胃出血并非都要开刀手术。（记者乔军伟摄）

胃出blood并非都要开刀手术.(Reporter Qiao Junwei perturbation)

　　●一出血就实施胃切除是不少基层医院的治疗误区，但其实绝大多数溃疡性消化道出血无需外科手术

●一出blood就实施胃切除是不少基层医院的治疗误区,But the vast majority of ulcerative gastrointestinal bleeding without surgery

　　●以前定时“光顾”的胃痛突然“消失”尤其要提高警惕，因为此时可能已发展成消化道出血或胃癌等严重疾病

●以前定时"visit"Stomach pain suddenly"disappear"Especially vigilant,Because this time may have developed into the digestive tract hemorrhage or severe diseases such as gastric cancer

　　胃出血了，并非只有开刀手术才能治好；老人突然晕倒，除了中风，原来还可能与消化道出血有关。胃痛难熬，但如果之前缠绵难愈的“胃痛”突然消失了，其实也不是什么好事，因为这极有可能是消化道出血甚至胃癌的先兆。

胃出blood了,Not only invasive surgery can cure;The old man suddenly fainted,除了In the风,The original may also be associated with gastrointestinal bleeding.Stomach pain difficult,But if before touching refractory"Stomach pain"Suddenly disappeared,It's not what good things,Because it is extremely likely gastrointestinal bleeding even precursor of gastric cancer.

　　记者日前在广州市第一人民医院消化内科采访时了解到，近年来胃病整体发病率正在日益升高。有数据显示，中国的胃病发病人数较6年前足足翻了两番，患者以老年人和都市上班族为主。专家指出，目前胃病治疗已经有很多成熟有效的方法，但由于知识普及率低，很多人对胃病不重视，对规范治疗不了解，从而错过了治疗时机，让普通的胃病演化为消化道出血甚至胃癌。

记者日前In the广州市第一人民医院消化内科采访时了解到,In recent years胃病整体发病率正In the日益升高.有According to data,In the国The stomach trouble发病人数较6年前足足翻了两番,Patient is given priority to with the elderly and urban workers.Experts point out that,The stomach disease treatment has a lot of mature and effective method,But as a result of intellectual penetration is low,Many people do not take on the stomach disease,Do not understand standard treatment,Thus missed the treatment opportunity,To common stomach trouble evolved into the digestive tract hemorrhage and even gastric cancer.

　　文/记者黎蘅 通讯员徐晶、魏星

文/记者黎蘅 通讯员徐晶/Wei Xing

　　医学指导/广州市第一人民医院副院长、内科主任医师聂玉强

医学指导/广州市第一人民医院副院长/Doctor of medical director NieYuJiang

　　●胃出血

●胃出blood

　　吃药能治好别急着动刀

吃药能治好别急着动刀

　　刘先生在广州一间大型企业打拼多年，28岁已升为部门经理。然而，长期不按时吃饭的他，一早就落下胃病，上腹间断疼痛，晚上尤其难忍。由于工作繁忙，刘先生只在药店买胃药吃，一直没有到医院接受规范治疗。今年春节，刘先生回老家过年，再次出现上腹时痛时不痛、黑便等现象，被医生诊断为胃出血。

刘先生In the广州一间大型企业打拼多年,28, has been promoted to department manager.however,For a long time he not eat on time,Early fall stomach trouble,Epigastric intermittent pain,Especially at night.Because the job is busy,刘先生只In the药店买胃药吃,Have not been to the hospital to accept standard treatment.The Spring Festival this year,Mr. Liu hometown Chinese New Year,Once again appeared epigastric pain less painful/The phenomenon such as black,Doctors diagnosed a stomach bleeding.

　　当时，家乡基层医院的医生建议刘先生通过外科手术切除部分胃组织来治疗出血。一听要动刀，刘先生吓坏了，赶紧回到广州找大医院看病。广州市第一人民医院内科主任医师聂玉强是刘先生的接诊大夫，他介绍，经胃镜检查后发现，刘先生只是十二指肠溃疡而无其他疾病，完全可以通过药物治疗就能止血。随后，聂玉强又对刘先生胃部的幽门螺杆菌进行了根除治疗，刘先生完全康复。

当时,Hometown grassroots hospital doctor advised liu treated by surgical removal of part of the stomach bleeding.Listen to the knife,Liu shocked,Hurry back to guangzhou looking for a large hospital.Guangzhou city first people's hospital of doctor of medical director NieYuJiang is liu sees a doctor,He introduced,Found by gastroscope examination,Mr Liu just duodenal ulcer without other diseases,Can completely through medication can stop the bleeding.then,NieYuJiang again to Mr. Liu gastric helicobacter pylori eradication therapy,Mr Liu is a full recovery.

