With mucous membrane hemorrhage

Introduction Mucocutaneous hemorrhage is caused by hemostasis or coagulopathy of the body. It is usually characterized by spontaneous bleeding of systemic or localized skin and mucous membranes or difficulty in stopping bleeding after injury. There are three main causes of skin and mucous membrane bleeding: abnormal function of the blood vessel wall, abnormal platelet count or dysfunction, and coagulopathy. When the vascular wall function is abnormal, when the blood vessel is damaged, the local small blood vessels will have a reflective contraction, which will slow the blood flow, so as to facilitate the early hemostasis, and then, under the action of serotonin such as angiotensin released by the platelets, make the capillary The blood vessels are more durable and contract to exert hemostasis.

Cause

When there is a congenital defect or damage to the capillary wall, it can not normally contract to exert hemostasis, and the skin and mucous membrane bleeding is common in:

(1) Hereditary hemorrhagic telangiectasia, vascular pseudohemophilia.

(2) Allergic purpura, simple purpura, senile purpura and mechanical purpura.

(3) Severe infection, chemical or drug poisoning and metabolic disorders, vitamin C or vitamin PP deficiency, uremia, arteriosclerosis, etc.

Platelet abnormal 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.

an examination

Related inspection

Coagulation time coagulation factor activity assay

1, blood time, urgency, location, scope, characteristics (spontaneous or after injury), incentives.

2, with or without nose bleeding, bleeding gums, hemoptysis, blood in the stool, hematuria and other bleeding symptoms.

3, with or without pale skin, fatigue, dizziness, vertigo, tinnitus, memory loss, fever, jaundice, abdominal pain, bone and joint pain and other symptoms of anemia.

4, history of allergies, trauma, infection, history of liver and kidney disease.

5, a family history of easy bleeding and bleeding disorders.

6. Occupational characteristics, history of exposure to chemical drugs and radioactive materials, history of medication.

Skin mucosal bleeding should check for coagulation, platelet function and number, and fibrinolysis system.

Differential diagnosis

Urine blood accompanied by symptoms:

(1) with lumbar pain or abdominal cramps on one side

The kidney and ureteral stones are the most likely. It can also be seen in urinary tract obstruction such as cheese-like substances and blood clots.

(2) frequent urination, urgency, and dysuria

Urine blood with frequent urination, urgency, dysuria, lumbar and abdominal pain and discomfort are mostly urinary tract infections or tuberculosis.

(3) with hypertension

Can be seen in acute and chronic glomerulonephritis, acute hypertensive disease, congenital polycystic kidney disease, renal artery embolism, nodular polyarteritis.

(4) with skin and mucous membrane bleeding

It can be seen in blood diseases such as hemophilia, leukemia, thrombocytopenic purpura. Urine blood is only part of systemic bleeding.

(5) with fever, joint swelling and pain, skin damage

Hematuria with fever, joint swelling and pain, skin damage, multiple organ damage may be connective tissue disease (such as systemic lupus erythematosus, nodular polyarteritis, etc.).

(6) Poor urination and urination

Hematuria with poor urination, laborious and urinary drip, in elderly men are mostly prostatic hypertrophy, in middle-aged men should consider urethral stricture, urethral stones or bladder tumors.

(7) Hematuria after strenuous exercise or strong physical labor

In this case, the possibility of renal ptosis, urinary calculi, or exercise hematuria should be considered (in men, stones or exercise hematuria, and in women, renal ptosis or stones).

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