Double-balloon triple-lumen tube compression

Curing disease: Indication Portal hypertension causes massive bleeding of esophageal and gastric varices. Contraindications There are no absolute contraindications. Surgical procedure 1. Before use, check whether the airbag is leaking, whether the lumen is unobstructed, and mark the passage of three chambers. First test the air injection volume of the airbag (the general gas balloon and esophageal balloon air injection volume are 100 ~ 200ml), and the airbag is required to have sufficient size after the gas injection. 2. When applying, firstly apply the liquid paraffin to the front part of the three-lumen tube, the air bag part and the patient's nasal cavity, and use a syringe to exhaust the residual gas in the air bag and then clamp the catheter. 3, the slope lying position, inserted into the three lumens from the nasal cavity, to the throat, the patient to swallow to pass through the three lumens. When it reaches 65cm and the gastric juice is pumped in the stomach tube, it indicates that the head has reached the stomach. 4, injecting gas into the gastric sac, so that the gastric sac is inflated (the amount of gas injection can be determined according to the maximum amount of gas injection measured beforehand), and the opening is bent back, and then clamped with a clip, and the three-chamber tube is pulled outward, and the resistance is encountered. It means that the stomach sac has reached the bottom of the stomach, and in the case of moderate resistance, the three-lumen tube is fixed to the patient's face with a wide tape. A 250 g heavy sand bag (or an equal weight item) is used to pull the three lumen tube through the pulley device and fixed to the bed frame to prevent the three lumen tube from slipping into the stomach. 5. Inject a gas of about 100 ml into the esophageal sac with a syringe, press the lower third of the esophagus, and then fold the opening back and clamp it with a clip. Finally, all the stomach contents are aspirated with a syringe. 6. The pressure inside the balloon is measured by a sphygmomanometer. The general gastric capsule should be 6, 6 kPa (50 mmHg), and the esophageal sac should be 4 to 5, 3 kPa (30 to 40 mmHg). In order to supplement the gas after the pressure measurement, the air can be refilled with 5ml after the pressure measurement. 7. Connect the stomach tube to the gastrointestinal pressure reducer, and learn from the suction bottle whether the hemostasis is effective. 8. After the bleeding stops for 24 hours, the gas in the esophageal sac can be put away, the traction is relaxed, and the bleeding is continuously observed. 9, after 24h, there is still no bleeding, you can remove the three lumen tube. Oral liquid paraffin 20 ~ 30ml, exhaust the gas in the esophageal sac and gastric sac, slowly extubate. 10. Observe the blood on the wall of the capsule to understand the approximate location of the bleeding.