消化道出血应该怎么治疗 陈明锴 武汉大学人民医院

消化道出血应该怎么治疗 陈明锴 武汉大学人民医院
消化道出血的治疗方式主要分为两块，第一个是对因的治疗，比方说这个病人是溃疡病的出血，我们肯定是抗溃疡治疗为主，如果这个病人是血管畸形动脉破了，那我们首先要选择内镜治疗，如果内镜治疗失败的话，我们会选择外科手术或者是介入治疗，那么对于一个急性胃黏膜病变或者中药引起的，又或者是阿司匹林这样药物引起的，我们首先要去掉损伤因素，然后再来进行护胃的治疗。当然去掉损伤因素也有它的原则，比方说阿司匹林引起的出血，对于有高危血栓风险的病人，那我们是不能马上去除阿司匹林的，甚至还要继续吃下去，对于中低危的病人，我们也会根据他的危险程度，进行相应的处理，这是对因的治疗。第二个就是对症的治疗，对于消化道出血的病人我们可以使用质子泵的抑制剂、黏膜保护剂进行治疗，对严重的病人，我们还可以使用血管活性的药物进行处理，当然内镜治疗也是一个很好的手段。

How to treat gastrointestinal bleeding
The treatment of gastrointestinal bleeding is mainly divided into two parts, The first is the treatment of the cause, For example, this patient is bleeding from an ulcer, We must focus on anti ulcer treatment, If the patient had a vascular malformation and a broken artery, So we have to choose endoscopic therapy first, If endoscopy fails, We will choose surgery or interventional therapy, So for an acute gastric mucosal disease or caused by traditional Chinese medicine, Or aspirin, First of all, we need to remove the damage factors, Then we will have the treatment of protecting stomach. Of course, there are principles to remove the damage factors, For example, the bleeding caused by aspirin, For patients at high risk of thrombosis, Then we can't get rid of aspirin right away, And even continue to eat, For patients with low to medium risk, We'll also be able to, Carry out corresponding treatment, This is the treatment of the cause. The second is the treatment of symptoms, For patients with gastrointestinal bleeding, we can use proton pump inhibitors and mucosal protectors, For serious patients, We can also treat it with vasoactive drugs, Of course, endoscopic therapy is also a good way.