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女患,33岁。因患系统性红斑性狼疮服用强的松住院治疗半年,病情稳定,饮食尚好,无噁心,呕吐及腹泻等。1987年6月25日下午食用火炕土豆后即出现噁心,呕吐,呕出物先为胃内容物,继之呕鲜红色血液约200ml,同时吐出条状粘膜样物一条,长约20cm,并与食管上段相连,当即由他人强行拔除。自觉咽部及胸骨后烧灼样疼痛。体检:体温36.5℃,血压21.23/11.97kPa,心肺未见异常,腹软,剑突下有轻微压痛,无反跳痛,肝脾肋下未触及。Hb90g/L,大便潜血试验(-)急请外科,五管科会诊,考虑为食道粘膜剥脱。给予禁食及对症支持治疗,强的松逐渐减量维持。当天夜间仍有少量呕血,次日下午呕血停止,第三天患
Female suffering, 33 years old. Due to systemic lupus erythematosus taking prednisone hospital for six months, stable condition, the diet is good, no nausea, vomiting and diarrhea. On the afternoon of June 25, 1987, nausea, vomiting and vomit appeared in the stomach after consumption of Oyon potatoes, followed by vomiting of bright red blood about 200ml. At the same time, a strip of mucous membrane was spit out about 20cm in length Connected to the upper esophagus, immediately forced removal by others. Conscious pharyngeal and sternal burning like pain. Physical examination: body temperature 36.5 ℃, blood pressure 21.23 / 11.97kPa, no abnormal heart and lung, abdominal soft, slightly tenderness under the xiphoid, no rebound tenderness, no contact with liver and spleen ribs. Hb90g / L, fecal occult blood test (-) urgent surgery, five tube consultation, consider esophageal mucosal exfoliation. Give fasting and symptomatic supportive treatment, prednisone gradually reduced maintenance. The same day there is still a small amount of hematemesis, vomiting the afternoon of the next day to stop, the third day of suffering