Mucous membrane hemorrhage

Introduction Due to the body's hemostasis or blood coagulation disorders, it is usually clinically characterized by spontaneous bleeding of the systemic or localized skin and mucous membranes or difficult to stop bleeding after injury. Hemorrhage of the skin and mucous membranes is characterized by blood stasis under the skin or under the mucous membranes, forming red or dark red spots, which are not faded. The size of the bleeding area can be divided into sputum spots, purpura and ecchymoses. Severe cases can cause cerebral hemorrhage. There are three common causes of the common causes, namely abnormal vascular wall function, abnormal platelet count or dysfunction, and coagulopathy.

Cause

1. Abnormal function of blood vessel wall: Under normal circumstances, when the blood vessel is damaged, the local small blood vessels will have a reflective contraction, which will make the blood flow slower, so as to facilitate the early hemostasis, and then, under the action of serotonin such as angiotensin released by platelets. To make the capillaries shrink longer and play a hemostatic effect. When there is a congenital defect or damage to the capillary wall, it can not normally contract to exert hemostasis, and cause skin and mucous membrane bleeding.

2. Platelet abnormality: Platelets play an important role in the process of hemostasis. At the vascular injury, platelets adhere to each other and aggregate into white thrombus to block the wound. Platelet membrane phospholipids release arachidonic acid under the action of phospholipase, and then convert to thromboxane (TXA2), further promote platelet aggregation, and have strong vasoconstriction, promoting local hemostasis. When the number or function of platelets is abnormal, it can cause bleeding of skin and mucous membranes.

3. Coagulation dysfunction: The coagulation process is more complicated, and many coagulation factors are involved. Any lack of coagulation factors or insufficient function can cause coagulopathy, leading to the appearance of skin and mucous membranes.

an examination

Related inspection

Blood routine bone marrow imaging surgical examination

1. Symptoms of the four limbs with purpura associated with joint pain, abdominal pain, hematuria, found in allergic purpura.

2. Skin mucosa extensive purpura, with bleeding gums, nasal discharge, or even blood in the stool, hematuria, more common in thrombocytopenic purpura, disseminated intravascular coagulation.

3. Astragalus: liver disease.

4. Since childhood, that is, bleeding after minor injuries, often with intra-articular bleeding and family history, should consider hemophilia, congenital platelet dysfunction.

Differential diagnosis

Thrombocytopenic hemorrhage is characterized by bleeding at the same time, purpura and ecchymosis, nosebleeds, bleeding gums, menorrhagia, hematuria and melena, which can cause cerebral hemorrhage. Patients with platelet disease have normal platelet counts and mild hemorrhage. They are mainly subcutaneous, nosebleed and menorrhagia, but bleeding can occur during surgery.

The bleeding caused by abnormal function of the blood vessel wall is characterized by sputum and ecchymosis of the skin and mucous membranes. For example, allergic purpura is characterized by symmetry of the limbs or arms, and higher than the skin (urticaria or papule-like) purpura, which may be accompanied by itching. , joint pain and abdominal pain, may have hematuria when the kidneys are involved. Senile purpura is often the side of the hand and foot.

Simple purpura is an occasional ecchymosis in chronic limbs, which is common in menstrual periods of female patients.

Hemorrhage caused by coagulopathy is often characterized by visceral, muscle bleeding or soft tissue hematoma, and often has joint cavity bleeding, and often has a family history or liver history.

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