Cirrhosis caused by venous bleeding
My mother 57-year-old, bleeding three times, each time interval bleeding 2 months or so are cirrhosis caused by upper gastrointestinal bleeding, splenomegaly, bleeding last after the lower abdomen are up, and how difficult stool do? Usual care how? (Note the last time there is no drug to stop bleeding after bleeding, the bleeding is not their own)
Answer:
Esophageal varices are "portal hypertension" caused by the formation of collateral circulation caused by. Present in the liver disease, such as advanced cirrhosis, liver cancer and so on.
Esophageal varices after easily because the breakdown of food stimuli, which happened upper gastrointestinal bleeding.
Treatment with the drug does not work, can be taken to surgery, put the backbone of esophageal vein ligation, or the use of more advanced "portosystemic shunt" to reduce pressure inside the varicose vein, thereby reducing the opportunity hemorrhage.
1, alcohol
2, eat less digestible residue of soft food to prevent food across the curved venous plexus. Vegetables should be chopped soft system. To avoid the use of high-fiber vegetables, tubers, and roots. Meat Tenderness of pork minced meat using the system soft - using methods such as steaming stew. do not have oil for frying food, staple food to soft food such as fermented bread, steamed breadand digestible for the good. hard to avoid eating rough food, such as coarse grains, fruit salad, as well as with spur of the chicken fish food. acidogenic aerogenes eating food: sweet potato such as gastric acid can increase gas production and other food products such as radisheasily cause flatulence. fasting strong pungent spices, such as pepper.
3, to maintain patency of stool to avoid forced defecation, coughing, such as increased abdominal pressure.
(B) do any work, emotional stability
One, pay attention to rest, avoid over exertion.
2, it is necessary to focus on disease, actively cooperate with the treatment, but also cultivate optimism; a long time because of illness, his condition and prognosis of repeated concerns usually heavier emotional burden, emotional instability. Modern medical science has discovered that emotions and the body of the immune closely related to the function of the system. with optimism, a positive attitude towards the disease, treatment of life can often have a multiplier effect.
Upper gastrointestinal bleeding in cirrhotic
1. Why cirrhosis will lead to upper gastrointestinal bleeding?
Lead to upper gastrointestinal bleeding due to a:
(1) esophageal varices
Esophageal, gastric varices are a result of liver cancer on the most important cause gastrointestinal bleeding. The main mechanism for its occurrence as follows: more than 80% of patients with liver cirrhosis, liver cirrhosis can lead to increased portal pressure, esophageal, gastric varicose veins, when the portal vein or hepatic vein obstruction, portal hypertension can be exacerbated, leading to have varices of esophagus, gastric bleeding, causing upper gastrointestinal bleeding; liver may increase the liver damage, so increase the degree of cirrhosis, leading to high portal and the poor; when the liver lesion is located at Hilar when oppression portal vein, but also will enable the portal vein hypertension.
(2) clotting mechanism obstacles
Hepatocellular carcinoma in patients with normal liver tissue because of decreased liver synthesis of clotting factor reduction, coagulation mechanisms obstacles happen. Because of hypersplenism, increased platelet destruction, coagulation mechanisms obstacles will happen. In addition, the tumor thrombus into the blood after the person, it is easy to cause acute disseminated intravascular coagulation (DIC), caused by gastrointestinal bleeding.
(3) gastrointestinal mucosal erosion
Liver cancer patients because of portal hypertension, often caused by gastrointestinal stasis, dynamic membrane edema erosion, caused by bleeding.
2. Cirrhosis complicated with upper gastrointestinal bleeding treatment
Liver cirrhosis complicated with esophageal, gastric bleeding occurred in many middle-aged men, the majority of patients have chronic liver disease, jaundice, history of schistosomiasis or chronic alcoholism. Prior to the onset, the vast majority of patients with no obvious precursor or discomfort, some patients hematemesis at the former have a sense of abdominal fullness. hematemesis caused by the volume of the disease more, mostly bright red, Chung spit out, and some cases of hematemesis was sprayed.
Hematemesis event, family members should be immediately taken to the hospital in patients with first-aid measures, as well as visions go pillow lying patients, cut hot food and other protein foods.
Upper gastrointestinal bleeding rescue principles are: to support the therapy, infusion, blood transfusion, to prevent and correct the shock, the use of appropriate drugs to stop bleeding. To rescue the most important process to a blood transfusion, and is rich in new blood clotting factor. Rescue measures are another important hemostasis. methods include drugs to stop bleeding, mechanical compression (three cavity second capsule tube oppression) to stop bleeding, endoscopic hemostatic vascular embolization and surgical hemostasis.
drug to stop bleeding: Liver cirrhosis with portal hypertension resulting in esophageal and gastric venous bleeding, should seek to reduce portal pressure, may be oral or intravenous infusion of propranolol Pituitrin, eight peptide vasopressin and somatostatin. At the same time, the use of hemostatic agents, such as vitamin K, an envelope of blood, 6 - amino-acid, anti-acid and blood fibrinolytic Baijigou medicine powder, etc. Callicarpa grass.
