呕血与黑便的处理
Management of haematemesis and melaena.
作者信息
Palmer K
机构信息
Department of Gastroenterology, Western General Hospital, Edinburgh EH4 2XU, UK.
出版信息
Postgrad Med J. 2004 Jul;80(945):399-404. doi: 10.1136/pgmj.2003.017558.
Abstract
Acute upper gastrointestinal bleeding is a common medical emergency which carries hospital mortality in excess of 10%. The most important causes are peptic ulcer and varices. Varices are treated by endoscopic band ligation or injection sclerotherapy and management of the underlying liver disease. Ulcers with major stigmata are treated by injection with dilute adrenaline, thrombin, or fibrin glue; application of heat using the heater probe, multipolar electrocoagulation, or Argon plasma coagulation; or endoclips. Intravenous omeprazole reduces the risk of re-bleeding in ulcer patients undergoing endoscopic therapy. Repeat endoscopic therapy or operative surgery are required if bleeding recurs.
摘要
急性上消化道出血是一种常见的医疗急症，其医院死亡率超过10%。最重要的病因是消化性溃疡和静脉曲张。静脉曲张通过内镜下套扎术或注射硬化疗法以及对潜在肝脏疾病的治疗来处理。有主要征象的溃疡通过注射稀释肾上腺素、凝血酶或纤维蛋白胶；使用热探头、多极电凝或氩等离子体凝固进行热应用；或使用内镜夹进行治疗。静脉注射奥美拉唑可降低接受内镜治疗的溃疡患者再出血的风险。如果出血复发，则需要重复内镜治疗或进行手术。
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