内镜下胃内血液清除术在急性上消化道出血中的应用及护理

Application and nursing of endoscopic entogastric blood cleaning in acute upper gastrointestinal hemorrhage

目的探讨内镜下胃内血液及血凝块清除在急性上消化道出血诊治中的可行性及护理配合。方法23例患者在常规急诊内镜检查时,发现大量血液及血凝块覆盖胃腔,影响观察。连通洗胃机,应用大口径多侧孔胃管进行内镜直视下胃内血液及血凝块清除,清除后进行内镜下检查和内镜下止血治疗。结果23例患者经过内镜下胃内血液及血凝块清除后,均能发现出血病灶,进行内镜下止血治疗,并配合有效的护理措施,22例患者有效止血。结论急性上消化道出血管腔内大量血液和血凝块影响内镜下诊治时,进行内镜下胃内血液及血凝块清除术可以清晰视野,有利于内镜的诊断和治疗。而术前心理护理、熟练的术中配合及术后严密观察病情是治疗成功的重要保证。

Objective To investigate the efficacy and nursing cooperation of endoscopic entogastric blood and clot cleaning in the treatment of acute upper gastrointestinal hemorrhage.Methods Much blood and clot were found in the stomach in 23 patients of upper gastrointestinal hemorrhage when receiving the routine emergency endoscopy,so the observation was influenced.Blood and clot in the stomach were cleaned by gastric irrigation through gastric tube with large diameter and multi-side holes companied with endoscopy by the gastric washing machine.The endoscopic examination and endoscopic hemostasis treatment were conducted after the cleaning.Results Causes of the bleeding lesion were all diagnosed in all of 23 patients whose blood and clot in the stomach were cleaned.The bleeding of 22 patients was stopped precisely through endoscopic treatment in combination with effective nursing intervention.Conclusions Endoscopic blood and clot cleaning is effective in diagnose and treatment for acute upper gastrointestinal hemorrhage,especially in cases with multiple bleeding lesions,superficial or blood covered lesions.So mental nursing before the operation,perfect cooperation during the operation and observing patient＇s condition accurately after the operation are the warrants for a successful treatment.