mechanical hemostasis: the main three-cavity second capsule tube compression hemostasis. Such as the use of these drugs no hemostatic effect, and should not immediately proceed to surgery should be put to immediate use by this method. Such as airbag placed spaces appropriate hemostatic effect can be achieved. Application , inflatableθTo many, the general filling 200-400 ml; esophageal inflatable sac relatively small (80 ml), because many of esophageal varices from gastric veins, gastric vein as long as the oppressed living, bleeding on can be ended. If still unable to effectively stop bleeding, should continue to increase the volume of esophageal inflatable bag. It was also called gastric tube with saline injection plus 8 mg of norepinephrine to gastric vascular contraction, which continued bleeding after the airbag suppression From effect. In order to avoid pressure on mucosal injury, should be 12 hours every oppression that is deflated 1-2 hours. oppression hemostatic measures are generally not more than 3 days, 3 days later still bleeding should consider taking other measures.
endoscopic hemostasis: conservative treatment of medical patients to be invalid under the use of endoscopic sclerotherapy hemostasis. Acute hemorrhagic bleeding rate of 95%, for parts of the blood vessels to stop bleeding for embolization to stop bleeding, such as bleeding site is not easy to determine and can at endoscopic hemostasis thrombin spraying.
surgery: application of the above treatment is still a large number of bleeding or recurrent bleeding, surgical treatment should be considered, methods are: ligation of gastric and esophageal varices; cross section at the bottom of the stomach, and then for the stomach - gastric anastomosis; if the situation is still sick body stable, could be considered for the portal vein or splenorenal venous anastomosis bypass surgery.
3. Cirrhosis of the prevention of upper gastrointestinal bleeding
Upper gastrointestinal bleeding cirrhosis are the most common and serious complications. Haemorrhage was mainly attributable to portal hypertension resulting in esophageal variceal bleeding. One by bleeding, ferocious, high mortality. Its more serious degree of esophageal varices, happen the greater the risk of bleeding. Therefore, patients with liver cirrhosis should be held in gastroscopy to find out the extent of esophageal varices and scope of understanding whether or not the possibility of recent hemorrhage.
Those who have been bleeding or gastroscopy have severe esophageal varices, especially in the near future have the possibility of bleeding patients should be taken to prevent bleeding or re-bleeding measures. Ways to prevent a lot of bleeding, widely used in clinical drug prevention of bleeding. The most commonly used drugs are propranolol (). encore experience slower heart rate, lower cardiac output, reduce portal pressure. for the treatment of bleeding and prevention of bleeding have good results. commonly used doses of each times 10-40 mg orally 3 times a day. dose should be started from a young age. heart rate after administration the heart rate than the original 25% to be effective. taking propranolol has certain side effects, therefore, has bronchial asthma, emphysema, diabetes mellitus, sinus bradycardia, and severe heart failure patients should be banned. long-term medication may reduce the blood supply to the liver, a small number can be induced by hepatic encephalopathy (hepatic coma). propranolol metabolites after oral administration of its most in 48 hours Neijing row of kidney exchange, in vivo accumulation generated Hing sticks. To play a role in the prevention of bleeding must be long-term use. In the course of medication can not be a sudden stop, otherwise, the sudden rise of portal pressure, there are likely to cause bleeding. If you need discontinuation should be gradual reductions. De'an some sick intentions ineffective and may increase with nifedipine or isosorbide dinitrate two drugs combined. De'an if intentions have taboos, can also be single-use oral nifedipine or isosorbide dinitrate. These two drugs also reduce portal pressure has the role of the prevention of bleeding. It should be noted that these drugs should be under the guidance of physicians at the application.
4. Cirrhotic patients with upper gastrointestinal hemorrhage substantial attention
(1) diet
1, alcohol
2, eat less digestible residue of soft food to prevent food across the curved venous plexus. Vegetables should be chopped soft system. To avoid the use of high-fiber vegetables, tubers, and roots. Meat Tenderness of pork minced meat using the system soft - using methods such as steaming stew. do not have oil for frying food, staple food to soft food such as fermented bread, steamed breadand digestible for the good. hard to avoid eating rough food, such as coarse grains, fruit salad, as well as with spur of the chicken fish food. acidogenic aerogenes eating food: sweet potato such as gastric acid can increase gas production and other food products such as radisheasily cause flatulence. fasting strong pungent spices, such as pepper.
3, to maintain patency of stool to avoid forced defecation, coughing, such as increased abdominal pressure.
(B) do any work, emotional stability
One, pay attention to rest, avoid over exertion.
2, it is necessary to focus on disease, actively cooperate with the treatment, but also cultivate optimism; a long time because of illness, his condition and prognosis of repeated concerns usually heavier emotional burden, emotional instability. Modern medical science has discovered that emotions and the body of the immune closely related to the function of the system. with optimism, a positive attitude towards the disease, treatment of life can often have a multiplier effect.
