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确定大量上消化道出血的来源甚为困难,如不及时止血,患者迅速死亡。紧急手术止血的死亡率较择期手术明显为高,因而寻求一种不借助于急诊手术的恰当止血措施颇为实用。作者对21例由不同原因引起的致命性胃肠道出血患者采用了腹腔和/或胃内高浓度去甲肾上腺素灌注法,其中16例(80%)出血很快停止。胃内灌注法:以8毫克%(结肠灌注用4毫克%)的去甲肾上腺素生理盐水溶液100毫升经胃管灌入胃内,钳闭胃管30分钟,然后以生理盐水经胃管冲洗并吸净,明确出血是否停止,此法可重复多次。腹腔灌注法:以细长穿刺针经患者侧腹部作腹腔穿刺,注入8毫克%去甲肾上腺素生理盐水溶液100毫升,然后协助患者来回转动腹部。出血一般在10分钟内停
It is very difficult to determine the source of a large number of upper gastrointestinal bleeding, if not stop bleeding in time, the patient died quickly. The mortality rate of emergency surgery is significantly higher than that of elective surgery, so it is useful to seek an appropriate hemostasis without emergency surgery. The authors used intraperitoneal and / or intragastric norepinephrine perfusion in 21 patients with fatal gastrointestinal hemorrhage caused by various causes, of which 16 (80%) stopped bleeding very soon. Intragastric perfusion method: 100 ml of norepinephrine physiological saline solution of 8 mg% (4 mg% for colon perfusion) was infused into the stomach through the gastric tube, the gastric tube was closed for 30 minutes and then rinsed with physiological saline And net absorption, a clear bleeding stop, this method can be repeated many times. Peritoneal perfusion method: With slender puncture needle through the patient’s abdomen for abdominal puncture, into the 8 mg% norepinephrine saline solution 100 ml, and then help patients to rotate the abdomen back and forth. Bleeding usually stop within 10 minutes