摘要
目的探讨内科危重病患者发生应激性溃疡出血的临床特征及防治。方法选择我院2014年1月—2017年9月诊治的40例各种危重病合并应激性溃疡出血患者作为研究对象,根据患者实际病情积极治疗原发病和消除应激因素;禁食或胃肠减压;静脉应用质子泵抑制剂;8.0%去甲肾上腺素胃管注入;必要时加用生长抑素;血压低于90/60 mm Hg、血红蛋白低于70 g/L给予输血治疗。结果 32例(80.00%)应激性溃疡消化道出血患者通过上述内科保守治疗得到控制,6例(15.00%)患者因原发病及多脏器功能衰竭而死亡、2例(5.00%)因消化道出血死亡。结论危重病患者是应激性溃疡出血的高发群体,具有临床症状不典型、影响因素复杂、预后不良的特征,要积极预防,密切观察,早期治疗。
Objective To college of critical care patients with stress ulcer bleeding occurred clinical characteristics and prevention. Methods Choose January 2014-September 2017 diagnosis and treatment 40 cases of various kinds of critical patients with stress ulcer hemorrhage patients as the research object,According to the actual condition of patients with active treatment and elimination of stress factors;fasting or gastrointestinal decompression;intravenous proton pump inhibitors;8% norepinephrine injected into the tube when necessary;plus somatostatin;blood pressure lower than 90/60 mm Hg,hemoglobin below70 g/L give blood transfusion treatment. Results 32 cases（80%,32/40）by the stress in patients undergoing conservative treatment under control of gastrointestinal ulcer bleeding,6 cases（15%,6/40） patients died of primary disease and multiple organ failure,2 cases（5%,2/40） died of gastrointestinal bleeding. Conclusion Critically ill patients are the high risk group of stress ulcer bleeding. They have atypical clinical symptoms,complex influencing factors,and adverse effects on prognosis,so they should be actively prevented,observed closely and treated early.
作者
沈健
shen Jian(The Branch Affiliated Hospital of Nantong University,Nantong,Jiangsu 226001)
出处
《基层医学论坛》
2018年第19期2635-2636,共2页
The Medical Forum
关键词
内科
危重病
应激性溃疡出血
临床特征
防治
Medical
Gravely ill
Stress ulcer bleeding
Clinical features Prevention and treatment