　　聂玉强指出，像刘先生这样的病人，常常会在基层医院“被手术”。

聂玉强指出,Like Mr. Liu of the patient,常常会In the基层医院"By surgery".

　　“事实上，消化道出血动辄开刀是一个治疗误区。医生要结合病人的年龄、有无合并病、出血时的表现和胃镜检查时出血的情况，将病人进行分级分类、规范治疗。”聂玉强还强调，患者也无需“谈‘血’色变”，因为随着医学的进步和治疗手段的发展，上消化道的非静脉曲张破裂出血，通过药物和内镜保守治疗，成功率很高。

"In fact,,Gastrointestinal bleeding at surgical treatment is a myth.The doctor should combine the patient's age/Whether merger disease/Hemorrhage when performance and gastroscopy,Will be classified by the patient/Standard treatment."NieYuJiang also stressed,Patients also need not"To talk about‘blood’The color change",Because with the progress of medicine and the development of treatments,Hemorrhage of upper gastrointestinal varicosity burst,Endoscopic and conservative treatment with drugs,The success rate is very high.

　　有数据显示，对于此类出血病人，通过注射肾上腺溶液止血治疗，初次止血率已达到96%，农村等医疗条件欠发达的地区，可多采用。而对于活动性血管性出血，在胃镜下通过止血夹止血也很有效。“只有那些药物和内胃镜下止血不成功或者不适合胃镜下治疗的患者，才考虑外科手术。”聂玉强说。

有According to data,For such hemorrhage patients,By injecting hemostatic treatment adrenal solution,First hemostatic rate has reached 96%,Rural medical conditions, such as the less developed regions,Can be used more.For the active vascular hemorrhage,In the胃镜下通过止blood夹止blood也很有效."Only those drugs and internal bleeding under gastroscope is not successful or not suitable for patients under gastroscope,To consider surgery."NieYuJiang said.

　　●老人晕倒也可能是消化道出血

●老人晕倒Also may be of gastrointestinal bleeding

　　“如果在街上发现一个老人突然昏倒，不一定都是中风，也可能是消化道出血。”聂玉强告诉记者，近年来，中风病人合并消化道出血的发生率很高。“人的年龄增大，胃的黏膜会逐渐变薄，各器官功能和抵抗力也会跟着下降。再加上老人多患有高血压、冠心病等基础病，一些需要长期服用的降压药对本来就薄的胃黏膜损伤更大，易导致消化道出血。”

"如果In the街上发现一个老人突然昏倒,不一定都是In the风,Also may be of gastrointestinal bleeding."NieYuJiang told reporters,In recent years,In the风病人合并消化道出blood的发生率很高."Increase a person's age,Tend to thin stomach mucous membrane,Each organ function and resistance will be decreased.Coupled with the old man suffered from high blood pressure/The basic disease such as coronary heart disease,Some need long-term use of antihypertensive agents on the already thin stomach mucosa damage is greater,Can cause gastrointestinal bleeding."

　　聂玉强提醒，万一家中老人突然晕倒，家属千万别乱给病人吃药，一定要在第一时间打120将老人送到医院，确定病因后再进行治疗。

NieYuJiang remind,万一家In theThe old man suddenly fainted,Family members don't to the patient to take medicine in disorder,一定要In the第一时间打120将老人送到医院,Determine the cause before treatment.

　　值得注意的是，一些老人因为腰腿疼痛、心脑血管病等，经常要服用止痛药和抗凝剂，但却忽视了对胃的保护。聂玉强表示，这类药物容易损伤胃黏膜，引起消化性溃疡甚至胃出血。临床研究发现，46%~75%长期使用抗炎药的患者，有出现过胃出血或溃疡的病史。尤其是在美国，每年因此住院的患者更是超过10万人次。

值得注意的是,Because some of the old people waist pain/Cardio-cerebrovascular diseases, etc.,Often have to take painkillers and anticoagulation,But ignored the protection of the stomach.NieYuJiang said,This class of drugs easily damaged gastric mucosa,Cause of peptic ulcer and even stomach bleeding.Clinical studies have found that,46% ~ 75% patients with long-term use of anti-inflammatory drugs,Have a history of stomach bleeding or ulcers.尤其是In the美国,So patients in hospital each year more than 100000 people.

