A (LES)(His)LESa. LESLES LES34cmLES1030mmHgLESLESGERDLESLESGERDb. LES(TLESR)TLESRGERDc. GERD B C D GERD GERD1 GERD 1 2 3 GERD(-)(20mg, 2/7days) 24hpH 1520cmLES () H2(H2RA) 8-12() LESH2RA.5-15ml/3-4/d,8-12weeks() (PPI) H2RA8-12weeks,() 3. (Peptic Ulcer PU)(GU);(DU) /-GU,DUi. HpPeptic Ulcer1. Hp()-a HpHpHpHpCO2HpHp. HpHpb HpHp(VacA)()(CagA)()HpHpH+HpAHpHpHp2. Hp a. HpDGb. HpHpGii. - DUiii. NSAIDPeptic UlcerNSAIDGUiv. v. DUGU-G-HpHSAIDvi. vii. 1 2(High salt) 3(HSV-1) Peptic Ulcer 1 2NSAID3i. DU2/31-32-4GU1/2-1DUii. Peptic Ulceriii. Peptic Ulcer1. 15%-35%Peptic Ulcer2. Peptic Ulcer 3. DUGUGUDU4. DU5. +X? X X? Peptic Ulcer(A)(H)(S)12 1. UlcerPeptic UlcerX2. PUB3. GU(X1 (-)2 GU 4. also called Zollinger-Ellison(200pg/ml,500pg/ml. 1. Peptic Ulcer50-100ml,1000ml1500ml40% NSAIDNSAID2. 1 () 2 ()3 DUGU 3. DU200mlX4. GUDUGUGU45 1. NSAID2. a. Hp PPI 40mg/d 500-1000mg/d 60mg/d 1000-2000mg/d()480mg/d 800mg/d 27b. H2RAPPIPPIH2RAHpc. ()()Hp()/d. NSAID NSAID GUDU,PPIe. HpNSAID3. X-rayHpHpHp2-4HpNSAIDH2RAPPIDU4-6GU6-8GU1 2 3 4 5 GUDUGU2.5cm 4cmDUGU1cm ()N()()()4. (Interstinal Tuberculosis)1. 2. 24/103. 4. 123X-ray4(2-6)1. Crohn 1 23X-ray4562. 40X-ray3. 4. 1. PN2. 3 4. 1 235. (Irritabl