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PostSubject: patients digestive   Fri Apr 06, 2007 2:23 pm

These data are relevant to the general distress hemodynamics. Receptacles those bodies is a very high density of innervation adrenergicescoy that it is very important to maintain an adequate blood circulation, and for a rapid response in stressful situations (such as bloody). An important consideration in determining the outcome and understanding of actions to be performed in the emergency pathology is morfofunktionalna knowledge of the vascular bed "hollow" splanhniceskih bodies. In accordance with the three main segments of the wall (redness, podslizistaya, muscle) and provide three parallel vascular network is vnutriorganne, of the circulatory and regulations that may be relatively independently of each other. Adequacy action in the face of bleeding depends on the study : 1. localize lesions (esophagus, stomach, PDK), the depth of injury (signs, podslizistaya, muscle membrane), the process (continued bleeding, stationary, bloody shock), the overall hemodynamics and the baseline status of the cardiovascular system, the starting time of bleeding and approximate krovopoteri; 2. selection : A Manual on stopping the ongoing bleeding, and bleeding ostanovivchemsa choice regime and its duration, time, the nature and duration of dietary interventions, the choice of products, taking into account the immediate and direct effects; 3. deferred for further tactics of the patient. Based on these provisions, a tactic can be summarized as follows : 1. Bleeding from the esophagus (varikozno-rasshirenna e Veins, erosivno-azwenne changes, the gap-eye syndrome Mallori-weissa) : * When ostanovivchemsa spontaneous bleeding from the arikozno-rasshirennah Eligible patients digestive appoint somatostatin (synthetic analogue - oktreotid) 100 g intravenously bolusno, then 50 g / h intravenously within 48 hours. In the future, you can go directly to a cord 50-100 g every 8 hours. The duration depends on the clinical situation as a whole. Therapy can be supplemented blokatorami secreta-in the majority of the states that must begin by intravenous famotidine 20 mg four times a day, from 2 to 10 days before proceeding to ingesting curative dose. When the arterial pressure, it may be discussed use? -blokatorov, First intravenously and then inwards. For stabilization, the issue of surgical correction pressure in the blood gantries. * The continuing hemorrhage - sklerotherapia (if possible) or probe Blackmore (which, according to the different authors are similar sklerotherapii) and pharmacotherapy described above. * If hemorrhage (erosivno-yazvennom or nasal fracture), endoscopic stops bleeding (clipirovanie, coagulation, including laser, etc.).

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