　　聂玉强建议，年纪大、既往有胃痛等病史的老年人，在服用消炎镇痛药（如芬必得等）和抗凝剂（如阿司匹林等）时要咨询医生，尽量选择对胃肠道相对安全的止痛药，如有条件可以先做个无痛胃镜，做到镇痛、保胃两不误。

聂玉强建议,older/A history of stomach pain, etc of the elderly,In the服用消炎镇痛药(Such as he will be)And anticoagulants(Such as aspirin, etc.)When to consult a physician,Try to choose for the relative safety of the gastrointestinal tract analgesic drugs,If there are conditions to be a painless gastroscopy,Do analgesia/Protect the stomach two not mistake.

　　●胃痛“消失”可能更危险

●Stomach pain"disappear"May be more dangerous

　　聂玉强说，如今像刘先生一样，许多年轻人得了胃溃疡不当回事，不治或者乱治，随意停药换药，用药“见好就收”，往往拖延了病情。他提醒说，那些原本有胃病、经常胃痛的人，如果在没有经过任何规范和长期治疗的情况下，胃痛突然间“消失”，这不一定是好事，还有可能“摊上大事”！

NieYuJiang said,Now like Mr. Liu,Many young people have gastric ulcer for granted,Don't treat or cure,Optional withdrawal treatment,Drug use"Too close",Tend to delay the disease.He cautioned,Would otherwise have stomach trouble/Often stomach pain,如果In the没有经过任何规范and长期治疗的情况下,Stomach pain suddenly"disappear",This is not necessarily a good thing,There may be"Stand on the issue"!

　　“我们在临床治疗中发现，很多胃病患者求医吃药后，病情得到缓解，就不再坚持治疗调养了。但实际上，不痛不一定代表痊愈。”对于“不痛”的胃病，尤其要高度警惕，因为这时发生消化道溃疡的地方有可能已经出血或癌变，神经受损，痛觉减弱，“也就是说，消化道溃疡有可能已经演变成消化道出血或胃癌。”因此，经常胃痛的人必须加以重视，溃疡并不是小问题，一旦病情加重或治疗不及，可能导致胃出血、胃穿孔、癌变等严重后果。

"我们In the临床治疗In the发现,After a lot of stomach trouble patient doctor to take medicine,The illness ease,Just no longer insist on treatment and nurse.But in fact,Pain does not necessarily represent to heal."for"With no pain"The stomach trouble,Especially on high alert,When the place may have been bleeding peptic ulcer or cancerous,Nerve damage,Pain abate,"That is to say,Digestive tract ulcer may have evolved into the digestive tract hemorrhage or stomach cancer."so,People often stomach-ache must consider,Ulcers are not small problems,Once the disease progression or treatment,May cause stomach bleeding/Gastric perforation/Cancer such as serious consequences.

　　●提醒：咳血OR呕血要分清

●提醒:Coughing up blood OR hematemesis to distinguish

　　消化道出血是十分危急的情况，医生正确判断病因，是治疗成功的关键。聂玉强提醒，有些病人或家属在陈述病情时，常常混淆“咳血”和“呕血”这两种症状。“分清这两种症状对于帮助医生判断一个因为晕倒而送院的病人，到底是胃病还是心脏病非常重要，所以一定要搞清楚。”

消化道出blood是十分危急的情况,The doctor determine the cause. Correct,Is the key to successful treatment.NieYuJiang remind,有些病人或家属In the陈述病情时,Often confused"Coughing up blood"and"hematemesis"Both of these symptoms."Distinguish between these two kinds of symptoms to help doctors determine a hospital patients because of the faint,Stomach disease or heart disease is very important,So be sure to clear."

　　呕血和咳血有本质不同。消化道出血属于呕血，多是消化性溃疡、胃癌、胆道出血等使然，而咳血的病因多见于肺结核、支气管扩张、心脏病。咳血的色泽通常是鲜红的，还可以伴有较为明显的痰液和泡沫，而呕血则是暗红、棕黑并且通常伴有食物残渣和胃液。

hematemesisandCoughing up blood有本质不同.Gastrointestinal bleeding belongs to hematemesis,How is peptic ulcer/Cancer of the stomach/Biliary tract bleeding and so on,While the causes of hemoptysis in tuberculosis/bronchiectasis/A heart attack.Coughing up blood colour and lustre is usually bright red,Can also be associated with more obvious sputum and bubble,And hematemesis is dark red/Brown, black and is usually associated with food residue and gastric juice.