参附注射液在预扩容治疗围手术期急性失血性休克中的疗效观察

Shenfu injection in the pre-expansion perioperative treatment of acute hemorrhagic shock effect of observation

目的观察围麻醉期参附注射液预扩容治疗在抢救急性失血性休克病人中的应用及效果评价，探讨参附注射液在预扩容治疗应用于急性失血性休克围术期治疗的可行性和临床意义。方法选择急性失血性休克病人50例，随机分成观察组（Ⅰ组，n=25例）和对照组（Ⅱ组，n=25例）。两组病人气管插管后行全身麻醉，Ⅰ组麻醉后即给予参附注射液100ml加入5％葡萄糖注射液500ml和预扩容治疗液（指胶体液中分子量羟乙基淀粉6％贺斯或万汶）静脉滴注；Ⅱ组给予5％葡萄糖氯化钠注射液500ml静脉滴注。其它输血、扩血管等抗休克治疗措施两组相同。监测注药后30、60、120min各时间段的血压、心率、心排血量（CO）及尿量的变化，记录两组的出血量和输液输血量。对比观察两组注药后的动脉血气变化。结果①Ⅰ组静注参附注射液和预扩容治疗液后30、60min，血压回升、心排血量（CO）回升、心率下降明显早于Ⅱ组（P〈0．05）；尿量在1h和2h时与Ⅱ组有极显著差异（P〈0．05或P〈0．01）。②注药后90min Ⅰ组血气分析各项指标明显升高，与Ⅱ组比较有显著性差异（P〈0．05或P〈0．01）。结论围麻醉期参附注射液在预扩容治疗急性失血性休克中，能迅速恢复血流动力学并稳定，改善微循环和组织代谢，在促进休克的复苏，提高围术期的安全性等方面有较好的疗效。

Objective To observe the Senate anesthesia injection in the pre-expansion treatment of acute hemorrhagic shock patients and evaluate the results, explore the Shenfu injection in the pre-expansion used in the treatment of acute hemorrhagic shock perioperative treatment of the feasibility of And clinical significance. Methods Acute hemorrhagic shock patients were randomly divided into 50 cases of the observation group （Ⅰ group, n = 25） and the control group （cn group, n = 25）. Two groups of patients with general anesthesia endotracheal intubation later. Group Ⅰ after the Narcotic give Shenfu injection 100ml in 5% glucose injection 500ml intravenous fluid therapy and pre-expansion （colloidal refers to the liquid molecular.weight hydroxyethyl starch 6% HES or Timor million）; Ⅱ group 5% Glucose and sodium chloride injection 500ml intravenous drip. Other blood transfusion, such as vasodilative anti-shock treatment 2, the same group. Monitoring 30,60,120 min after the injection of all time blood pressure, heart rate, cardiac output （CO） and volume changes in Group cn of the record amount of bleeding and blood transfusion volume. Compare the two groups were observed after injection of changes in arterial blood gases. Results ① Ⅰ results of the Group Participation intravenous injection and preexpansion treatment of liquid after 30, 60 min, blood pressure picked up, cardiac output （CO rebound）, heart rate decreased significantly with the early Ⅱ group （P 〈 0.05）; in the urine 1 h And 2 h with the group Ⅱ a very significant difference （P〈0.05 orP〈 0.01）.② Injection after 90 min cn group of blood gas analysis and indicators increased Ⅱ group were significantly different （P 〈 0.05 or P 〈 0.01）. Conclusion Conclusions of the Senate anesthesia injection in the pre-expansion in the treatment of acute hemorrhagic shock, and rapid restoration of hemodynamic stability, improve microcirculation and metabolism of the organization to promote the recovery of shock, Perioperative to increase security in areas such as better Effect.