A small amount of gastric bleeding may manifest as melena, while a large amount may manifest as vomiting coffee-colored or red blood. The following is a detailed description, I hope it is useful to you. Vomiting blood and melena: Any bleeding due to blood irritation If it causes nausea and vomiting, there may be vomiting of blood. If the blood is vomited immediately after bleeding, the blood will appear bright red; if the blood stays in the stomach for a period of time and is then vomited after being acted upon by gastric acid, it will appear brown like coffee grounds. In addition to vomiting, blood is mostly discharged from the intestines. Because hemoglobin reacts with sulfide in the intestine to form black iron sulfide, the discharged blood is usually tarry black stool. Only when the amount of bleeding is large and the blood passes through the intestines quickly will the discharged blood appear dark red or occasionally bright red. Generally speaking, when the amount of bleeding is large, there is black stool and hematemesis; when the amount of bleeding is small, there is often only black stool. Vomiting blood is less common if the bleeding site is in the duodenum. 2. Systemic symptoms caused by bleeding: If the bleeding rate is slow and the amount is small, there are generally no obvious systemic symptoms, and anemia only occurs after prolonged bleeding. If the amount of bleeding is large and rapid, acute blood loss symptoms such as palpitations, cold sweats, pale complexion, and even a drop in blood pressure may occur. 3. Symptoms of primary disease: The most common causes of upper gastrointestinal bleeding are ulcer disease, esophageal and gastric variceal rupture, gastric cancer, esophageal cancer or duodenal cancer, acute gastric mucosal injury and bleeding, etc. If it is ulcer bleeding, there is often a history of upper abdominal pain before bleeding; if it is esophageal and gastric variceal bleeding, there is a history of cirrhosis and clinical manifestations of cirrhosis. Auxiliary examination gastroscopy can often make a rapid and correct diagnosis of the bleeding site and cause, and has been listed as the preferred examination method. Treatment plan 1. Routine treatment: ① The patient should be in a supine position. When irritable and silent, 10 mg of diazepam can be injected intramuscularly; ② Those who vomit hematuria should fast, and those with simple melena can take a liquid diet; ③ Those who are seriously ill should inhale oxygen; ④ Place Gastric tube can suck out the blood accumulated in the stomach, understand the bleeding situation, and infuse drugs; ⑤ Strengthen nursing care to prevent vomitus from being inhaled into the respiratory tract and causing pneumonia or suffocation. 2. Rescue shock: ① Estimated blood transfusion volume. In mild bleeding, blood transfusion may be the main method, but blood transfusion may not be needed temporarily; moderate bleeding requires 400-600ml of blood supplement; severe bleeding requires blood transfusion of 900-1200ml, or even more; ② Estimated transfusion volume , in principle, live within your means. The infusion volume and speed can be adjusted based on central venous pressure measurement. Use crystalloid and dextran as liquids; ③ Correct acid-base balance and electrolyte balance. 3. Application of hemostatic agents: ① Use anluoxue, hemostatic sensitive or hemostatic aromatic acid as appropriate, and add it to the rehydration solution for infusion; ② Infuse the gastric tube with a concentration of 80 mg/L norepinephrine or thrombin; ③ Local hemostasis under gastroscopy You can choose to spray a hemostatic agent, such as 80 mg/L norepinephrine or thrombin; or inject a hemostatic agent, such as 1 to 2 mg epinephrine added to 10 ml of 10% saline for point injection; or high-frequency electrocoagulation to stop bleeding; or microwave hemostasis. ; Or laser hemostasis. 4. Treatment of the cause: ① Bleeding from stress lesions or ulcers, or the H2-receptor blocker cimetidine or ranitidine intravenously; or oral administration of Losec 20 mg, twice a day; ② For esophageal and gastric varicose rupture and bleeding, a three-lumen tube should be inserted to compress and stop bleeding. Generally, 200ml of air or water should be injected into the gastric pouch at a pressure of 5.3~6.6kPa. A 1~2kg pulley should be used for traction. Bleeding will occur after 24 hours. Stop, deflate and observe for 24 hours; at the same time, add 20 U of pituitaryin to 100 ml of glucose solution, intravenous drip, repeat every 3 to 4 hours, inject sclerosing agent under direct vision of the gastroscope, usually 1% ethoxylate is used Sclerosing alcohol or 5% sodium cod liver oleate is injected into and around varicose veins to cause embolism and stop bleeding. 5. Surgical treatment: Mainly suitable for: ① tumor bleeding; ② massive bleeding that is ineffective after medical treatment. What most people refer to as gastric bleeding is often not necessarily gastric bleeding, but may be a wider range of upper gastrointestinal bleeding. Going to the hospital for a gastroscopy to find out the cause is what you need to do right away. Not much else to say

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