Why does the digestive tract bleed?
Portal vein is the normal passage of blood through the liver, blood will eventually flow into the superior vena cava, but when the liver hardens, the portal vein pressure will naturally rise, called portal hypertension, due to the increase in pressure, the portal vein at this time blocks the normal passage of blood, at this time the blood flowing through the liver only through other pathways into the superior vena cava, other pathways include the esophagus gastric floor vein, abdominal wall vein, hemorrhoid vein and so on. When blood flows through the esophagus gastric vein, the blood vessels will be varicose, and the varicose esophageal gastric vein is like a time bomb, when a patient with cirrhosis eats hard, rough food, and the food cuts through the gastric floor vein, it will cause bleeding. And because the varicose vein wall is thin, the lack of elastic contraction, it is difficult to stop bleeding, resulting in high mortality.
Upper gastrointestinal bleeding is a serious complication of the decompensated period of cirrhosis, and patients with large bleeding will be life-threatening and need urgent rescue.
Many patients bleed due to improper diet and other reasons, and the family is the first place of bleeding. Once bleeding, every step of rescue and treatment is related to the patient's life.
What are the clinical manifestations of upper gastrointestinal bleeding?
1. Hematemesis: when the patient has a lot of bleeding, there may be hematemesis, if the patient bleeds less, there is generally no manifestation of hematemesis, if the vomited blood is brown or brown, it means that the bleeding rate is slower, if it is bright red, it means that the bleeding rate is faster;
2. Melaena: In general, when the amount of bleeding in the upper gastrointestinal tract of the patient reaches 50ml or more, the clinical manifestations of melaena will appear, which is because the blood flows through the intestine, and the original trivalent iron in the blood combines with sulfide under the action of intestinal bacteria to form iron sulfide, that is, divalent iron, and divalent iron ions are mostly black, so the color of the stool is also black.
If a patient with cirrhosis has upper gastrointestinal bleeding, how should the patient's family do a good job of pre-hospital first aid?
1. Dial 120 immediately. Or contact a specialist for treatment.
At the same time, the implementation of home care to stabilize the patient's condition, at this time it is not recommended to carry the patient to the hospital by private car or non-ambulance special vehicle.
2. Immediately place patients in situ and avoid handling.
Leave the patient in a lateral lying position, and when vomiting blood, the patient's head is tilted to one side to avoid blood inhalation into the trachea;
Use words and actions to eliminate their tension;
Keeping the head low and high to prevent suffocation during severe vomiting, this position can also ensure the supply of blood flow to the brain in the event of major blood loss, so as to avoid collapse or fainting on the ground;
Pay attention to keeping the patient warm, and closely observe the patient's consciousness, breathing, and pulse;
Patients with multiple bleeding can prepare some necessary hemostasis drugs at home.
When the amount of bleeding is large, maintain the upper body and lower limbs to raise the position, the upper body elevation is about 30 ° -45 °, the lower limb elevation is about 15 ° -25 °, this position can ensure that the patient is in the case of major bleeding, important organs are supplied to blood, to avoid collapse.
3. Immediately fast and drink water.
Patients may be allowed to rinse their mouths with water; however, they should not swallow food or drink water;
Do not apply warm compresses to the abdomen, so as not to congestion in the gastrointestinal tract and aggravate the bleeding;
If available, oxygen can be given immediately;
strengthening care to prevent vomit inhalation into the respiratory tract causing pneumonia or asphyxia;
The patient's vomit or feces are retained and the total amount is roughly estimated, and some specimens are left for testing at the time of medical treatment.
4. Oxygen can be inhaled under conditions.
5. For those who have experienced shock coma, remove the pillow lying flat, the head is tilted to one side, remove the blood in the mouth, and avoid aspiration.
Pay attention to keep warm, closely observe the patient's breathing and pulse, and measure blood pressure if possible, waiting for the arrival of ambulance personnel.