胃十二指肠出血是.ppt

海医附院消化内科 林尤冠;概述;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;一.胃、十二指肠出血治疗方法;二、适应症与禁忌症;禁忌症;三、术前准备;内镜治疗前应向病人家属做好解释工作，取得病人的配合，并履行知情同意书上签字手续。 在内镜操作过程中监测血压、心率、血氧饱和度。 术中可酌情静脉注射安定和654－2各10mg，并保持静脉通道开放。 以防止误吸发生，事前做好气管插管的准备工作。 对有高危人群或有心血管系统疾病者检查及治疗中均心电监护。;四、止血操作方法;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;操作方法及步骤;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;注意事项;2、氩离子凝固治疗;器械准备;电凝止血原理;电凝止血示意图;操作方法与步骤;氩离子电凝止血;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;3、微波凝固术;器械准备;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd.;操作步骤;对胃黏膜下血管出血者，用球状电极紧贴血管瘤处部位，点灼病灶，进行反复发射凝固直至出血停止。 观察数分钟，确定止血后退镜。;4、药物喷洒止血术;2）孟氏液 机理：其具有很强的收敛作用，能使血液凝固，在出血灶表面形成附着牢固的棕黑色收敛膜，其尚有促进血管收缩及平滑肌收??，有利于止血。 3）生物蛋白胶 其为从生物组织中提取的多种可凝性蛋白凝胶，能有效制止组织创面渗血和小静脉出血，封闭缺损组织，促进组织创面愈合。其形成止血膜覆盖在溃疡表面，将胃酸和溃疡面隔离开，减少酸对溃疡的刺激，促进溃疡愈合。 ;器械和药物准备;喷洒止血用生物蛋白胶;操作方法及步骤;注意事项;5、药物注射止血术;3）无水酒精可使组织脱水，血管和周围组织固定，导致血管收缩、蛋白变性，形成血栓。 4）1%乙氧化醇等硬化剂可引起组织坏死及血管内血栓形成。 此外，局部注射组织肿胀可压迫血管而止血。;器械与药物准备;操作方法与步骤;E