Symptoms of ulcer bleeding
Generally refers to bleeding ulcer bleeding gastric ulcer and duodenal bleeding. Also known as upper gastrointestinal bleeding is acute digestive system, especially bleeding, often can jeopardize the patient’s life. Must therefore be a clear diagnosis and early treatment as soon as possible.
Generally based on patient history, vomitus and stool examination, diagnosis is not difficult. It should be noted that 10% of the patients could no ulcer history. Gastric analysis and X-ray examination has just bleeding in general taboo, at least 1-2 weeks in the blood only after the implementation. Unexplained vomiting blood of patients with ulcer bleeding whether or cirrhosis esophageal variceal bleeding, should be differentiated from. Esophageal variceal bleeding, bleeding liver, often pre-history, history of non-rhythmic abdominal pain have mostly hepatosplenomegaly, abdominal varices, ascites, jaundice and other signs of cirrhosis of the liver; mostly sudden and massive hematemesis, blood red or dark red bleeding after the enlargement of the spleen significantly reduced; ammonia increased, abnormal liver function and so on. In addition, also with gastric cancer, gastric mucosa prolapse and other identification.
Emergency fiber endoscopy, that is bleeding experts endoscopy 24-48 hours, it is more timely, convenient, safe, accurate and high rate of diagnostic tools. Therefore, when found in upper gastrointestinal bleeding, active rehydration, bleeding, blood transfusion, anti-shock therapy, while patients with contraindications to non-emergency fiber endoscopy, we can discover bleeding site and the original disease, but also through the conduct spraying endoscopy, electrocoagulation, laser and a series of hemostasis.
Ulcer bleeding can cause clinical symptoms and the amount of blood loss and blood loss is closely related to the pace. 50-100 ml when the bleeding can occur melena, bleeding of 400 ml, not only will be black, but there may be vomiting blood and a range of bleeding symptoms. Sustained massive bleeding can lead to reduced blood volume, anemia, tissue hypoxia, circulatory failure and death.
(1), hematemesis and melena: General Helicobacter bleeding or bleeding following a small who does not cause nausea, vomiting, hematemesis occurred not only melena. If the large amount of bleeding can cause nausea, vomiting blood, blood in the stomach if the retention time is short, then Chenganhongse even vomit bright red; if the blood in the stomach to stay for a long time into the role of oxyhemoglobin by the acid methemoglobin which was brown. Stomach bleeding, if the end of vomit, then discharged into the intestine, the formation of melena or tarry then, large amount of bleeding, intestinal peristalsis may soon be as dark red blood.
(2), upper abdominal pain and discomfort: Most patients with bleeding ulcer before the abdominal pain, seizures, or increased, while hemorrhage is often painful to reduce or disappear.
(3) changes in blood: Bleeding early stage of red blood cells due to peripheral vascular contraction and re-distribution of physiological regulation, hemoglobin, red blood cells and hematocrit values can be no change. 6-12 hours after the hemorrhage, due to inter-organizational fluid into the blood circulation, so that hemoglobin (hemoglobin) and red blood cell dilution and lower values. Hemorrhage leukocytosis 1 million or more often, neutrophils also increased.
(4) fever: moderate or severe haemorrhage patients, often accompanied by fever, usually appear within 24 hours, mostly in 38.5 ℃ below, ranging from several days to a week. This is due to decomposition products of the intestine of blood absorption, hypovolemia, anemia, body proteins are damaged, such as circulatory failure due to instability in central thermoregulation.
(5) peripheral circulatory failure: blood loss, the blood volume reduction, blood pressure, can cause rapid heartbeat. If the bleeding is excessive, Rhodobryum roseum blood volume and cardiac output decrease, can lead to circulatory failure, and respiratory function were also affected. As the heart, brain, kidneys and other vital organs of severe ischemia, hypoxia, then the shock will become irreversible. In the peripheral circulation failure, the patient can be expressed as irritability, fatigue, palpitation, headache, nausea, thirst, difficulty in breathing (hypoxia), skin pale, sometimes cyanosis, limbs cold chisel, slim and fragile until the pulse can not have and, to reduce or even blood pressure could not be determined. Persistent bleeding can cause oliguria or anuria, severe can cause acute renal failure.
(6) azotemia: Many ulcer patients in the bleeding occur within the first few days after the azotemia. When continued bleeding, the blood concentration of nitrogen increased gradually. This is partly due to the lumen of the blood out through the digestion of protein decomposition products are Xishouruxue, causing azotemia; another bleeding can cause renal dysfunction can not be the quality of nitrogen, resulting in azotemia.
Acute gastrointestinal bleeding is one of the common symptoms. Mostly due to gastrointestinal illness itself cited. Also adjacent organs of digestive tract diseases, such as the pancreas, gall bladder inflammation, or tumors can cause gastrointestinal bleeding, a small number is due to systemic disease caused by localized gastrointestinal bleeding. For example some blood disease, aplastic anemia, hemophilia, etc. As another example, chronic kidney disease uremia, heart disease, with severe heart failure, cerebral hemorrhage, encephalitis and other diseases have the possibility of gastrointestinal bleeding. Again, certain medications can cause gastrointestinal bleeding caused by operations, such as aspirin class, adrenal cortex hormones drugs. If the family has the above-mentioned patients, we must guard against gastrointestinal bleeding occurred.
Aid measures
1, if the heavy bleeding has failed to promptly sent to the hospital, the patient should immediately comforting repose, to eliminate the tension, pay attention to the patient warm, will urge his side to maintain, take the first low-foot high, to prevent violent vomiting caused by suffocation. This position may also be the protection of patients in large loss of blood flow when the supply of the brain to avoid collapse, or collapse to the ground.
2, the patient’s vomit or faeces should be temporarily retained, a rough estimate of its total, and specimens from some medical treatment when the test specimens to be.
3, less moving of patients, but also make the patient walk Wang also closely observe the patient’s consciousness, breathing, pulse, and quickly notify the emergency center.
Notes
1, gastrointestinal bleeding of clinical performance is vomiting blood and blood in the stool, vomit and blood may be bright red, it may be brown; they will come out of the blood may be bright red or dull red, we probably showed a black tar-like.
2, vomiting blood, it is best for patients gargle, and use cold bags of cold Xinwo Office. At this point can not be drinking water, can contain of ice.
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