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目的探讨肝炎后肝硬化并发上消化道出血的抢救体会。方法回顾性分析我院2013年2月至2013年10月急诊科救治的48例肝炎后肝硬化并发上消化道出血患者的临床资料。采取相应抢救和护理措施,密切检测患者生命体征和观察其呕血、黑便、昏迷情况;采用静脉滴注醋酸奥曲肽止血,20μg/h,持续48h;对失血过多患者给予静脉输入706代血浆和浓缩红细胞;对止血效果不佳者,采用三腔二囊管压迫止血或内镜下结扎止血;早期给予药物以积极预防并发症发生。同时在抢救和恢复期间对患者进行心理护理、饮食护理和出院指导。观察本组48例患者治疗效果。结果本组48例经过抢救,显效40例(83.33%),有效4例(8.33%),无效3例(6.25%),死亡1例(2.08%)。结论在抢救肝硬化合并上消化出血时应灵活采取抢救措施进行治疗,以提高抢救成功率。
Objective To explore the experience of post-hepatitis cirrhosis complicated by upper gastrointestinal bleeding. Methods The clinical data of 48 patients with posthepatitic cirrhosis complicated with upper gastrointestinal bleeding treated in the emergency department from February 2013 to October 2013 in our hospital were retrospectively analyzed. Take appropriate rescue and care measures, close examination of patients vital signs and observe the hematemesis, melena, coma; intravenous infusion of octreotide acetate, hemostasis, 20μg / h for 48h; given excessive bleeding in patients with intravenous infusion of 706 generations of plasma and Reduce the concentration of red blood cells; poor hemostasis effect, the use of three-chamber two cystic compression hemostasis or endoscopic ligation to stop bleeding; early drug to actively prevent complications. At the same time during the rescue and recovery of patients with psychological care, diet and discharge guidance. Observed in this group of 48 patients with treatment. Results Forty-eight patients (83.33%) were cured, 4 were effective (8.33%), 3 were ineffective (6.25%) and 1 died (2.08%). Conclusion In the rescue of cirrhosis combined with upper gastrointestinal bleeding should be taken to rescue the rescue treatment measures to improve the success rate of rescue.