双管双输用于急性上消化道大出血治疗对患者血流动力学、血气指标的影响

The effect of double tube and double transfusion on hemodynamics and blood gas in patients with acute upper gastrointestinal hemorrhage

目的探讨双管双输在急性上消化道大出血患者救治中的临床应用效果。方法选取宝山区罗店医院2015年3月~2017年3月收治的120例急性上消化道大出血患者,采用随机数表法分为试验组(采用双管双输法补充血容量)和对照组(采取常规方法补充血容量)各60例,对比两组患者治疗前后不同时间的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_2)、动脉血氧分压(PaO_2)、动脉血二氧化碳分压(Pa CO_2)、p H值及两组患者的治愈率、死亡率。结果试验组输血量为(685.2±85.0)ml/h、对照组输血量为(456.8±64.0)ml/h,试验组单位时间输血量高于对照组,差异有统计学意义(t=9.064、P<0.01)。治疗前,两组患者的HR、MAP、SBP值差异无统计学意义(P>0.05);治疗1、2和4 h后,试验组的HR低于对照组,MAP、SBP值高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的SpO_2、PaO_2、Pa CO_2、p H值差异均无统计学意义(P>0.05);治疗1、2和4 h后,试验组和对照组Pa CO_2值差异无统计学意义(P>0.05),SpO_2、PaO_2、p H值均高于对照组,差异有统计学意义(P<0.05)。试验组的治愈率95.00%与对照组的90.00%比较,差异无统计学意义(P>0.05);两组输血不良反应发生率差异无统计学意义(P>0.05)。结论双管双输在急性上消化道大出血患者救治中能较快纠正患者的循环功能障碍、改善其血气水平,但是对于患者临床死亡率的降低在本研究中尚不明显。

Objective This study explored the clinical effect of double tube and double transfusion in the treatment of patients with acute upper gastrointestinal bleeding. Methods 120 patients with acute upper gastrointestinal bleeding admitted to our hospital from 2015.3 to 2017.3 were selected. Patients were randomly divided into two groups ：the experimental group（the double tube double transfusion method was added to the blood volume） and the control group（routine blood volume supplement） in 60 cases. The HR,MAP,SpO2,PaO2,Pa CO2,and p H values were compared between the two groups before and after treatment. The cure rate and mortality of the two groups were compared. Results The volume of blood transfusion in the experimental group was 685.2 ＋ 85 ml/h,the blood transfusion amount in the control group was 456.8 ＋ 64 ml/h,and the volume of blood transfusion at unit time in the test group was higher than that of the control group（P 〈0.05）. Before treatment,the difference in HR,MAP,SBP values between the two groups was not statistically significant（P 〉0.05）;after 1 hour of treatment, 2 hours of treatment, and 4 hours of treatment, the HR of the experimental group was lower than that of the control group（P〈 0.05）, and the MAP, SBP value was high. In the control group（P 〈0.05）;Before treatment,there was no statistically significant difference in SpO2,PaO2,Pa CO2,p H values between the two groups（P〉 0.05）. After 1 hour of treatment, 2 hours of treatment, and 4 hours of treatment, the Pa CO2 values of the experimental group and the control group were not statistically different（P 〉0.05）. SpO2, PaO2, p H value were higher than the control group（P 〈0.05）;The cure rate of the experimental group was 95.00% compared with 90.00% of the control group, and the difference was not statistically significant（P 〉0.05）. There was no significant difference in the incidence of adverse reactions in blood transfusion between the two groups（P 〉0.05）. Conclusion In the treatment of acute upper gastrointestinal bleeding, double tube and double transfusion can quickly correct the circulatory dysfunction and improve the blood gas level of the patients, but the decrease of clinical mortality is not obvious in this study.