限制性液体复苏和控制升压治疗上消化道出血护理观察

Nursing Observation of Upper Gastrointestinal Bleeding with the Treatment of Restricted Fluid Resuscitation and Controlling Pressurization

目的观察限制性液体复苏和控制升压治疗肝硬化门脉高压食管胃底静脉曲张破裂出血的临床疗效。方法将76例患者分为两组。观察组38例采用限制性液体复苏和控制患者平均动脉压（MAP）维持在40-50 mm Hg（1mm Hg=0.133 kPa）,同时进行其它常规止血治疗和综合性护理监护。对照组38例采用相对无限制性液体复苏方法治疗,并控制患者平均动脉压维持在70-80 mm Hg,余治疗方法和综合性护理监护同观察组。分别观察两组患者24 h内、24-48 h、48-72 h止血效果和总有效率。结果观察组患者24 h内、24-48 h、48-72 h止血效果和总有效率明显高于对照组。结论限制性液体复苏和控制性升压治疗肝硬化门脉高压症出血的止血率高,其作用明显优于相对无限制性液体复苏对其治疗。

Objective Observe clinical curative effect of restricted fluid resuscitation and controlling blood pressure＇ boosting to treat liver cirrhosis portal hypertension stomach EVB bleeding.Methods 76 cases were randomly divided into two groups.Restricted fluid resuscitation was applied to the treatment group of 38 patients and the patients＇ mean arterial pressure（MAP） was maintained in 40-50 mm Hg,moreover,other routine hemostatic treatment and comprehensive nursing care was also processed simultaneously.Unrestricted relatively fluid resuscitation was applied to the counterpart group of 38 patients,the patients＇ mean arterial pressure（MAP） was maintained in 70-80 mm Hg,meanwhile,the rest of treatment and comprehensive nursing care was as same as the treatment group.Bleeding stopped situation and the total effective rate of two groups of patients in the period of 0-24 h,24-48 h and 48-72 h respectively were observed.Results Bleeding stopped situation and the total effective rate within 0-24 h,24-48 h and 48-72 h of the treatment group were obviously higher than those of the control group.Conclusion The emostatic rate of applying restricted fluid resuscitation to treat liver cirrhosis portal hypertension bleeding was high,the curative effect was obviously better than that of unrestricted relatively fluid resuscitation.