怎样治疗胃出血

如何治疗胃出血配图，仅供参考

Treatments
Drugs
Non-variceal haemorrhage—There is increasing evidence to support the use of intravenous omeprazole,which in clinical trials reduces the risk of rebleeding and the need for surgical operation. Patients infected with H pylori should undergo eradication treatment after haemostasis has been achieved in order to prevent further ulcer complications. One study has shown that tranexamic acid reduces transfusion requirements in patients presenting with non-variceal haemorrhage.
Variceal haemorrhage—Vasoactive drugs (such as terlipressin) reduce bleeding rates but have little impact on survival. If bleeding continues despite this treatment,a modified Sengstaken-Blakemore (Minnesota) tube is inserted. It must be remembered that both vasoactive drugs and the Minnesota tube are temporising measures used to control active bleeding until definitive endoscopic,surgical,or radiological measures are taken. When varices have been obliterated portal pressure is reduced with propanolol at a dose to decrease the pulse rate by 20%. This diminishes the risk of subsequent rebleeding.
Endoscopic treatment
Non-variceal bleeding—A range of endoscopic haemostatic approaches are available. Each has a similar efficacy,but there is evidence that an injection combined with a thermal method is best. Endoscopic treatment fails in about 20% of patients with bleeding ulcers,most often those with large,actively bleeding posterior duodenal ulcers. Endoscopist and surgeon must work together to identify and treat these patients at an early stage.
Varices—When active variceal bleeding is seen at endoscopy,intravariceal injection of a sclerosant (such as 5% ethanolamine,1% polidoconal,or sodium tetradecyl sulphate) is attempted. An alternative approach is oesophageal band ligation. Banding obliterates varices more efficiently and has few complications,but it may be more difficult to perform in a patient with active bleeding.","department":"