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Wang Li Bing
Intensive Care Medicine Department
About me
Loudi Central Hospital, ICU, attending physician, has been engaged in ICU clinical work for many years, with rich clinical experience in the treatment of emergency patients.
Proficient in diseases
Proficient in using equipment such as continuous electrocardiogram monitoring, oxygen saturation detection, blood pressure monitoring, and disease monitoring.
Voices
Upper gastrointestinal bleeding clinical manifestations
Upper gastrointestinal bleeding primarily refers to bleeding above the Treitz ligament. The most common causes in clinical practice are peptic ulcers, rupture of esophagogastric varices, acute erosive hemorrhagic gastritis, gastric cancer, etc. The clinical manifestations of upper gastrointestinal bleeding mainly depend on the volume and speed of the bleeding, with the main symptoms being vomiting blood and black stools. After significant blood loss, patients may experience symptoms of peripheral circulatory failure due to reduced circulating blood volume, such as dizziness, palpitations, fatigue, cold limbs, increased heart rate, and low blood pressure. If the patient enters a state of shock, it could even be life-threatening.
Clinical manifestations of subarachnoid hemorrhage
The main clinical manifestations of subarachnoid hemorrhage are sudden severe headache, accompanied by nausea and vomiting, with positive signs of meningeal irritation. If such symptoms occur, it is urgent to seek medical attention and perform a cranial CT scan. If the CT shows a high-density shadow in the subarachnoid space, it can be diagnosed as subarachnoid hemorrhage, and the patient should be treated in neurology or neurosurgery for active management. Clinically, conservative medication treatment is generally adopted, paying attention to changes in the patient's consciousness and pupils, and surgical treatment may be considered if necessary.
Principles of Treatment for Severe Pancreatitis
The treatment principles for severe pancreatitis mainly include the following points: First, closely monitor the patient's heartbeat, respiration, blood pressure, blood oxygen, etc., and if possible, transfer them to the intensive care unit. Second, maintain electrolyte balance and blood volume, and actively rehydrate. Third, enhance nutritional support, which can include parenteral nutrition outside of gastrointestinal digestion. Fourth, routinely use antibiotics in severe pancreatitis to prevent infection from necrotizing pancreatitis. Fifth, reduce the secretion of pancreatic fluid, inhibit the synthesis of pancreatic enzymes, and suppress the activity of pancreatic enzymes. If the patient develops an infection associated with pancreatic necrosis, consider surgical treatment, etc.
Pulmonary embolism means
The formation of thrombotic foreign bodies in the human venous system or the right atrium and ventricle system, ultimately leading to the blockage in the pulmonary artery, is referred to as pulmonary embolism. After the onset of pulmonary embolism, patients may experience symptoms such as shortness of breath, chest pain, coughing, and even coughing up blood. It is crucial to immediately conduct a pulmonary artery CTA scan for further diagnosis. If the diagnosis of pulmonary embolism is confirmed, thrombolytic or interventional treatments can be considered.
The most common cause of upper gastrointestinal bleeding
Upper gastrointestinal bleeding is also relatively common clinically. The most common causes mainly include the following points: the first is bleeding from gastric and duodenal ulcers, the second category is esophageal and gastric fundal variceal rupture caused by liver cirrhosis, the third category includes bleeding caused by stress ulcers and acute erosive gastritis, and another category includes bleeding caused by gastric cancer, etc. After upper gastrointestinal bleeding occurs, blood transfusion should be administered to replenish blood volume and stop the bleeding. If conditions allow, a complete gastroscopy should be performed for endoscopic hemostasis. If drug treatment is not effective, surgical treatment may be considered, etc.
How is heart failure treated?
Heart failure is very common in clinical settings. The main treatments include strengthening the heart, diuresis, and vasodilation for symptomatic treatment. A mask or high-flow oxygen can be used if the patient's heart failure symptoms are difficult to correct, or if cardiogenic shock occurs. Aortic balloon counterpulsation and tracheal intubation can be adopted, with ventilator support for ventilation, and blood dialysis and other symptomatic supportive treatments can be used. Another point is to actively control or eliminate the causes of heart failure, etc.
Common Causes of Upper Gastrointestinal Bleeding
The common causes of upper gastrointestinal bleeding mainly include the following points: First, esophageal diseases, such as esophagitis, Mallory-Weiss syndrome. Secondly, peptic ulcers, gastric cancer, acute erosive hemorrhagic gastritis, and then esophageal gastric variceal rupture caused by portal hypertension. There are also diseases of neighboring organs or tissues of the upper digestive tract, such as biliary bleeding, pancreatic diseases involving the duodenum, such as pancreatic cancer, acute pancreatitis complicated by abscess rupture and bleeding. Additionally, there are systemic diseases, such as allergic purpura, hemophilia, leukemia, etc.
Is upper gastrointestinal bleeding dangerous?
Upper gastrointestinal bleeding is life-threatening if the amount and speed of bleeding are substantial. Therefore, proactive and effective measures should be taken to rescue the patient. Generally, after anti-shock treatment and rapid blood volume replenishment, the patient's life can be saved. The main clinical treatment measures include the following: First, keep the patient in a recumbent position at rest, ensure that the airway is clear, and prevent blood aspiration due to vomiting. Second, during the bleeding period, it is necessary to enforce fasting, closely monitor the patient's vital signs, such as heartbeat, breathing, blood pressure, consciousness, etc. Third, after hospitalization, it is crucial to actively replenish blood volume, such as transfusing compatible red blood cells, plasma, cryoprecipitate, etc., for fluid expansion. Drugs like proton pump inhibitors and octreotide can be used for hemostasis. If conditions permit, a gastroscopy can be performed to stop the bleeding, and surgical treatment may be considered if necessary.
Severe pancreatitis treatment process
Severe pancreatitis generally develops rapidly, progresses urgently, and can even be life-threatening. Therefore, the main treatment initially involves fasting, gastrointestinal decompression, suppression of pancreatic enzyme secretion, promotion of gastrointestinal motility, and maintaining regular bowel movements. Antibiotics can be used to prevent infection and necrosis of pancreatic tissue. If necrotic pancreatic tissue and ascites occur in the abdominal cavity, appropriate puncture and drainage may be used.
Can hypokalemia be cured?
Hypokalemia is very common in clinical settings, and there are mainly two treatment methods. The first one is the oral administration of sustained-release potassium chloride tablets or oral potassium chloride solution. Patients can be advised to consume potassium-rich vegetables and fruits, etc. The second method is intravenous potassium supplementation, which has higher requirements. It is important to monitor the patient's urination; if urination is adequate, intravenous supplementation can proceed, but the concentration of potassium should not exceed 0.3%. After the occurrence of hypokalemia, it is crucial to actively search for the cause and provide symptomatic treatment. Generally, the prognosis for hypokalemia is good.