Vomiting in patients with cirrhosis of the liver h

e707004304 · Wysłany: Nie 19:41, 20 Mar 2011

How to do vomiting blood in patients with cirrhosis

How to prevent the kind of patients the incidence of blood Kou? If there Kou at home next time how should the timely processing of blood nickname? Embroidery won circle 2 / I / 3 are called upper gastrointestinal bleeding, which is mainly due to cirrhosis of the liver lead to rupture of esophageal varices, about 6o% of all gastrointestinal bleeding a 7s%. Why cause bleeding during liver development, organizational structure alteration, making the liver blood circulation disorder, portal vein pressure was significantly higher, from the gastrointestinal tract, spleen and other organs of the blood in the portal vein at the obstructed and forced to find another way out , between the rich and the circulation of the Comparison of the formation of several clinically important traffic branch, of which the esophagus and fundus varicose Jingmai Xingcheng the most important and most likely to rupture. Rough diet, overeating, emotional, constipation and other causes of bleeding is often evoked. If patients variceal bleeding occurs, often there will be vomiting blood, which can be big mouth spit blood, often mixed with blood clots, suggesting that large amount of bleeding, bleeding speed; also vomit or black like coffee grounds, red blood. Although some patients did not vomiting, but basically they have black, tarry stools can be as black and thick; also be increased with the number of times, showing a dark red bloody, often prompt a larger amount of bleeding, when patients often dizziness , vertigo, palpitation, nausea and even fainting; accompanied by pale, cold extremities, cold sweat dripping and other performance. How instructors Ji-Yao Wang / Dong Ling shock if the above symptoms, have yet to appear hematemesis and melena, gastrointestinal bleeding should be suspected, especially in elderly patients with constipation or original. How to do in the event of hematemesis hematemesis, the patient should be supine to the pillow, head to one side, vomit spit blood to try to clean, do not swallow, keep the airway open, to avoid choking the blood and vomit into the trachea caused by the patient breathe. Both patients and their families is also important to remain calm. Variceal bleeding due to portal vein blood flow increased, the pressure rise caused by venous bleeding after a certain amount of pressure reduction, bleeding slowed, reducing the amount of bleeding, many patients stop bleeding on their own. Remember that just because the patient thirsty, stomach discomfort and give the patient drink water or eat anything. Families need to do is call and emergency contact as soon as possible, as soon as possible to the nearest qualified hospital. How to prevent rebleeding in patients with bleeding stopped after active treatment failure to take preventive measures,[link widoczny dla zalogowanych], most patients will re-bleeding. General through the following measures to prevent further bleeding varices: prevention of oral medication and then a simple method of bleeding. More effective is the current D-adrenergic receptor blockers such as propranolol, Naduoluoer, more patients for the prevention of initial and re-bleeding. The use of propranolol should start small dose and gradually increase the volume to heart rate or pulse (wake up) down to not taking pre-7s%. If the original heart rate 8o beats / min,[link widoczny dla zalogowanych], heart rate drug content added to 6o times / min or so, when propranolol dose required dose for the patient,[link widoczny dla zalogowanych], to be taken for life,[link widoczny dla zalogowanych], not arbitrarily stop. Drug prevention of rebleeding overall effect is not ideal, only 20% to 25% of patients effectively. Endoscopic treatment has recently developed rapidly, according to the specific circumstances of the patient choice of endoscopic therapy, such as the ligation of esophageal varices. But some of repeated bleeding of liver function were better choose the right time to consider surgery. The operation of some critically ill or lose the opportunity of advanced cirrhosis variceal hemorrhage repeatedly, through interventions by the jugular vein catheter placed in the support tube between the hepatic vein and portal vein bridge, this method is less invasive, safer, lower door more significant pulse pressure, generally within 24 hours to control the bleeding, but long-term effect is not clear. The above measures to prevent further bleeding, do not fundamentally solve the problem of portal hypertension. Therefore the patient's self-care is particularly important. Should pay attention to eating light,[link widoczny dla zalogowanych], cut out the rough, hot and sour food stimulation; to maintain smooth bowel movements, if necessary, supplemented with laxative drugs; should not hold your breath and lifting heavy loads, can only do some minor or moderate physical exercise outdoors, do not do sit-ups and any other cause of increased abdominal pressure and other sports. ■ i 【19】 Family Medicine I2003.8