双管双输法在急性上消化道出血患者血容量补充中的应用效果观察

Application effect of double-tube and double-transfusion on blood volume supplement for acute upper gastrointestinal hemorrhage

目的:探讨双管双输法在急性上消化道出血(AUGB)患者血容量补充中的应用效果。方法:将110例AUGB患者按照随机数字表法分为2组,每组55例;2组均给予常规紧急救治,研究组建立2条静脉输血通道,即应用双管双输法补充血容量,对照组常规应用条静脉输血通道补充血容量。比较2组输血1、2、4 h时心率、收缩压、中心静脉压、血氧饱和度(SpO2)、动脉血氧分压(PaO2)和动脉血二氧化碳分压(PaCO2);比较2组输血前后凝血酶原时间(PT)和活化部分凝血酶原时间(APTT)并比较2组止血率。结果:输血后2组心率逐渐降低(P<0.05),收缩压、平均动脉压逐渐升高(P<0.05),输血后各时间点研究组心率均低于对照组(P<0.05),收缩压、平均动脉压均高于对照组(P<0.05);输血后各时间点2组SpO2、PaO2逐渐升高(P<0.05),PaCO2逐渐降低(P<0.05),研究组各时间点SpO2、PaO2均高于对照组,PaCO2低于对照组(P<0.05);输血后2组PT、APTT均延长,组间比较差异无统计学意义(P>0.05);输血24 h研究组止血率高于对照组(P<0.05),48 h、72 h2组止血率差异无统计学意义(P>0.05)。结论:双管双输法补血可快速补充血容量,改善血气指标,稳定生命体征,早期提高止血率,且不会加重对凝血功能指标的影响,治疗AUGB效果显著。

Objective:To investigate the effect of double-tube and double-transfusion on blood volume supplement in patients with acute upper gastrointestinal bleeding(AUGB).Method:110 patients with AUGB were divided into two groups according to the digital random table method,with 55 cases in each group.Both groups were given routine emergency treatment.Two venous transfusion channels were established in the study group,that is,double-tube double-transfusion method was used to supplement blood volume,while the control group were routinely used strip-vein transfusion channel to supplement blood volume.Heart rate,systolic blood pressure,central venous pressure,SpO2,PaO2 and PaCO2 in 1 h,2 h and 4 h of blood transfusion were compared between the two groups.The prothrombin time(PT)and activated partial thrombin time(APTT)before and after blood transfusion were compared and hemostasis rate was compared between the two groups.Result:Heart rate of the two groups decreased gradually after transfusion(P<0.05),systolic blood pressure and mean arterial pressure increased gradually(P<0.05),heart rate of the study group was lower than that of the control group at different time points(P<0.05),systolic blood pressure and mean arterial pressure were higher than those of the control group(P<0.05);SpO2 and PaO2 increased gradually(P<0.05)and PaCO2 decreased gradually(P<0.05)of the two groups at different time points after transfusion.SpO2 and PaO2 of the group A were higher than those of the control group at different time points,while PaCO2 was lower than that of the control group(P<0.05);PT and APTT were prolonged in both groups after transfusion,and there was no significant difference between groups(P>0.05);The hemostatic rate of the study group was higher than that of the control group in 24 hours after transfusion(P<0.05),and there was no significant difference in hemostatic rate between two groups in 48 hours and 72 hours(P>0.05).Conclusion:Double-tube and double-transfusion can rapidly supplement blood volume,improve blood gas index,stabilize vital signs,improve hemostasis rate in the early stage,and it will not aggravate the impact on coagulation function index.So it has remarkable effect on AUGB.