Gastric bleeding is caused by many factors, such as acute inflammation, gastric ulcer, portal hypertension, tumors and other factors. If the cause has been determined, in addition to drug treatment, dietary therapy also plays an important role. Precautions There are: you should avoid eating sour and over-sealed foods, avoid eating raw, cold and hard foods, and take medicated meals such as Angelica and Chicken Soup. It is also important to avoid taking drugs that are irritating to the stomach and are not conducive to the healing of sores. Try not to do strenuous exercise. If gastric disease persists and becomes chronic, it will be very troublesome.
Treatment Plan
1. Routine treatment: ① The patient should lie on his back. 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 with severe illness should inhale oxygen; ④ Place a gastric tube to suck out the blood accumulated in the stomach, understand the bleeding situation, and instill drugs; ⑤ Strengthen care to prevent vomitus from being inhaled into the respiratory tract and causing pneumonia or suffocation.
2. Rescue shock: ① Estimate the amount of blood transfusion. In mild bleeding, blood transfusion is the main method, and blood transfusion may not be needed temporarily; for moderate bleeding, 400-600ml of blood needs to be supplemented; for severe bleeding, 900-1200ml of blood transfusion is required, or even More; ②Estimation of infusion volume should, in principle, be within one’s 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 Sensitivity 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 coagulation. Enzyme; ③ Local hemostasis under gastroscopy can be sprayed with a hemostatic agent, such as 80 mg/L norepinephrine or thrombin; or injected with a hemostatic agent, such as 1 to 2 mg epinephrine added to 10 ml of 10% saline for point injection; or high-frequency injection Hemostasis by electrocoagulation; 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 losec 20mg, 2 times a day; ② For esophageal and gastric variceal 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. Use 1~2kg Pulley traction, bleeding stops after 24 hours, deflation and observation for another 24 hours; at the same time, give 20U of pituitaryin added to 100ml of glucose solution, intravenous drip, repeat every 3 to 4 hours, and inject sclerosing agent under direct vision of the gastroscope , generally use 1% ethoxysclerosing alcohol or 5% cod liver sodium oleate, and inject it into the varicose veins and beside the 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.