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大便出血就是痔瘡嗎,

醫案日記 2023-06-14 08:18:25

大便(bian)出血(xue)就(jiu)是痔瘡嗎,

大便(bian)(bian)(bian)(bian)出(chu)(chu)(chu)(chu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)就(jiu)是(shi)(shi)痔(zhi)瘡(chuang)嗎?很多(duo)人認(ren)為(wei):只要大便(bian)(bian)(bian)(bian)時出(chu)(chu)(chu)(chu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)就(jiu)是(shi)(shi)患了痔(zhi)瘡(chuang)。實際上這(zhe)是(shi)(shi)一(yi)個(ge)錯(cuo)誤概念。因為(wei)便(bian)(bian)(bian)(bian)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)不(bu)僅僅是(shi)(shi)痔(zhi)瘡(chuang)獨有的(de)(de)癥(zheng)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)。便(bian)(bian)(bian)(bian)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),意味著消(xiao)(xiao)化(hua)道出(chu)(chu)(chu)(chu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),而消(xiao)(xiao)化(hua)道出(chu)(chu)(chu)(chu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)又分為(wei)高位(wei)出(chu)(chu)(chu)(chu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)和(he)低位(wei)出(chu)(chu)(chu)(chu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)兩種(zhong)。消(xiao)(xiao)化(hua)道高位(wei)出(chu)(chu)(chu)(chu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),例如食(shi)管下(xia)(xia)端靜(jing)脈曲張(zhang)破裂引起(qi)的(de)(de)出(chu)(chu)(chu)(chu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),消(xiao)(xiao)化(hua)性(xing)潰瘍出(chu)(chu)(chu)(chu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)等(deng),由于(yu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)液(ye)(ye)離開血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)管后存(cun)留(liu)在(zai)腸(chang)腔的(de)(de)時間較長,排出(chu)(chu)(chu)(chu)體(ti)外(wai)時糞便(bian)(bian)(bian)(bian)呈柏油狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang),色(se)黑,或(huo)咖啡色(se),呈漿糊(hu)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang),大便(bian)(bian)(bian)(bian)潛血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)陽性(xing)。消(xiao)(xiao)化(hua)道低位(wei)出(chu)(chu)(chu)(chu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),尤其是(shi)(shi)結(jie)腸(chang)、直腸(chang)下(xia)(xia)端出(chu)(chu)(chu)(chu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)色(se)鮮(xian)紅且(qie)(qie)與排便(bian)(bian)(bian)(bian)關系(xi)密切。其中,痔(zhi)瘡(chuang)出(chu)(chu)(chu)(chu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)的(de)(de)特點是(shi)(shi)用(yong)力排便(bian)(bian)(bian)(bian)時,血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)液(ye)(ye)從肛(gang)門內排出(chu)(chu)(chu)(chu),量不(bu)等(deng),或(huo)便(bian)(bian)(bian)(bian)后手紙帶血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),或(huo)滴血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),或(huo)呈噴射狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)。肛(gang)裂引起(qi)的(de)(de)便(bian)(bian)(bian)(bian)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),一(yi)般量較少且(qie)(qie)伴(ban)有劇烈的(de)(de)疼(teng)痛。直腸(chang)息(xi)肉出(chu)(chu)(chu)(chu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue),多(duo)見于(yu)兒童排便(bian)(bian)(bian)(bian)時血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)液(ye)(ye)污染肛(gang)門周圍。若為(wei)成年人,糞便(bian)(bian)(bian)(bian)中帶血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)并混有粘液(ye)(ye)和(he)膿性(xing)分泌(mi)物,氣味奇臭(chou),伴(ban)有便(bian)(bian)(bian)(bian)條變細癥(zheng)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang),應(ying)(ying)高度注意直腸(chang)和(he)下(xia)(xia)段結(jie)腸(chang)有無癌(ai)瘤存(cun)在(zai)。若糞便(bian)(bian)(bian)(bian)中帶血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)并伴(ban)有粘液(ye)(ye),里(li)急后重(zhong),大便(bian)(bian)(bian)(bian)次(ci)數增多(duo),左下(xia)(xia)腹疼(teng)痛者,首先(xian)應(ying)(ying)考慮痢(li)疾和(he)慢性(xing)腸(chang)炎。以(yi)上論(lun)述了便(bian)(bian)(bian)(bian)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)可由多(duo)種(zhong)疾病(bing)(bing)所(suo)(suo)導致(zhi),并非(fei)痔(zhi)瘡(chuang)所(suo)(suo)特有。另外(wai),痔(zhi)瘡(chuang)并非(fei)僅有便(bian)(bian)(bian)(bian)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)這(zhe)一(yi)癥(zheng)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)。一(yi)般的(de)(de)講(jiang),痔(zhi)瘡(chuang)除便(bian)(bian)(bian)(bian)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)外(wai),還會出(chu)(chu)(chu)(chu)現(xian)便(bian)(bian)(bian)(bian)后有物脫出(chu)(chu)(chu)(chu)于(yu)肛(gang)門外(wai)、肛(gang)門周圍瘙癢、流粘液(ye)(ye)、肛(gang)旁腫痛等(deng)癥(zheng)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)。這(zhe)些(xie)癥(zheng)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)對某個(ge)具(ju)體(ti)病(bing)(bing)人來(lai)講(jiang),可以(yi)單獨存(cun)在(zai),也可以(yi)幾個(ge)癥(zheng)狀(zhuang)(zhuang)(zhuang)(zhuang)(zhuang)并存(cun)。因此,不(bu)應(ying)(ying)該認(ren)為(wei)大便(bian)(bian)(bian)(bian)出(chu)(chu)(chu)(chu)血(xue)(xue)(xue)(xue)(xue)(xue)(xue)(xue)就(jiu)是(shi)(shi)患了痔(zhi)瘡(chuang)。應(ying)(ying)該全面(mian)考慮,盡早(zao)去專(zhuan)科醫院診(zhen)治,以(yi)防誤診(zhen)、誤治。

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