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 patients in the acute period

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PostSubject: patients in the acute period   Fri Apr 06, 2007 12:14 pm

The pharmacological agents in the first place should be vazopressin of infuzionna therapy first 48 hours. In the absence of identity can be used oktreotid necessarily blockers secreta (famotidin users with the transition to ingesting or inhibitors protonova pump) to the scars, and the subsequent treatment of a major illness. 2. Bleeding from the stomach and KDP-hospital illness symptomatic ulcers. The statistics showed that 20% of patients bleeding is massive. The 80% of patients had stopped spontaneously. Relapses are bleeding in patients with massive bleeding and multiple sores. General activities : * intensive care krovopoteri, restoration and maintenance of a stable, hemodynamics; * Endoskopiceski gemostaz with prognosticeski than in the past has been done, the better the outcome (the first 12 hours), with the ineffectiveness of endoscopic hemostasis or repeat bleeding, surgical benefit to minimum-tubal receptacle. Previously, it was believed that bleeding, especially massive, is a testimony to the operation, the current evidence for the prompt treatment arise after two massive bleeding. 3. If the bleeding stopped spontaneously, or a successful endoskopiceski gemostaz, patients should appoint users blockers secreta at least 48 hours. In superficial izgyazwlenia-blockers protonova film with a deeper (podslizistye or muscle groups), the best famotidin combined with miolitikami. Later in stable ostanovivchemsa bleeding Pharmacotherapy should be per os. In doing so, in patients Nr-assotsiirovanna ulcers is to be held eradikatine treatment to be followed by therapy blokatorami secreta and protectorami (sukralfat) to rubtsevania ulcers, and in patients with Chinese medicine as a river can be used synthetic prostaglandins. If bleeding occurred in the patient receiving anticoagulants or antiagreganta should assess the need to continue to receive them. If a patient requires continued antikoagulyantna therapy, correction should be frozen plasma and / or low doses of vitamin C (intravenously 0.5-1 mg). When expressed trombozitopenia (less than 50,000), adding trombozitarna estate. The stable period during the testimony of a surgical treatment, but categorical refusal patient, it is a preventive protivoyazvennogo permanent cure. All patients in the acute period (the first 48 hours), a hunger, and then, depending on the development of clinical situations, or are in the process of injecting food or die diet (such as table 1a). Length dietary restrictions depends on the massiveness of bleeding and ulcers depth, because those splanhniceski disorders require the muscular peace, which has eluded them for the use of blocking secreta. In all cases, is the basic therapy infection, which had been a cause of bleeding from the upper gastrointestinal divisions, and lekarstvenno-inducir Bathroom ulcers should reconsider the nature of the treatment, and if it should be continued, it is only with active disease

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