Most patients with acute gastric bleeding can be treated non-surgically. Specific measures include blood transfusions, infusions, and the use of various hemostatic drugs through different channels. Surgery may be considered for bleeding caused by gastric cancer and gastric bleeding that cannot be controlled by the above treatment measures.
Therefore, the best way to treat gastric diseases is to allow the stomach to directly absorb the medicine. The only substances that the stomach can directly absorb are water and alcohol. The medicinal liquid enters the stomach and directly forms a slurry repair film attached to the stomach. On the surface of the gastric mucosa, this slurry repair membrane has very similar properties to the gastric mucosa. It can effectively isolate the gastric mucosa from damage caused by gastric acid, Helicobacter pylori, and irritating food. It can also continuously repair ulcerated gastric mucosa, balance gastric acid secretion, and inhibit Helicobacter pylori. Excessive reproduction of bacteria promotes the regeneration of gastric mucosa, making various gastric discomfort symptoms less likely to occur.
Once hemorrhagic gastritis is diagnosed, it must be hospitalized in time to prevent the patient from bleeding heavily, which may lead to life-threatening consequences. The principle of treatment is to remove various predisposing factors, reduce the acidity in the stomach to prevent hydrogen ion counter-diffusion and aggravate gastric mucosal damage, actively stop bleeding, and perform blood transfusion and fluid replenishment. (1) Supplement blood volume: Give intravenous infusion of whole blood or fresh frozen plasma, plasma substitute, balanced salt solution, etc. as appropriate. Those with shock should actively improve microcirculation.
(2) Gastric lavage with iced salt water: It can constrict the blood vessels in the gastric wall, reduce gastric acid secretion, and promote hemostasis. The method is to leave the gastric tube in the stomach, first drain out the gastric juice, inject 200 to 300 ml of ice saline, then withdraw it, rinse it repeatedly 3 to 4 times, and finally add 4 mg of norepinephrine to 250 ml of ice saline and inject it into the stomach. to further constrict the blood vessels. It can be repeated once after 4 hours.
(3) Application of H2 receptor antagonists: H2 receptor antagonists such as cimetidine, ranitidine, and famotidine have a strong effect on inhibiting gastric acid secretion and reducing hydrogen ion concentration. Under normal circumstances, 0.2 g of cimetidine can be given once every 6 hours; or 150 mg of ranitidine can be given orally once every 12 hours; for critically ill patients, 0.4 g of cimetidine or ranitidine can be used Tidine 300 mg intravenously.
(4) Antacids: Take 0.75 grams of sucralfate or a mixture of aluminum hydroxide and magnesium hydroxide orally every hour, which can neutralize gastric acid and protect the gastric mucosa.
(5) Hemostasis by fiberoptic electrocoagulation or laser is reliable. Due to limited conditions, it is still difficult to popularize it.
(6) Pituitrin is instilled during selective arteriography to contract bleeding blood vessels and achieve hemostasis. There are currently few clinical applications.
(7) Surgical treatment: The vast majority of patients can stop bleeding after medical treatment, but about 10% of patients still require surgical treatment, otherwise it will be difficult to control bleeding. Surgery usually uses vagotomy plus subtotal gastrectomy. Imported omeprazole and aluminum hydroxide gel are used as antacid medicine, Yunnan Baiyao capsules are used as hemostatic medicine, bismuth agents such as Livzon Dela can be used for sterilization and gastric mucosal protection, and Xinweilexin capsules can also be used.