Subscribe
76
Wang Li Bing
Intensive Care Medicine Department
About me
Loudi Central Hospital, ICU, attending physician, has been engaged in ICU clinical work for many years, with rich clinical experience in the treatment of emergency patients.
Proficient in diseases
Proficient in using equipment such as continuous electrocardiogram monitoring, oxygen saturation detection, blood pressure monitoring, and disease monitoring.
Voices
What causes upper gastrointestinal bleeding?
The most common causes of upper gastrointestinal bleeding. The first is hemorrhage due to peptic ulcers. The second is bleeding from ruptured esophageal and gastric varices. The third is acute erosive hemorrhagic gastritis. The fourth is bleeding caused by gastric cancer. The fifth is bleeding caused by Mallory-Weiss syndrome. After the occurrence of gastrointestinal bleeding, it is necessary to seek medical attention promptly, undergo treatments like hemostasis and blood transfusion in the hospital, and actively manage the symptoms. If necessary, a gastroscopy can be performed for endoscopic hemostasis. If not treated actively, emaciated individuals' lives may be at risk, so caution is necessary.
How to treat upper gastrointestinal bleeding?
After gastrointestinal bleeding, the patient should be kept in a recumbent position to rest and ensure that the airway is clear to avoid aspiration of blood due to vomiting. Close monitoring of the patient's vital signs, such as heart rate, blood pressure, and breathing, is necessary. It is important to actively replenish blood volume, correct hypovolemic shock, and administer medications for hemostasis. Endoscopic hemostasis with a gastroscope can also be used. If conservative drug treatment is not effective, surgical treatment may be considered. Emergency treatment is essential after gastrointestinal bleeding, as delays can be life-threatening.
What causes uremia?
Uremia is very common in clinical practice. It is mainly caused by abnormal kidney functions, leading to abnormalities in glomerular filtration, as well as in the reabsorption and secretion functions of the renal tubules, which results in a series of symptoms. Once uremia occurs, it can disrupt the internal environment of the body, cause electrolyte abnormalities, and even lead to life-threatening arrhythmias. Uremia is very dangerous in clinical practice and often requires regular hemodialysis treatment. Therefore, once uremia occurs, medical attention must be sought promptly.
Upper gastrointestinal bleeding clinical manifestations
Upper gastrointestinal bleeding primarily refers to bleeding above the Treitz ligament. The most common causes in clinical practice are peptic ulcers, rupture of esophagogastric varices, acute erosive hemorrhagic gastritis, gastric cancer, etc. The clinical manifestations of upper gastrointestinal bleeding mainly depend on the volume and speed of the bleeding, with the main symptoms being vomiting blood and black stools. After significant blood loss, patients may experience symptoms of peripheral circulatory failure due to reduced circulating blood volume, such as dizziness, palpitations, fatigue, cold limbs, increased heart rate, and low blood pressure. If the patient enters a state of shock, it could even be life-threatening.
Clinical manifestations of subarachnoid hemorrhage
The main clinical manifestations of subarachnoid hemorrhage are sudden severe headache, accompanied by nausea and vomiting, with positive signs of meningeal irritation. If such symptoms occur, it is urgent to seek medical attention and perform a cranial CT scan. If the CT shows a high-density shadow in the subarachnoid space, it can be diagnosed as subarachnoid hemorrhage, and the patient should be treated in neurology or neurosurgery for active management. Clinically, conservative medication treatment is generally adopted, paying attention to changes in the patient's consciousness and pupils, and surgical treatment may be considered if necessary.
Principles of Treatment for Severe Pancreatitis
The treatment principles for severe pancreatitis mainly include the following points: First, closely monitor the patient's heartbeat, respiration, blood pressure, blood oxygen, etc., and if possible, transfer them to the intensive care unit. Second, maintain electrolyte balance and blood volume, and actively rehydrate. Third, enhance nutritional support, which can include parenteral nutrition outside of gastrointestinal digestion. Fourth, routinely use antibiotics in severe pancreatitis to prevent infection from necrotizing pancreatitis. Fifth, reduce the secretion of pancreatic fluid, inhibit the synthesis of pancreatic enzymes, and suppress the activity of pancreatic enzymes. If the patient develops an infection associated with pancreatic necrosis, consider surgical treatment, etc.
Pulmonary embolism means
The formation of thrombotic foreign bodies in the human venous system or the right atrium and ventricle system, ultimately leading to the blockage in the pulmonary artery, is referred to as pulmonary embolism. After the onset of pulmonary embolism, patients may experience symptoms such as shortness of breath, chest pain, coughing, and even coughing up blood. It is crucial to immediately conduct a pulmonary artery CTA scan for further diagnosis. If the diagnosis of pulmonary embolism is confirmed, thrombolytic or interventional treatments can be considered.
The most common cause of upper gastrointestinal bleeding
Upper gastrointestinal bleeding is also relatively common clinically. The most common causes mainly include the following points: the first is bleeding from gastric and duodenal ulcers, the second category is esophageal and gastric fundal variceal rupture caused by liver cirrhosis, the third category includes bleeding caused by stress ulcers and acute erosive gastritis, and another category includes bleeding caused by gastric cancer, etc. After upper gastrointestinal bleeding occurs, blood transfusion should be administered to replenish blood volume and stop the bleeding. If conditions allow, a complete gastroscopy should be performed for endoscopic hemostasis. If drug treatment is not effective, surgical treatment may be considered, etc.
How is heart failure treated?
Heart failure is very common in clinical settings. The main treatments include strengthening the heart, diuresis, and vasodilation for symptomatic treatment. A mask or high-flow oxygen can be used if the patient's heart failure symptoms are difficult to correct, or if cardiogenic shock occurs. Aortic balloon counterpulsation and tracheal intubation can be adopted, with ventilator support for ventilation, and blood dialysis and other symptomatic supportive treatments can be used. Another point is to actively control or eliminate the causes of heart failure, etc.
Common Causes of Upper Gastrointestinal Bleeding
The common causes of upper gastrointestinal bleeding mainly include the following points: First, esophageal diseases, such as esophagitis, Mallory-Weiss syndrome. Secondly, peptic ulcers, gastric cancer, acute erosive hemorrhagic gastritis, and then esophageal gastric variceal rupture caused by portal hypertension. There are also diseases of neighboring organs or tissues of the upper digestive tract, such as biliary bleeding, pancreatic diseases involving the duodenum, such as pancreatic cancer, acute pancreatitis complicated by abscess rupture and bleeding. Additionally, there are systemic diseases, such as allergic purpura, hemophilia, leukemia, etc.