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急性上消化道大出血是老人急症之一。３年来我院收治４５例，年龄６０～９１岁，平均年龄７０３岁。３７例经纤维胃镜检查：消化性溃疡２４例；急性胃粘膜病变、糜烂性胃炎１０例；胃癌２例；肝硬化并食道静脉破裂１例。大部分病人由于出血量多，入院时多处于休克状态，病情危重，需及时抢救。在综合疗效法基础上，联合应用奥美拉唑及胃腔降温，疗效满意，成功率达９５６％，２４ｈ内大部分患者止血。其作用机理：奥美拉唑是质子泵抑制剂，抑制Ｈ＋Ｋ＋－ＡＴＰ酶活性，对胃酸分泌有强而持久的抑制作用，使血小板能很好地凝集形成凝血块，减少Ｈ＋回渗致胃粘膜产生糜烂和溃疡，有利于止血。胃腔降温也可抑制胃酶分泌，抑制胃蛋白酶活性及血块溶解；冰冻盐水加入去甲肾上腺素、凝血酶等局部应用，可起到协同止血作用
Acute upper gastrointestinal bleeding is one of the elderly emergency. 3 years 45 cases admitted to our hospital, aged 60 to 91 years old, with an average age of 70 3 years. 37 cases of gastroscopy: peptic ulcer in 24 cases; acute gastric mucosal lesions, erosive gastritis in 10 cases; gastric cancer in 2 cases; liver cirrhosis and esophageal vein rupture in 1 case. Due to the large amount of bleeding in most patients, most of them are in a state of shock when they are admitted to hospital. The patients are in critical condition and need prompt rescue. On the basis of comprehensive curative effect, the combined application of omeprazole and gastric cavity cooling, with satisfactory results, the success rate was 95 6%, most patients within 24h to stop bleeding. Its mechanism of action: omeprazole is a proton pump inhibitor, inhibition of H + K + -ATP enzyme activity on gastric acid secretion has a strong and lasting inhibitory effect, so that platelets can agglutinate to form clot, reducing H + Gastric mucosa erosion and ulcers, is conducive to stop bleeding. Gastric cavity cooling can also inhibit the secretion of gastric enzymes, inhibition of pepsin activity and clot lysis; freezing saline to join norepinephrine, thrombin and other topical applications, can play a synergistic hemostatic effect