Dr. Wang, Internal Medicine Department of Beijing Hospital, said:
General therapy
Rest in bed; observe whether the skin of the eyes and limbs is cold, wet or hot; record blood pressure, pulse, blood loss and hourly urine output; maintain the venous energy path and measure the central venous pressure. Keep the patient's airway open to avoid choking from vomiting blood. Large amounts of bleeding should be fasted, and small amounts of bleeding can be appropriately rehydrated.
Supplementation of blood volume
When hemoglobin is less than 9g/dl, a sufficient amount of whole blood should be immediately imported. Patients with cirrhotic portal hypertension should beware of the possibility of re-bleeding due to increased portal pressure caused by blood transfusion. Avoid acute pulmonary edema or rebleeding caused by excessive blood and fluid transfusion.
Treatment of upper gastrointestinal hemorrhage to stop bleeding
1. Cool the stomach by repeatedly rinsing the lumen with ice water through a gastric tube. This constricts blood vessels, reduces blood flow, and inhibits gastric juice secretion and digestion. Fibrinolytic enzyme activity at the bleeding site is weakened, thus stopping bleeding.
2. Oral hemostatic agents for peptic ulcer bleeding is mucosal lesion bleeding. With vasoconstrictor, can make the bleeding of small arteries strong contraction and hemostasis. This method is not advocated for use in old age.
3. Inhibition of gastric acid secretion, through the inhibition of gastric acid, increase intragastric pH, reduce H + diffusion, promote hemostasis, for the prevention and treatment of stress ulcers and acute gastric mucosal lesion bleeding has a better effect.
How to take care of gastric bleeding?1. Recumbent position:After bleeding the patient needs to immediately rest in bed. You can take the prone position, elevate the lower limbs. It is not suitable to head down, feet up, so as not to affect breathing. Keep calm to eliminate the patient's nervousness, and pay attention to keep warm. Be especially careful when changing position suddenly, as patients tend to lose a lot of blood and go into hemorrhagic shock. If they are not careful, they tend to faint due to transient cerebral ischemia when standing up suddenly, leading to accidents such as falls.
2. Fasting and water fasting:If the patient vomits blood or has black stools, he should stop eating or drinking immediately. Because eating and drinking will not only aggravate the bleeding of the lesion, but also increase the difficulty of endoscopic treatment after admission to the hospital. After vomiting blood, it is best to have the patient rinse his mouth and spit it out. Water cannot be swallowed, but you can pack melted ice and use a cold water bag to apply cold compresses to the left upper abdomen.
Warm tips:I hope you can pay attention to the gastrointestinal problems, and at the same time timely to the professional and formal medical institutions for a detailed examination of the causes of the disease, and actively cooperate with the correct and effective treatment, so that the body early recovery.