Erosive gastritis treatment should be cautious, how to treat gastritis skillfully? The occurrence of gastritis will affect your eating and sleeping. Acute erosive gastritis, also known as acute hemorrhagic gastritis, is often caused by taking acetylsalicylic acid, Baotaisong, indomethacin, adrenocortical hormone, or by drinking, serious trauma, major surgery, and failure of important organs (heart, liver, kidney). Sudden onset, clinical upper gastrointestinal bleeding is the main manifestation of the disease, its incidence accounts for more than 1 / 4 of the causes of upper gastrointestinal bleeding, second only to peptic ulcer bleeding. Mild stool occult blood positive only, and most patients have hematemesis and black stool. The bleeding occurred intermittently with the recurrence of the disease. Usually the condition of this disease is more serious than peptic ulcer bleeding, although after a lot of blood transfusion, hemoglobin is difficult to rise.
In addition to bleeding, most patients have upper abdominal discomfort, abdominal pain, dizziness, fatigue and loss of appetite and other symptoms. But physical examination in addition to rapid pulse, pulse pressure difference decreased, anemia and other bleeding signs, generally no other obvious abnormal signs.
Once diagnosed, hemorrhagic gastritis must be treated in time, in order to prevent massive bleeding in patients, leading to life-threatening. The principle of treatment is to remove all kinds of inducing factors, reduce the acidity in the stomach, prevent the hydrogen ion anti diffusion from aggravating the damage of gastric mucosa, actively stop bleeding, blood transfusion and rehydration. The specific measures are as follows:
(1) Blood volume supplement: intravenous drip of whole blood or fresh frozen plasma, plasma substitute and balanced salt solution should be given as appropriate, and microcirculation should be improved in patients with shock.
(2) Gastric lavage with ice salt water: it can make the blood vessels of gastric wall contract, reduce the secretion of gastric acid, and promote hemostasis. The method is to leave the gastric tube in the stomach, first pump out the gastric juice, inject 200-300 ml of ice salt water, then pump out, repeatedly rinse 3-4 times, finally add 4 mg of norepinephrine into 250 ml of ice salt water, inject into the stomach, so as to further constrict the blood vessels. It can be repeated once after 4 hours.
(3) Application of H2 receptor antagonists: H2 receptor antagonists such as cimetidine, ranitidine and famotidine can inhibit gastric acid secretion and reduce hydrogen ion concentration. In general, cimetidine 0.2g, once every 6 hours; ranitidine 150mg, once every 12 hours; in critically ill patients, cimetidine 0.4g or ranitidine 300mg can be given intravenously.
(4) Antacids: oral sucralfate 0.75g per hour or aluminum hydroxide and magnesium hydroxide mixture can neutralize gastric acid and protect gastric mucosa.
(5) The hemostasis effect is reliable by electrocoagulation or laser hemostasis. Due to limited conditions, it is still difficult to popularize.
(6) In selective arteriography, pituitrin was infused to constrict the bleeding vessels and stop bleeding. At present, the clinical application is less.
(7) Surgical treatment: the vast majority of patients can stop bleeding after medical treatment, but there are still about 10% patients need surgical treatment, otherwise it is difficult to control bleeding. Vagotomy and subtotal gastrectomy were used in the operation.
Sihai health network warm tips: once diagnosed with hemorrhagic gastritis, must be treated in time, in order to prevent patients with massive bleeding, leading to life-threatening. The principle of treatment is to remove all kinds of inducing factors, reduce the acidity in the stomach, prevent the hydrogen ion anti diffusion from aggravating the damage of gastric mucosa, actively stop bleeding, blood transfusion and rehydration.