Repeated bleeding

Introduction In medicine, blood comes out of the heart and the lumen of the blood vessels is called hemorrhage. The outflow of blood into the body cavity or tissue, called internal bleeding, blood outflow is called external bleeding. After hemostasis, the bleeding recurs repeatedly, which is easy to form an infection and cannot be completely recovered. Defects in the structure and function of platelets can also cause leakage bleeding. Many of these diseases are congenital, such as platelet insufficiency (thrombasthenia, platelet cell membrane lack of fibrin receptor) and platelet particle disease (storage pool disease) When a variety of particles are deficient, ADP reserves are insufficient, and can also occur due to damage to acquired bone marrow megakaryocytes, platelets cannot adhere to collagen fibers, which may have coagulopathy or bleeding tendency.

Cause

1. Vascular wall damage is common in hypoxia, degeneration of capillary endothelial cells, sepsis (especially meningococcal sepsis), rickettsial infection, epidemic hemorrhagic fever, snake venom, organophosphate poisoning, etc., causing capillary wall damage, Some drugs can cause allergic vasculitis, vitamin C deficiency can cause rupture of capillary basement membrane, decrease of capillary perivascular collagen and separation of endothelial cell junctions, resulting in increased permeability of the wall, allergic purpura due to immune complexes Sinking on the walls of blood vessels causes allergic vasculitis.

2. Thrombocytopenia and dysfunction, the normal quantity and quality of platelets is an important factor in maintaining normal capillary permeability. Leaky bleeding can occur when thrombocytopenia is reduced to a certain number, such as aplastic anemia, leukemia, and extensive bone marrow. Sexual tumor metastasis can reduce thrombocytosis, primary thrombocytopenic purpura, thrombotic thrombocytopenic purpura, DIC platelet destruction or excessive consumption, certain drugs in the body induced antigen-antibody complex immune response The immune complex is adsorbed on the surface of the platelets, so that the latter together with the immune complex is swallowed by macrophages, and the endotoxin and exotoxin of some bacteria also have the effect of destroying platelets.

an examination

Related inspection

Cardiovascular angiography hot saline test oxidized acetic acid AS-D naphthol esterase staining platelet calcium flow determination serum transferrin

Internal bleeding can occur in any part of the body. Blood accumulates in the body cavity and is called blood in the body cavity, such as hemorrhage in the abdominal cavity, blood in the pericardium, blood or clots in the body cavity. Hemorrhage occurs in the tissue. When the amount is large, hematoma is formed, such as cerebral hematoma and subcutaneous hematoma. When the amount is small, only the microscope can detect the number of red blood cells or hemosiderin in the tissue. The presence of orange blood crystals (hematoidin).

Differential diagnosis

The effect of bleeding on the body depends on the amount of bleeding, the rate of bleeding, and the location of the bleeding. The leaking bleeding process is slow, the amount of bleeding is small, and will not cause serious consequences. However, if the leakage of hemorrhage is extensive, such as extensive gastrointestinal mucosal leakage due to portal hypertension during cirrhosis, hemorrhagic shock may be caused by a large amount of bleeding at one time. The bleeding process of ruptured hemorrhage is rapid. If the loss of circulating blood volume is 20% to 25% in a short time, hemorrhagic shock can occur. Hemorrhage in vital organs, even if the amount of bleeding is not much, can be fatal, such as heart rupture caused by pericardial hemorrhage, due to pericardial tamponade, can lead to acute cardiac insufficiency, cerebral hemorrhage, especially brain stem hemorrhage, due to important nerve center compression lethal. Local bleeding can lead to corresponding dysfunction, such as hemiplegia caused by intracranial sac bleeding, retinal hemorrhage caused by vision loss or blindness. Chronic bleeding can cause anemia.

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