参附注射液在急诊多发伤伴发休克治疗中的应用效果及对相关血液指标的影响

Application Effect of Shenfu Injection in the Treatment of Emergency Multiple Injury with Shock and Its Influence on Blood Indexes

目的:探讨参附注射液(Shenfu Injection,SFI)在急诊多发伤伴发休克治疗中的应用效果及对相关血液指标影响。方法:回顾性分析2020年1月-2021年12月于佳木斯市中心医院急诊就诊的90例多发伤伴发休克患者的临床资料。按照治疗方法将其分为对照组与研究组,每组45例。对照组实施急诊多发伤伴发休克的常规治疗,研究组在对照组基础上联合SFI治疗。对比两组临床治疗相关指标、治疗前后的生命体征指标、凝血功能指标、炎症因子水平及不良反应发生率等。结果:研究组ICU治疗时间、休克缓解时间、体温恢复时间均短于对照组(P<0.05)。治疗第12小时,两组生命体征指标较治疗前均改善,且研究组中心静脉血氧饱和度均高于对照组(P<0.05),但两组平均动脉压、心率比较,差异均无统计学意义(P>0.05);治疗第24小时,两组生命体征指标较治疗前与治疗第12小时均改善,且研究组均优于对照组(P<0.05)。治疗第1、3天,两组凝血功能指标较治疗前均改善(P<0.05);治疗第3天,两组凝血功能指标较治疗第1天均改善(P<0.05);且研究组治疗第1、3天PT、APTT、FIB、D-D水平均优于对照组(P<0.05)。治疗第1天,两组IL-6、IL-10、TNF-α水平均低于治疗前(P>0.05);治疗第3天,两组炎症因子水平均低于治疗前、治疗第1天,且研究组均低于对照组,差异均有统计学意义(P<0.05)。研究组(DIC)、成人呼吸窘迫综合征(ARDS)、多器官功能障碍综合征(MODS)、急性肾功能衰竭(ARF)发生率均低于对照组(P<0.05)。结论:通过对急诊多发伤伴发休克患者在常规治疗基础上联合SFI治疗,可取得较为满意的治疗效果,有效改善了生命体征、凝血及炎症因子等相关指标水平,促进了患者的复苏,且有效降低了不良反应发生率,值得临床应用与推广。

Objective:To analyze the clinical effect of Shenfu Injection(SFI)in the treatment of emergency multiple injury with shock and its influence on blood indexes.Method:The clinical data of 90 patients with emergency multiple injury with shock treated in the Emergency Department of Jiamusi Central Hospital from January 2020 to December 2021 were analyzed retrospectively.According to the different treatment methods,patients were divided into the control group and the study group,45 cases in each group.The control group was given conventional treatment of emergency multiple injury with shock,while the study group was given SFI treatment on the basis of the control group.The clinical treating-related indicators,vital signs,coagulation function indicators,levels of inflammatory factors before and after treatment and incidence of adverse reactions of two groups were compared.Resut:The ICU treatment time,shock relief time and body temperature recovery time in the study group were shorter than those in the control group(P<0.05).At the 12th h of treatment,the vital signs of two groups were improved compared with those before treatment,and the central venous oxygen saturation in the study group was significantly higher than that in the control group(P<0.05),but there were no statistical significances in the mean arterial pressure and heart rate between two groups(P>0.05).At the 24th h of treatment,the vital signs of two groups were improved compared with those before treatment and the 12th h of treatment,and the study group were better than those in the control group(P<0.05).On the first and third days of treatment,the indexes of coagulation function in two groups were improved compared with those before treatment(P<0.05);on the third day of treatment,the indexes of coagulation function in two groups were improved compared with those on the first day of treatment(P<0.05);the levels of PT,APTT,FIB and D-D in the study group were better than those in the control group(P<0.05).On the first and third days of treatment,The levels of IL-6,IL-10 and TNF-αin two groups were lower than those before treatment(P>0.05);on the third day of treatment,the levels of inflammatory factors in two groups were lower than those before treatment and on the first day of treatment,and the study group were lower than those of the control group,the differences were statistically significant(P<0.05).The incidences of DIC,ARDS,MODS,ARF in the study group were lower than those in the control group(P<0.05).Conclusion:In emergency department patients with multiple trauma with a shock on the basis of conventional treatment combined SFI treatment,can achieve more satisfactory treatment effect,effectively improve the patient’s vital signs,blood coagulation and inflammation factors related indexes such as level,promote the patient’s recovery,and effectively reduce the incidence of adverse reactions related to the patients and worth clinical application and promotion.