Therapeutic _'s treatment that hepatocarcinoma erupts the upper digestive tract simultaneously and bleeds

Therapeutic _'s treatment that hepatocarcinoma erupts the upper digestive tract simultaneously and bleeds
Make a definite diagnosis of for hepatocarcinoma already, especially patient to amalgamate liver cirrhosis, appear spitting blood, black, the intersection of blood and make or behavior person of collapse of bleeding etc., can diagnose as and erupt the upper digestive tract simultaneously that bleed. Blood routine, stool occult blood, gastroscope,etc. check the diagnosis contributing to going straight and combining.
(1) Treatment of internal medicine department
1.Generally treat: Oxygen intake, stay in bed, enter the diet of warm cool liquid, the great one of bleeding amount should prohibit to eat; To body temperature, blood pressure,
Pulse, breathing, heart rate, stool color, stool quantity and spitting blood situation,etc. guard tightly, patient should go pillow lie while being flat, hair partial to side, prevent the blood from suck the trachea and suffocate for spitting blood.
2.Arrest blood promptly
(1)Two bags of three are in charge of oppression and arrest blood: Treat portal vein while being clinical at present high pressure due to oesophageal fundus of stomach variceal to break, produce
The traditional method of the blood, the already clear oesophageal fundus of stomach is variceal to break to bleed, generally difficult to produce effects to treat, the urgent styptic measure when can't perform the operation immediately. Suitable for clear, cooperate with the good patient in minding. It is that the bleeding rate is up to 50% after but 50%-80% bleed that this law is efficient.
(2)Oral noradrenaline liquid: Noradrenaline solution of high density can make the mucous membrane of stomach arteriolar and accept strongly in the stomach
Contract, through the supersession in the liver of portal vein after absorb, no effect will take place all over the body. Daily dosage whether 8-10ml add people in the physiological saline, formulate solution of 100ml, had better ice take orally to 40C, separate one for less than 1-2 hour each time, bleed, can change into every 4-6 hour once control.
(3)Thrombese is taken orally: 500-2000U, once of every 4-6h.
(4)Lower the temperature in the stomach: Can make the esophagus attempt and shrink for the surface blood vessel, reduce and bleed. Can irritate the clothes and ice the brine, or ice noradrenaline.
(2) Surgery treatment
Adapt to the card
(1)Only if perform the operation and fail to respond to any medical treatment, patient's liver function and persons who can still tolerate surgery of whole body situation;
(2)The patient has no yellow subcutaneous ulcer, ascites, tumour has been already excising tumour has been less, person who compensates liver function in advance;
(3)Already had variceal patients of obvious oesophageal fundus of stomach before the liver carcinectomy, it is estimated that is excising hepatocarcinoma and tolerating the variceal therapeutic surgery of oesophageal fundus of stomach, even can't excise, the artery intubate chemotherapy of also feasible liver, liver artery thromboembolism treatment or tumour part inject hardening or microwave treatment of absolute alcohol etc..
|