's treatment of first aid principle of bleeding of gastric ulcer

's treatment of first aid principle of bleeding of gastric ulcer
The therapeutic principle is to guard and treat internal medicine department actively that ulcer bleeds, internal medicine department guards and just considers the surgical treatment while failing to respond to any medical treatment.
(1)The patient absolutely stays in bed, try hard to remove its worry and tense mood, the inspection having no relations with rescuing, should delay going on. Pay attention to keeping hot, can adopt the low order of head if necessary, in order to increase the blood supplt of the brain. When there is anxiety or have the fidgets, but skin note sedative.
(2)Observe condition closely, notice blood pressure, pulse, breathe, body temperature, urinate quantity and general situation. Bleed more patient, measure blood pressure one 0.5-1 hour while being every, consult erythrocyte, hemochrome 4-6 hour while being every.
(3)Blood pressure on the low side should suffer from shock hour oxygen intaking.
(4)During it bleed generally should not fasting,can have inhibited hunger of stomach from shrinking to make blood not solidified because of food, secondly can neutralize the gastric acid, supply nutrition. Should offer small quantity numerous the intersection of liquid and diet, milk, soya-bean milk, the intersection of egg and soup, broth,etc.. Have sick vomiting and can delay the diet, waiting for vomits to stop, can recover diet.
(5)Supplement the blood capacity in time, prevent and cure shock. The indication of blood transfusion is: Shrink and force down it to 12kPa (90 millimetres of mercury columns) : It is second-class in pulse 120 /divide by the above; Hemochrome is under 7 grams; There is physical sign of shock. Have opportunity body more under bleeding amount at 300 ml can oneself compensate,generally needn't blood transfusion and infusion; Is the bleeding amount in 300? When the 600, may correct blood pressure through the infusion, needn't transfuse blood; The bleeding amount will supplement the blood capacity in 600 ml of the above as soon as possible. Accord with indication of the above-mentioned blood transfusion, blood transfusion is urgent. Blood transfusion quantity can depend on detailed conditions, each blood transfusion 300 1400, for instance, the hemochrome has not rebounded, can transfuse blood again. Blood transfusion can already correct shock, has had styptic function to improve the hemochrome.
(6)Employ the styptic treatment in time. The styptic measure still employs hemorrhage besides opening blood transfusion. Various commonly used hemorrhage if vitamin Kl, etamsylate, arrest blood sweet-smellingly and sourly, etc, can also narrow clothes, Renee with first cyanogen match gram,etc. restrain sour injection and arrest blood for man, Lip river for man, law, oral thrombese or injecting the complex of thrombinogen to arrest blood etc., traditional Chinese medicine such as BAIYAO (white drug) (sic) of also very oral Yunnan arrest blood, can also adopt and ice the salt and wash measures such as the stomach,etc..
(7)In the course of treating ulcer and and massive haemorrhage, it is disorderly to pay attention to checking and dealing with the acidosis and water electrolyte. After the massive haemorrhage, blood potassium, the intersection of blood and sodium lose apt to cause electrolyte to be at the same time easy to cause acidosis disorderly. So should pay attention to supplementing and correcting in time.
(8)Prevent the acute renal function from being depleted, protect the functions of the heart, brain, important internal organs of kidney. Blood pressure drops, even suffer from shock, if has not corrected in time, can influence the heart, brain, renal function after massive haemorrhage, if suffering from shock for a long time can have no urine, even the renal function is depleted. Should be quiet on the basis of positive fluid infusion at this moment to drip 100 ml of 20% mannitol, urine quantity is no less than 30 ml by up to per houring.
(9)Treat ulcer, main prevention actively.
(10)If internal medicine department can't control the persons who bleed to treat to guard, should consider the surgical treatment of the conduct.
|