限制性液体复苏联合甘草人参汤治疗上消化道出血合并失血性休克的临床疗效分析

Clinical effect of restrictive fluid resuscitation combined with Radix glycyrrhizae ginseng decoction in the treatment of upper gastrointestinal hemorrhage with hemorrhagic shock

目的分析对上消化道出血合并失血性休克患者给予限制性液体复苏联合甘草人参汤治疗的临床疗效。方法对本院2016年11月至2017年11月收治的120例上消化道出血合并失血性休克患者进行观察,采用随机数字表法分为研究组、对照组各60例。对照组给予常规液体复苏治疗,研究组给予限制性液体复苏联合甘草人参汤治疗。治疗3 d,记录两组患者总有效率、住院时间、输液量、凝血酶原时间、血压、不良反应及实验室各项指标。结果研究组住院时间、输液量、凝血酶原时间均低于对照组,差异有统计学意义(P<0.05)。研究组总有效率明显优于对照组,且不良反应发生率明显更低,差异有统计学意义(P<0.05);研究组患者的平均血乳酸、BE值均低于对照组,且血红蛋白、血小板计数明显更高,差异有统计学意义(P<0.05)。结论对上消化道出血合并失血性休克患者给予限制性液体复苏治疗可以平稳降压,维持机体代偿平衡,减少输液量。联合甘草人参汤治疗可以缩短患者的凝血酶原时间、住院时间,止血效果突出,减少不良反应,疗效安全可靠,值得推广应用。

Objective To analyze the clinical effect of restrictive fluid resuscitation combined with Radix Glycyrrhizae Ginseng decoction in the treatment of upper gastrointestinal hemorrhage with hemorrhagic shock. Methods 120 patients with upper gastrointestinal bleeding complicated with hemorrhagic shock who were treated in our hospital from Nov 2016 to Nov 2017 were observed, Random digital table method divided into the study group (n=60) and the control group (n=60). The control group was treated with conventional fluid resuscitation, the study group was treated with restricted fluid resuscitation combined with liquorice ginseng decoction. 3 days after treatment, the total effective rate, hospital stay time, infusion volume, prothrombin time, blood pressure, dverse reactions and laboratory indicators were recorded of the two groups. Results The hospitalization time, infusion volume and prothrombin time in the study group were significantly lower than the control group, the difference is statistically significant (P<0.05). The total effective rate of the study group was significantly better than the control group, and the incidence of adverse reactions was significantly lower (P<0.05). The mean blood lactate and BE in the study group were lower than the control group, and the hemoglobin and platelet count were significantly higher,the difference is statistically significant (P<0.05). Conclusion The treatment of restrictive fluid resuscitation for patients with upper gastrointestinal bleeding and hemorrhagic shock can reduce blood pressure smoothly, maintain compensatory balance and decrease infusion. Combined treatment with radix glycyrrhizae ginseng decoction can shorten the prothrombin time and hospitalization time of the patients, prominent hemostatic effect, reduce adverse reactions, the effect is safe and reliable, it’s worthy of popularization and application.